Heather Saxena A DOCTOR who walked off

2023 . The doctor , who had nine years ’ experience as a locum ,

Having signed a contract for four days of on-call cover , the

showed no abnormalities . “ This patient was also being

breathlessness , and should see a GP for a mental health

a locum job after 45 minutes

appealed to the SA Civil and

locum said she decided to stay

treated with a very high dose of

plan and psychiatry referral .

because she believed the hos-

Administrative Tribunal .

because an experienced nurse

benzodiazepines ( temazepam

She spoke to the ward

pital was unsafe has failed to

In a written statement , she

could answer her questions

30mg tds ) — apparently for her

nurse , who could not explain

overturn her sanction at a tri-

said she had wanted a junior

about the hospital systems .

history of anxiety disorder ,” the

why the patient had been pre-

bunal hearing .

doctor to support her and had

But after assessing one

locum said in a written state-

scribed antibiotics .

The Medical Board of Aus-

received her locum agency ’ s

patient , she decided the hos-

ment to the tribunal .

“ It was then that I formed

tralia ordered the general phy-

assurance that the hospital

pital was unsafe .

“ I have never seen a dose

the view that my position as an

sician to undergo six hours of

had acquiesced .

The patient had been admit-

this high prescribed to any

on-call physician in this hospi-

mentoring and to prepare a

But when she arrived at

ted for antibiotics to treat pneu-

patient in my entire career .”

tal was so problematic as to be

reflective report in response to

Port Pirie Hospital , 200km

monia , but the locum believed

She said she had told

pointless for the patients and

a complaint that she had aban-

north of Adelaide , there was

they had been misdiagnosed

the patient they likely had

would put me in an impossible

doned her patients in February

no junior doctor .

because an X-ray and CT scan

a panic attack , causing

position ,” the locum said .

“ I could not , over a weekend

and without junior support ,

completely reassess and reverse

the treatment plans for patients .

“ Equally , it would be

unsafe for me to continue

their current and planned

treatment if I could not understand

the justification for it .”

The tribunal heard that the

doctor had told a nurse , “ This

place should not be a hospital ,”

then caught a flight to Victoria .

The doctor said she

informed the out-of-hours

nurse manager that she was

leaving and the reasons why .

She told the tribunal that

she did not know who else to

contact and assumed informing

the nurse manager would

be sufficient .

Medical board lawyers

argued that the doctor had

compromised patient care and

disrespected the two ED doctors

by not telling them she was

leaving .

The tribunal agreed : “[ The ]

doctor should have notified the

ED doctors that she was leaving

, and why she was leaving , so

that they would be aware that

they would need to provide care

for the ward patients .

“ In particular , she ought to

have provided a handover to

the ED doctors in respect of [ the

patient ], whose treatment plan

[ she ] had significantly changed .”

It added : “ Her conversation

with [ the nurse manager

], whatever its contents , did not absolve her of the

professional responsibility to

conduct a handover .”

Additionally , the tribunal

took exception to the

fact that the doctor had also

failed to inform a hospital

executive .

“[ If the doctor ] had spoken

to a hospital executive

or her ED colleagues , it may

have been possible to arrive

at a solution to the problems

perceived by [ her ] and that it

would have been more appropriate

that she attempt that

rather than leave Port Pirie to

fly home to Victoria .

“ Her departure from the

hospital resulted in a one-third

reduction of available medical

officers remaining to cover

both the ED and the wards .

The locum ’ s continued

denials that her conduct was

unsatisfactory “ reinforced

the need in the public interest

for her to engage in professional

mentoring ”.