A colleague’s unsafe workload

Step 1 · Read the instruction

WHAT TO DO

Check the format and the direction of the scale before anything else.

• 1InstructionRank these independent actions
  Judge each action on its own. This matters here because two options (A and B) both look like reasonable first moves, and it’s tempting to imagine doing one and then the other. Don’t: rank how appropriate each is on its own.
• 2Instruction1, most appropriate, to 4, least appropriate
  1 is best. Every rank is used once.

Step 2 · Work out your role and who is affected

WHAT TO DO

Identify who could be harmed, including people who aren’t in the conversation.

• 3ScenarioA colleague says
  The person speaking to you is your colleague, but they aren’t the person most at risk. The patients waiting for reviews are, and they aren’t in the room. Keep them in mind as you read the options.
• 4ScenarioYou cannot safely absorb the extra work yourself.
  The question has deliberately removed the heroic option. Taking all the work on yourself isn’t available, so the answer must involve someone else.

Step 3 · Separate facts from assumptions, and find the risk

WHAT TO DO

Check how the question frames each fact. Has something been confirmed, or only reported? How soon could harm happen?

• 5Scenariorequired patient reviews
  “Required” tells you these reviews can’t simply be dropped. If they aren’t done, patients miss care they need.
• 6ScenarioYou have confirmed that there is no effective cover arranged.
  This has been confirmed, so options that “find out more” would add little. The gap is real.
• 7ScenarioThe responsible registrar is available to help allocate cover
  This tells you who can fix the problem. The registrar is responsible, available, and the person whose job includes allocating cover.
• 8Scenariono patient currently needs resuscitation
  This sets the timescale. It isn’t an emergency that needs a crash call, but the reviews are due this shift. Action is needed now, not tomorrow.

Don’t assume that your colleague is slow or disorganised, or that they’re unwell. Nothing in the scenario suggests it.

Step 4 · Name the tension and write your task

WHAT TO DO

Name the duties that pull against each other, then write a one-sentence task.

You need to support a struggling colleague, make sure patients get required care and stay within your own safe limits. Reassurance alone won’t fill a gap in care, and you can’t fill it yourself.

Your task: I need to get a safe plan for the outstanding reviews this shift, from someone who can organise cover, without taking on more than I can safely do.

Step 5 · Read each option literally

WHAT TO DO

Break each option into verb + recipient + timing + condition. Ask what it would actually achieve.

• 9Option AContact the responsible registrar now
  Verb: contact, so you act yourself. Recipient: the person who can allocate cover. Timing: now. A also says exactly what to pass on, “which reviews remain”, and what to ask for: “a safe plan”.
• 10Option Bwhether they can help
  B asks the right kind of person, but the condition matters. “Whether they can” means help isn’t secured, and one doctor’s spare time can’t solve a ward-wide cover problem.
• 11Option Cencourage them to keep going as best they can
  C is kind in tone, but read what it asks: that your colleague carries on doing what they’ve just told you they can’t do safely. Nothing changes for the patients.
• 12Option Dleave the remaining reviews until the morning
  D actively recommends delaying required care, and nobody responsible is told. It sounds pragmatic, but it turns the gap into a plan.

Step 6 · Sort into good, acceptable and poor

WHAT TO DO

Group first, then compare within the groups. An option can be useful without solving everything.

Step 7 · Compare neighbours and settle the order

WHAT TO DO

Use a fact from the scenario to explain each comparison.

A versus B. A ranks above B because no effective cover is arranged and the registrar is available to allocate it. A goes straight to the person whose role is to solve that. B depends on one colleague happening to have time.

B versus C. B ranks above C because B at least tries to get the reviews done. C supports your colleague’s feelings but leaves the patients exactly where they were. Don’t mark B down for failing to solve everything: a focused, useful action can still rank well.

C versus D. Both leave the gap, so compare the harm. D is worse because it actively endorses delaying required care. C fails to help; D makes the problem part of the plan.

The chronology trap. You might think, “I’d ask a colleague first, then call the registrar if they couldn’t help”, and so put B first. That ranks the order you’d act in, not how appropriate each action is.

What could change the answer

WHAT TO DO

Ask which fact would make your preferred action inappropriate.

• If a competent colleague had already accepted and safely covered the work, the gap that makes A strongest would be gone.
• If a patient on the list were deteriorating now, the priority would change to getting urgent clinical help for that patient. That would be because a fact had changed, not because your attitude to the colleague had.

The exam-speed version

1. Ranking, 1 is best; judge each action alone.
2. Confirmed gap in required care, and I can’t fill it. The registrar is available to allocate cover.
3. Task: get a safe plan from someone who can organise it.
4. A goes to that person now, so first. B is useful but uncertain. C changes nothing; D endorses delay, so D last.

Take this into your next question

Lesson: escalation has a purpose. Choose the person who can fix the specific problem (here, allocating cover), rather than whoever sounds most senior.

When it applies: workload, cover and handover problems. See match escalation to the need and a colleague who is struggling.