Support a burned-out colleague and hold a safety frame — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are a psychiatry registrar speaking with a junior doctor colleague who has asked to talk after handover. [3]

Candidate instructions. Your colleague is exhausted, cynical, made a near-miss error, and has passive suicidal thoughts after a complaint. Respond with warmth and professionalism, normalise help-seeking without minimising risk, assess suicide risk sensitively, discuss fitness for remaining duties, offer concrete support pathways (GP, doctor health service/PHP, supervisor), and name organisational factors without dumping all responsibility on the individual. Do not shame, lecture, or invent legal section numbers. [2][3]

Candidate scenario

Your colleague is 28, six months into a busy psychiatry rotation. They say: "I am completely empty. I do not care about the patients the way I used to. I nearly prescribed the wrong dose last night. Now there is a complaint letter and I keep thinking everyone would be better off if I was not here. Please do not tell anyone — I cannot have this on my record." They appear tearful, sleep-deprived, and frightened. [1][3]

Marking domains

• Empathic opening; non-shaming stance; stigma addressed
• Names burnout features (exhaustion, cynicism/detachment, reduced accomplishment) without stopping there
• Direct but sensitive suicide enquiry (ideation, plan, intent, means, protective factors)
• Fitness for duty discussed honestly; safety of patients prioritised
• Concrete plan: rest, leave if needed, GP/doctor-health pathway, supervisor involvement for roster/safety
• Explains limits of confidentiality if risk to self/patients requires escalation (principles)
• Offers hope and organisational as well as individual solutions
• Avoids collusion with total secrecy when safety is at stake [1][2][3][4]