What this area covers
Interns and residents in Australian hospitals manage ward calls, fluids, prescribing and deteriorating patients, often overnight. This page is for interns, residents and IMGs starting their first Australian hospital job, and focuses on safe, practical decisions.
High-yield topics
| Topic | What to know |
|---|---|
| ISBAR | Structured handover |
| Consent | Material risks, capacity |
| Documentation | Timely, legible, dated |
| Death and certificates | When to refer to the coroner |
| Mandatory reporting | Children and colleagues |
Worked example
Worked question · Handover
What does the R in ISBAR stand for?
- A Recommendation
- B Review of systems
- C Risk score
- D Results
- E Referral letter
Show the reasoning
Answer A. ISBAR: Identify, Situation, Background, Assessment, Recommendation.
A short study plan
| Week | Focus |
|---|---|
| 1 | Core principles |
| 2 | Common ward calls |
| 3 | Timed questions and review |
Do a short timed set most days and review every explanation, including the options you ruled out.
Common traps
- Acting without checking local protocols.
- Delaying escalation.
- Poor documentation.
Free sample handover and documentation questions
Questions from our Junior Doctor bank. Choose your answer, then open the explanation.
On a night shift, you notice a registrar slurring words and smelling strongly of alcohol while reviewing patients. What is your obligation?
- AConfront the registrar in front of patients and nurses on the ward
- BAct to protect patients now and notify
- CWait to see whether it happens again next month
- DSay nothing because you are more junior than the registrar
- EPost about it in a private group chat with other interns
Show answer and explanation
Answer B. Practising while intoxicated with alcohol or drugs is notifiable conduct under the Health Practitioner Regulation National Law. The immediate priority is patient safety: involve the consultant or a senior manager so the registrar stops working. A mandatory notification to Ahpra is then required when you have a reasonable belief. What to do next: Escalate tonight to the on-call consultant or after-hours manager, document facts objectively, and seek advice from your medical defence organisation or supervisor about the notification.
Learning point: Practising while intoxicated is notifiable: protect patients now, escalate, then notify Ahpra.
A confused patient is pulling at his IV line. A nurse suggests tying his wrists to the bed. What is the correct approach?
- AAsk his roommate to watch him all night
- BRemove all lines and stop his treatment
- CAlternatives first; restraint as last resort
- DSedate him heavily so he stays still overnight
- ETie his wrists immediately as suggested
Show answer and explanation
Answer C. Physical restraint carries risks (injury, distress, delirium, death) and is a last resort. Use alternatives first: treat the cause of delirium, review the need for the line, secure or hide lines, increase observation, involve family. If restraint is unavoidable, follow the hospital policy on authorisation, monitoring and review, and document. What to do next: Review whether the IV line is still needed, screen for delirium causes, and document the decision-making clearly.
Learning point: Restraint is a last resort: treat delirium, use alternatives, follow policy and document.
Before taking blood for a crossmatch, what is the minimum identification check at the bedside?
- ARoom number and bed number on the board
- BThe diagnosis written on the bedside whiteboard
- CThree identifiers, checked with the patient
- DThe nurse's verbal confirmation at the bed
- EThe patient's first name, asked out loud
Show answer and explanation
Answer C. Australian standards require at least three approved patient identifiers (such as full name, date of birth and medical record number), checked with the patient where possible against the identification band and request. Label crossmatch samples at the bedside. What to do next: Label samples at the bedside before leaving the patient, and never pre-label tubes.
Learning point: Blood samples: three identifiers checked with the patient, labelled at the bedside.
Practise more handover and documentation questions free
Every handover and documentation subtopic in our bank
The bank holds 50 handover and documentation questions across 50 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Advance care planning1
- Arterial blood gas1
- Aseptic non-touch technique1
- Blood cultures1
- Cannula care1
- Cannulation1
- Capacity1
- Child protection concern1
- Clinical handover1
- Clinical photography1
- Closed-loop communication1
- Confidentiality on the phone1
- Consent and capacity1
- Crossmatch sample labelling1
- Death certificate1
- Difficult male catheterisation1
- Discharge medicines1
- Discharge summary1
- Documentation1
- Documentation errors1
- Fatigue and unsafe hours1
- Graded assertiveness1
- Hand hygiene1
- Imaging in pregnancy1
- Incident reporting1
- Infection control1
- Informed consent1
- Interpreters1
- ISBAR handover1
- Leaving against medical advice1
- Lumbar puncture1
- Lumbar puncture safety1
- Mandatory notification1
- Material risk1
- Medical certificate1
- Needle-stick injury1
- NG tube1
- Open disclosure1
- Opioids on discharge1
- Patient identification1
- Prescribing errors1
- Referral to the coroner1
- Requesting help overnight1
- Restrictive practices1
- Sharps1
- Social media1
- Telephone orders1
- Transfusion reaction1
- Urinary catheter1
- Venepuncture1
Common questions
Is this relevant to IMGs?
Yes. Australian hospital systems, protocols and escalation pathways may differ from your previous experience.
Should I follow local protocols?
Always. This page explains principles; local policies apply.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.