Professional Practice, Documentation, and Ethics
Documentation
Record what was done, by whom, when, and with what result: device type and size, site, number of attempts, ultrasound findings, patient tolerance, complications, and patient education. Documentation should be contemporaneous, objective, and sufficient for another clinician to continue care. Late or reconstructed documentation is a risk; note addenda rather than altering prior entries.
Professional and ethical duties
Scope of practice, competence, and escalation are professional obligations. Informed consent requires capacity, disclosure of risks and alternatives, and voluntariness. Confidentiality, privacy, and honest disclosure of errors are ethical requirements. When an error occurs, the priority is patient safety, then honest reporting through the appropriate channel.
Traps
Questions test whether you document findings versus interpretations, and whether you report an error versus conceal it. Another trap is assuming consent is a signature rather than a process, or that a colleague's scope covers your action. Be alert to scenarios where the correct answer is to stop and escalate rather than to proceed independently.
Rule of thumb
Document facts you observed and actions you took; escalate anything outside your scope rather than improvising.
Worked example
A clinician recognizes a catheter malposition after the procedure and is unsure whether to document it. The correct action is to document the finding objectively, notify the responsible clinician, and ensure the device is not used until resolved - disclosure and patient safety take priority over appearance.