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AIBU?

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Original poster

Nhs students and lack of consent.

809 replies

MarbleQueen · 21/01/2022 21:26

I’m wondering if something has changed within the Nhs. At one time you were asked if you minded having a student being present.In my area they are present at every appointment without any discussion and I’m getting fed up with it.

In the last two years these things have happened.

A student midwife was brought into my room and participated in my delivery without any discussion. She was instructed to break my waters and deliver my baby without any discussion with myself. The midwife focused on talking her through things instead of supporting me. I was alone because of covid restrictions. I later discovered it was the first baby she delivered. I felt like a piece of meat.

I went for a smear and when I walked in the room there was a nurse and 3 very young women present. When I asked who they were I was told they were trainee health care assistants. I objected and the nurse insinuated I was being a bit silly and shy. I left that appointment without it being done.

I had a dentist appointment for my first ever dental treatment. I told them I was nervous. Again when I went in, I was told, not asked that the 2 people present were dental students and would only be observing. The dentist focused on explaining things to them and actually allowed one to place the filling. I didn’t agree to this.

I went to a gp apointment for something intimate to find a man around 18 years old sat in the room. Again I had to ask who he was and was told he was a student. I had to ask for him to leave and it was really uncomfortable.

I had an apointment to have a very unpleasant procedure. There was the usual student perched in the corner without any discussion. Again I had to ask who they were and was told, not asked, that they would be observing. The doctor focused on explaining things to them and when the procedure was finished I actually realised 3 more students had been brought in to watch without me noticing.

I have previously had a type of abdominal cancer. I have checks with scans and have seen the same consultant for years. On my last visit there was the usual student perched in the corner without any discussion. On this occasion, and this occasion only, the surgeon suggested doing a VE. I asked him what information he was hoping to get from this considering he had a recent MRI scan in front of him and he simply dropped it. I strongly suspect this was going to be for the students benefit because it certainly wasn’t going to benefit me.

Each of these places have standard notices in their waiting rooms informing you that a student might be present but this is not consent. I think this is now something you have to actively opt out of instead of opting in.

Has anyone else noticed this happening? I worry about what these students are learning about consent in these circumstances.

OP posts:
RegardingMary · 22/01/2022 19:18

I'm a nurse, so I understand the importance of students having hands on experience or even just sitting in.

My local dentist, GPs and hospitals do have signs warning of students being present and aay to let staff know in advance if you don't want them in the room.

However, as a nurse, first and foremost its my job to teach new students patient consent and respect. I'm not doing that if I just foist a student upon you. Consent is a constant thing, and should be sought at very new interaction.

So...

'This is Becca my student, is it okay if she sits in'

'Is it okay with you if Becca weighs you/ does your BP/steps closer to watch this procedure'

At no point should the patient be made to feel uncomfortable for refusing

Croissantly · 22/01/2022 19:11

People do have to learn I agree, and many people don't mind and some are happy with some procedures and not others, absolutely fair enough.

Croissantly · 22/01/2022 19:10

I agree OP, I hate when you're asked but put into an awkward position as well. It's always hard to get blood out of me, the midwife asked if I'd mind having a student try I said sorry no, I'd rather if you did it and the midwife said nope well I'm not doing it she needs to learn- I said okay ill get it done at the GP and she looked shocked. Had a painful examination in labour and asked the midwife to stop, she said sure. A minute later a student comes in with a different midwife, can she repeat the examination please, again, awkward saying no. Other scenarios been more than happy to say yes.

greenmarlin · 22/01/2022 19:08

The thing is, when you are having a medical procedure, you kind of are a mannequin.

No I'm not. I'm a person.

AutomaticMoon · 22/01/2022 19:07

This thread is scarily eye opening re coercion. The Nuremberg code obviously hasn’t gone viral 😞

mbosnz · 22/01/2022 19:06

No worries, hangrylady! I may come across as rigid and harsh, but that's because I am completely not prepared to have to explain the reason I have a strict no medical students rule, and get quite angry if I feel I'm put in the position where I either have to do so, or come across as a right grumpy, unreasonable cow.

I find seeking medical treatment difficult in and of itself, and avoid doing so. So being put in the position of having to say no to a breezy medical professional on their turf, along with their eager beaver of a student, is not helpful in overcoming my reluctance!

Elsiebear90 · 22/01/2022 19:06

I’ve been in both situations, I think for intimate procedures or examinations then it should be limited to one student, I certainly don’t agree with multiple students watching gynae procedures. If there are signs around the hospital or GP practice etc saying this is a teaching hospital, students may be present, but you can opt out of them being there, then imo the onus is on you to speak up, tell them receptionist prior to going into the clinic room if it’s that big of a deal to you to refuse with the student there. It’s the same if you don’t want a male HCP, you either need to speak up when you enter the clinic room and see one, or if you know that’s going to be uncomfortable for you call in advance or tell the receptionist.

Students have to learn, I’ve had gynae procedures performed by doctors who are training and being supervised, yes I would have preferred someone more experienced doing the procedure, but people have to learn and this is the only way. I work in a large teaching hospital and there are signs everywhere saying students may be present, so it shouldn’t be a shock when you come into my clinic room and are introduced to a student.

But yes I agree it’s not good practice to bring students in without introducing them, it’s also not good practice to allow multiple students in to see intimate procedures and you should always ask patients for consent prior to a student (or anyone for that matter) performing a procedure, so I would absolutely complain if that has happened to anyone.

AutomaticMoon · 22/01/2022 19:04

Oh and for the PP who asked whether I would take an organ donation, that’s a moot point as with the delays for treatment many people are unable to even access a diagnosis on NHS, nevermind treatment. I’ve not had good experiences with them either, have been left disabled and with chronic pain due to NHS negligence.

hangrylady · 22/01/2022 19:02

@mbosnz

I appreciate that, thank you, because, past master that I am at dissociation, I cannot dissociate when having medical attention, because of past experiences. I am not a mannequin, I am a person, and thankfully now, I am able to believe that and assert that. We are all different, with our different life experiences, and different abilities and tolerances as a result.
I am sure I'd feel completely differently if I'd ever suffered any sort of trauma previously and I totally appreciate why it would be uncomfortable for someone who has. I was being flippant I'm sorry Flowers
AutomaticMoon · 22/01/2022 19:01

@RedToothBrush It IS really scary that many don’t seem to understand the concept of consent. I’ve seem a PP say she wouldn’t have dreamt of objecting, then it’s not actual consent, is it?

AutomaticMoon · 22/01/2022 18:58

@hangrylady Dissociation is extremely triggering for people with trauma

AutomaticMoon · 22/01/2022 18:57

@Ducksareruiningmypatio Well not really, they could have had gov ads on TV to notify everyone, I didn’t know it was happening, only found out two years after the fact, when I started using social media. I am disabled, I have MH problems and I wasn’t reading newspapers daily.

mbosnz · 22/01/2022 18:57

I appreciate that, thank you, because, past master that I am at dissociation, I cannot dissociate when having medical attention, because of past experiences. I am not a mannequin, I am a person, and thankfully now, I am able to believe that and assert that. We are all different, with our different life experiences, and different abilities and tolerances as a result.

hangrylady · 22/01/2022 18:53

The thing is, when you are having a medical procedure, you kind of are a mannequin. I honestly don't care and can detach from the situation and forget it immediately afterwards but I understand others may not be able to so apologies if I came across a little harsh.

mbosnz · 22/01/2022 18:49

@hangrylady

"I am very appreciative of the likes of you for enabling future medical professionals having proper training by allowing them to see your procedures in action. I just don't feel guilty for not doing the same, and certainly will not be guilted into it, either by you, by medical professionals, or by future medical professionals"

Well done you. As I said, you're welcome.

Why thank you! Pats on the back all round, jolly good show, wot?!
hangrylady · 22/01/2022 18:45

"I am very appreciative of the likes of you for enabling future medical professionals having proper training by allowing them to see your procedures in action. I just don't feel guilty for not doing the same, and certainly will not be guilted into it, either by you, by medical professionals, or by future medical professionals"

Well done you. As I said, you're welcome.

AngelinaFibres · 22/01/2022 18:42

At my last smear there was a female student in the room. She was introduced to me and I was asked if I minded her observing the procedure. I was happy with all of that. If it had been a male student I would have been conflicted really. It is very important that students, of either sex, learn the procedures they may have to perform. However I am a human, not a visual aid , and I feel very uncomfortable seeing a male doctor for anything like that never mind having a male student involved. I realise it's not a sexual thing before anyone says that.

mbosnz · 22/01/2022 18:41

@hangrylady

"You go ahead and have hoards of strangers ogle your privates while you are spread eagle and vulnerable. I won't allow myself to be treated as a piece of meat or a learning prop. But you do you!"

Hoards of strangers! Behave yourself please. You can thank the likes of me for future medical professionals having proper training by seeing procedures in action. You're welcome.

You sound really rather silly telling another grown person to 'behave themselves please'!

I am very appreciative of the likes of you for enabling future medical professionals having proper training by allowing them to see your procedures in action. I just don't feel guilty for not doing the same, and certainly will not be guilted into it, either by you, by medical professionals, or by future medical professionals.

greenmarlin · 22/01/2022 18:41

hangrylady at times it is literally hoards of strangers. Personally I have done my bit for the future doctors of the world, and have decided that if it's anything intimate it's women only in the room - which is the direction those specialities are going in anyway, thankfully, so will be much easier in future. I will consent to students, but on my terms. I'm not a mannequin.

TurquoiseDragon · 22/01/2022 18:39

I would most likely be fine with students observing if my consent was asked for before the students were in the room.

Being presented with students there and consent effectively being assumed is a big no for me and I would firmly tell them to leave.

I do not care how many notices are on the walls about students, they don't have the right to ride roughshod over properly obtaining consent.

hangrylady · 22/01/2022 18:37

"You go ahead and have hoards of strangers ogle your privates while you are spread eagle and vulnerable. I won't allow myself to be treated as a piece of meat or a learning prop. But you do you!"

Hoards of strangers! Behave yourself please. You can thank the likes of me for future medical professionals having proper training by seeing procedures in action. You're welcome.

HacerSonarSusPasos · 22/01/2022 18:31

@hangrylady

YABU to object to students being present. They are the future doctors and nurses who will be treating other people/yourself and how else are they supposed to learn? I do think they should ask permission but if you say no YABU.
You go ahead and have hoards of strangers ogle your privates while you are spread eagle and vulnerable. I won't allow myself to be treated as a piece of meat or a learning prop. But you do you!
mbosnz · 22/01/2022 18:30

@hangrylady

YABU to object to students being present. They are the future doctors and nurses who will be treating other people/yourself and how else are they supposed to learn? I do think they should ask permission but if you say no YABU.
They can learn on people who are comfortable with them learning on them. That's reasonable.

Patient centred treatment - not practitioner centred treatment. . .

hangrylady · 22/01/2022 18:28

YABU to object to students being present. They are the future doctors and nurses who will be treating other people/yourself and how else are they supposed to learn? I do think they should ask permission but if you say no YABU.

hesbeen2021 · 22/01/2022 18:28

I went for a smear and when I walked in the room there was a nurse and 3 very young women present. When I asked who they were I was told they were trainee health care assistants.
Glad to hear you objected, why on earth would HCA's need to view a procedure they would never be doing? ( and as far as I know mine are always done by one nurse alone)