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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:
LoveFall · 22/01/2022 01:04

@Redsquirrel5

LoveFall That is awful. Wow 😲 can you do anything to follow up how that happened. I would want an explanation after they investigate.
The police are investigating and she has been charged. It has been all over our media so you can probably find it with Google,

I hope they follow up. I have been a bit creeped out and my confidence in our system has been shaken. Some other woman have been in the media but this is as public as I want to get.

LoveFall · 22/01/2022 01:00

@MarbleQueen

had gyne surgery last year and have recently received a letter from the hospital saying I had a phony, fake nurse during my surgery. I am now wondering if I need to check credentials too

I don’t understand. Do you mean someone pretending to be a nurse?

Yes, someone pretending to be a nurse. This was in. Vancouver. She lied her way into quite a few nurse jobs in Canada. She has been charged.

So, so creepy and frankly upsetting.

HonestwithHope1 · 22/01/2022 00:47

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Seasidemumma77 · 22/01/2022 00:41

With 1st dc I was asked if I minded students being present during antenatal, birth, postal, naively said yes. Didn't realise that during my complicated delivery that obstetrician, midwife, paediatrician would ALL attend the birth with their students! My mum and I can now laugh at the number of people squished into the delivery room but at the time it was frankly shockling. For subsequent births I made it clear only one student was allowed in the room.

NiceTwin · 22/01/2022 00:41

It wouldn't bother me but I have been part of a medical research study for about 25 years, so am more than happy for students to sit in.

I would draw the line if it was a yr11 on their work experience week Grin

Original poster
MarbleQueen · 22/01/2022 00:35

find it laughable that someone is raging about a first/or one off service appointment getting agro about consent being asked not in the exact way she'd like

Can you not read? I’m not being asked at all.

OP posts:
Cbtb · 22/01/2022 00:34

No one should have people they don’t want present for their healthcare. It can be really overwhelming and traumatic.

I do wonder is people say no more now and this has led to a change in policy:

However male medical students often qualify as Doctors without ever having seen a birth or performed a vaginal exam and then go onto be then junior doctor on overnight for obs and Gynae performing their first ever exam unsupervised on a real sick women and that’s not great either

(Source - married to a Dr who qualified without ever seeing a birth or doing a vaginal exam despite turning up every day for his 4 month obs and Gynae placement)

I’m a qualified dr (trainee GP) and just started a new job so wanted to watch the people who work there already for a few days to see how the computer system worked etc. Patients were asked before and most said no. So instead I just got dropped in the deep end consulting on my own - not a smooth experience for my first few patients!

Not sure what the solution is.

Original poster
MarbleQueen · 22/01/2022 00:27

EmbarrassingHadrosauru Im aware of this practice and this is part of my issue. It’s interesting that many posters seem to think that all students are trainee doctors or third year students.

I suspect the young man at my gp appointment was on a work experience thing, he looked about 17.

OP posts:
nildesparandum · 22/01/2022 00:20

I know this is a sensitive subject to many people.
My DS1 is alive today mostly because a midwifery tutor as they were known 52 years ago, brought two student midwives into room while I was in labour. She asked me if I would be happy for the students to palpate my abdomen as part of their training process.As a former student midwife myself I agreed despite being in really bad pain.
The tutor pulled down the sheet covering me, then without touching me immediately stood back, told me it was best or a doctor to see me first and quickly left the room taking the students with her. She returned within minutes with a doctor who proceeded to feel my my abdomen nodded his head then quickly left leaving the lovely tutor to tell me that my baby was in danger and I would have to have a crash caesarian now.
My waters were meconium stained as well.The nurses came and got me on a trolley and ran with me on it to the theatre. My son was actually in transverse lie and a Bandle's ring had formed around him.He was brought out of me with an Apgar of 1 which is almost dead but was successfully resuscitated.
Even today I wonder what would have happened if I had not been used for a teaching subject at that time.The section had other complications as well but it was life saving.

Original poster
MarbleQueen · 22/01/2022 00:17

I want to be really clear that having students at gp and hospital appointments is not a new thing in my area. We are part of a teaching hospital and it’s been this way for as long as I can remember. It’s not been a problem.

You would turn up for your appointment and the receptionist or gp would say they have a student on a placement and do you mind if they sit in. You would say yes or no based on your own preference and the appointment would go ahead.

The problem is not the students, the problem is they have stopped asking for consent.

To the person wondering if the healthcare assistant was brought in as a chaperone from a ward. No. This happened at a family planning clinic and no one would need 3 chaperones.

OP posts:
Blossomtoes · 22/01/2022 00:17

Like I said, it wouldn’t happen at my surgery 🤷‍♀️

EmbarrassingHadrosaurus · 22/01/2022 00:14

@Blossomtoes

but that is not the same as an A level student doing work experience at the local GP practice to fill out their application to medical/nursing school

That wouldn’t happen.

If you'd read the BMJ link, you'd see it does happen and A level students are advised how to go about it.
Nhs students and lack of consent.
HonestwithHope1 · 22/01/2022 00:13

@NoRaceInThisHorse

Then it's simple. If they have such trauma that they can't say the word 'no'. They phone up before an first appointment and explain and have it added to file for x service.

Withthemonsters · 22/01/2022 00:12

@MarbleQueen
No of course not, I was with a paramedic and either a technician or another ambulance student paramedic ( I was a uni student paramedic so was a ‘3rd man’ on the crew), but my point was that there was no way of asking patients to consent to me being there without me already being there.

Warmduscher · 22/01/2022 00:10

@Lessofallthisunpleasantness

If student medics can't observe they will have less chance to become good at their jobs.... which is what we want!!
Oh RTFT will you?

No one is saying students can’t learn. They are saying they can learn after informed consent has been obtained from the patient.

Original poster
MarbleQueen · 22/01/2022 00:09

had gyne surgery last year and have recently received a letter from the hospital saying I had a phony, fake nurse during my surgery. I am now wondering if I need to check credentials too

I don’t understand. Do you mean someone pretending to be a nurse?

OP posts:
NoRaceInThisHorse · 22/01/2022 00:06

@Lessofallthisunpleasantness

If student medics can't observe they will have less chance to become good at their jobs.... which is what we want!!
And if people don't feel they can say no, there is less chance some will seek care. Which is what we do not want.
Lessofallthisunpleasantness · 22/01/2022 00:05

If student medics can't observe they will have less chance to become good at their jobs.... which is what we want!!

Original poster
MarbleQueen · 22/01/2022 00:05

it’s a lot more difficult to get ‘true’ consent in the way you’re suggesting @MarbleQueen because I was already in the house when it’s being asked. I don’t know what you’d want us to do in that case because the alternative is waiting for another ambulance who probably also have a student?

Are you saying you were a student paramedic and you were out on calls with no trained supervisor?

OP posts:
Redsquirrel5 · 22/01/2022 00:04

LoveFall That is awful. Wow 😲 can you do anything to follow up how that happened. I would want an explanation after they investigate.

LadyinRead · 22/01/2022 00:03

Yes I have noticed this also. "Allowing" (I wasn't asked) a student to perform a procedure turned out very badly for me recently, and I had to have a major surgery as a result.

BobbyeinArkansas · 22/01/2022 00:03

I was about to undergo an operation a few years back. A student doctor came in and asked if he could observe. I said no. Felt bad for him but I just don’t want anyone observing. You should never feel pressurised into being observed. No need to give a reason.

Beseen22 · 22/01/2022 00:02

I have little experience of how it works in primary care/outpatients where you are going into a room and I can understand why it makes you feel a bit ambushed. They should absolutely ask for consent.

But in a hospital setting (again only from a nurse perspective) whilst our students are supernumerary unnofficially they are absolutely counted within the numbers and expected to be delivering care. Infact most were on nhs contracts all 2020 and employed. They are trained in moving and handling and basic life support and a large amount come from a support worker or care background. We ask consent prior to every care delivery "hello Mrs Smith, its the student nurse here would I be able to check your blood pressure" and as explained before they are all working under a registered nurse so I would check absolutely everything. Within some wards at the moment overnight there can be ratios of 1 nurse to 16 patients which is less than 4 minutes per hour per patient, so students nurses are considered part of the team and actively involved in the day to day work because some shifts I literally wouldn't make it through without them.

Another thing that happens constantly in hospital during intimate examinations is that the doctor will request a chaperone especially when a male doctor. I believe that if this is what has happened with yourself some strong communication around why this is required would go a long way rather than you feeling like a piece of meat. The chaperone would often be a student nurse because they are the most available on the ward.

Redsquirrel5 · 22/01/2022 00:02

I have still been asked.

If you really don’t like it then I would contact the surgery and have it put on your notes. The hospital might be a bit more difficult but if you are there quite often I would have thought a note could be attached. You have every right to refuse.

LoveFall · 21/01/2022 23:58

I have had a student or resident etc. in the room for procedures, including colonoscopy. Last time my gi specialist brought me in the room and there was someone else there. They didn't seem like they were going to tell me who he was so I asked. Then they told me, asked me for consent etc. i was fine with it but I like to know.

I had gyne surgery last year and have recently received a letter from the hospital saying I had a phony, fake nurse during my surgery. I am now wondering if I need to check credentials too.