Nhs students and lack of consent.

@Dinosauratemydaffodils

Then in your case i'd phone up before appointments to make sure it's noted. But realistically (and my mum has SMI so i do get it) you are a rare category. The majority of people would be fine being asked on the day of a first apppintment to something.

Things like labour are tricky and I'm sorry- you went through such an awful thing. That should not have happened.

And i believe everyone having surgical medical procedures, labour ect should have an advocate to ensure informed consent during vulnerable times. I know i was so drugged up and in agony after foot surgery i couldn't give informed consent. Not nice.

For bog standard appointments, therapy ect. You can also bring along someone if that helps.

But again, just sticking to standard appointments like OP has. Splitting hairs is useless. The outcome re consent should always be your wishes and always asked - again never seen it not be.

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.

Just re read this. Do you mean a vaginal exam here OP? An unnecessary, unchaperoned one? That is shocking and should definitely be raised as a concern/complaint.

Of course consent should be obtained, I have had this on a few occasions and always been happy for them to sit in on appointment. I was a student once and the experience I gained during my placements/ actually doing the job taught me so much more than the lectures!

I had this with a gynae. I wasn't told there was a student in there. I'd specifically asked for female doctor when booking. Walk in and there's a young chap sitting next to her. I've been sexually assaulted by drs and raped (not by drs). It's actually in my notes. I came in and went into a kind of shock. She didn't introduce him. I started visibly shaking, could barely speak when she asked why I was there. I eventually managed to stammer out that it said in my notes I needed to see a woman only. She sniffed and said she'd not read my notes. I apologised to him - and by then he was standing up to go, apologising to me and saying it really wasn't a problem. And he left. She carried on being a bitch and I wish I'd reported her (I was advised to by another medic later but I couldn't face it).

I apologised to him again as I past the reception desk leaving and he again said it was totally fine.

To the people saying "They need to learn". Of course. But there are many ways for that. If you are happy for your body to be used and viewed like that (including multiple people staring at your genitals) go for it. But your comfort with it does not transfer to everybody. Volunteer yourself to the medical school where they can get a chance to try out on you.

It's also possible to practice things on realistic dummies now and if that's not possible, then they always have each other. And if that's not ethical, then why on Earth is it ethical to practice on people who are by definition of being unwell and seeking help, vulnerable, without consent?! Or with coerced consent (which isn't actually consent).

OP I believe you. There are people who think that once someone enters medical school they develop wings and upon graduation a polished halo appears, I'm guessing they haven't spent much time in bars that medical students frequent, listening to them one-up on the grossest vulva or biggest testicles of the day, or smelliest body etc*. In life or death situations, consent may need to be bypassed. On all other occasions there's no excuse for anything other than informed consent.

*I have dr friends who don't do this. However, I spent a fair amount of time in uni in the vicinity of nee students in bars, beer gardens etc and there were too many who did - and the ones who didn't, didn't shut them up.

@Wineandrun, I don’t get your comment at all. No of course it doesn’t help that it was an enriching experience for the student midwife… If something is traumatic, who would be able to separate out their own response to that extent and be glad they’ve supported someone else’s learning, albeit been left traumatised??? It’s irrelevant how the student midwife feels in these circs tbh.

[quote arghdilema]@Blossomtoes why wouldn't that happen? I did it, as did all my peers. [/quote]
It wouldn’t happen at my surgery.

I was a student paramedic up until recently and although I introduced myself as a student and I’d always ask for consent before performing any sort of procedure, 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?

I have a disability and had lots of hospital appointments related to it as a child. I remember being asked for my consent for students to be present from when I was about 8 years old. I presume my parent was asked as well, but I remember the doctors explaining it to me, and that I agreed to it. This was decades ago. It's really shocking if some people aren't even being asked now.

I haven't seen an NHS doctor in a long time, but if I did, I'd be happy for students to be present for routine things, but not anything related to my mental health or anything which would involve them seeing intimate parts of my body. Those things are too private and personal. If other people wouldn't mind, that's fine for them, but we should all have the option to decide for ourselves.

@Blossomtoes why wouldn't that happen? I did it, as did all my peers.

www.hee.nhs.uk/our-work/work-experience/north-east/opportunities-primary-care

@MarbleQueen

You literally said you didn't want to see any students.

Look. If admin/receptionist started asking you invasive stuff on your first visit, you'd probably kick off at that!

For healthcare. Healthcare staff. Not admin. Not reception.

On your first appointment need to ask consent for treatment also re their students THEN

IT CAN BE ADDED TO YOUR FILE.

And you'll never have to lay eyes on a student unless god forbid they qualify and have to treat you

What is the bloody big drama??

Completely normal to have a student in on most appointments if you live in certain areas. I always said no in case they were someone I knew from uni! Outside of those areas they're much rarer, so understandable some people might find it unlikely.

I'm a more the merrier kind of patient.

Students need to learn and they are curious, in my experience more caring.

I actually stated in my birth plans that I was happy with to have a student midwife present. I was lucky enough to have one too, held my hand while I pushed. I apologised to her for having been at the wrong end 😁

I'm currently undergoing tests for something very often misdiagnosed and if it's that hope there are students present so I can explain how it feels and they can take that away for future patients. Even if it helps one other person, not suffer the pain I have for along time.

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 do not feel comfortable being asked by the receptionist when booking, or in the clinic at point of care or wherever, I wonder if there could be a solution like flagging on your notes in all these different settings that you do not want to be asked at any point if students can be present as you do not consent to it. I can imagine must be worrying now with each upcoming appointment about who else is going to be there, and whether or not you’ll feel you have a realistic chance to say you don’t want them there.

From the points of view of students, it should be like water off a duck’s back to be asked to leave by a patient, but I appreciate a patient’s perception may be different.

You walk in, see 2 people instead of 1.

You are asked if you will allow student to observe (however way they phrase the question you are still being asked)

You say no

Or you have a diagnosis of ptsd and had a childhood which left you terrified of conflict so you say yes and then end up retraumatised/miminising why you are there because you can't discuss it in front of an extra person/a male.

When I was in labour with dc1, it was phased in such a way that the poor student would be kicking about with nothing to do all night if I said no. I was already 60 odd hours into back labour with no sleep for 4 days and didn't feel I could say no without coming across as a total cow.

HonestwithHope1 Admin can ask and flag a clear "no" surely? Doesn't affect the treatment in any way as they would still see their HCP for what they came in for. Doctor/student can then double check the others.

I have always been asked. I had my smear done in the last few months and i was asked if someone training could watch

For the PPs who affect to be unconcerned about this—I wonder how many of you ask what the young people are students of?

There's a distinction between someone doing an internship (UK sense, not the US medical sense) or work experience, and somebody who is an actual healthcare assistant/medical, nursing, or affiliated healthcare student.

I quite understand why people would be OK about a student in a teaching hospital 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.

www.bma.org.uk/advice-and-support/studying-medicine/becoming-a-doctor/getting-medical-work-experience

I’ve also had several situations with students, my doctor’s surgery is attached to a hospital/school of medicine. Only time I’ve been happy is when I first tried the pill as an 18 year old and my blood pressure went through the roof. My GP brought in loads of students to see that and I was happy to help.

The gp once left the room and I asked the students if they had done any study on consent and they said no and they didn’t know much about it. A friend trained as a midwife and had to stay an extra 6mo to complete her studies because she insisted on getting consent from each mother she worked with during their birth. Which you’re meant to do! But ppl just don’t.

@NoRaceInThisHorse. Nope. Informed consent between health professionals/patients then depending on area of work we may ask admin/receptionists to do that or we ourselves would make a note.

Think we'd be hung if we took only our admin staffs sayso for consent. (Only kinda kidding)

Obviously for future appointments it's not an issue if that's on the system (remember not many places are joined up)

I 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.

Consent or no consent. That's pretty simple ask and I have never seen anyone ignore consent like that and as often as OP is apparently experiencing

The one experience I had was personal and i 'only' lacked full informed consent by a surgeon giving me medication he shouldn't have. (I consented but didn't know it was against nice guidelines for my disability until i looked it up after as i had bad effects)

Informed consent is vital obviously. No one is saying it isn't and I'm sorry to see others have had the rare (individual wise for them) bad experience with this.

I'm disabled all my life surrounded by health professionals and surgeries. I've worked/trained//volunteered in healthcare for 10 years. Never ever witnessed non consent of anyone sitting in on appointment or doing any type of procedure.

So i do take skepticism with OP.

Were you planning to do something else with your organs? Would you accept a donated organ if you needed one?

Not at all the point.