Active discussions

Please or to access all these features

Talk
AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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:
NoRaceInThisHorse · 21/01/2022 23:25

@SC215

How should patients be asked for consent about students? Genuine question.
On booking in at the appointment: "We have a medical student working in the GP surgery/clinic etc today. Would you rather see the doctor alone or are you happy for the student to sit in?" (framed as a choice, not a blanket "are you OK with that, which forces a "yes").

Simple.

Reallycantbesarsed · 21/01/2022 23:25

I genuinely do not have a problem with students…they do need to learn !

HonestwithHope1 · 21/01/2022 23:25

Gaining consent takes seconds and doesn’t prevent them from learning.

YES!

BUT

precious you clearly doesn't want to see any student before appointment

This isn't realistic for 99% of people/services at a first appointment. It would frankly take more time to boot student out then potentially call them back then ask question then get on with appointment.

Here's how it works

You arrive (hopefully on time for appointment)

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

Student walks out.

Sorted in less than 2 mins :)

Then, if your having frequent appointments with X service you can ask for it to be specifically noted. Most services aren't joined up so you'd have to do them for all obvs.

Oh wow lovely! You do realise phoning people could easily take 10 mins with them hanging on the phone, or the redials or the interruptions if they phone back having missed your call

When the simple question could be asked far more quickly in person on the day

Yespmed · 21/01/2022 23:22

I don’t mind students being present at all but I agree with most posters here that it would nice to be asked before any type of procedure or examination was done on me and for it to be monitored. It sounds like you’ve been unlucky with the amount of students you’ve had but you have every right to say no if you don’t want a student at your appointment.

I have a history of borderline ovarian cysts & have had several operations and have routine internal ultrasound checkups to monitor for recurrence. Eventually after I’ve “completed” my family I’ve been told I’ll need a hysterectomy. So each time is a bit un-nerving never knowing what they’ll find or want to do. I once had a student at my ultrasound appointment and the consultant said to the student that he was going to let her prep/start off the internal ultrasound for him (I assume for experience..and to be honest I thought ok everyone has to learn and said it was fine). He left the room for a moment and she began the ultrasound and then started telling me that she could see both ovaries and reassured me that everything was fine. My consultant came back in and took one look at the screen, told her that she had put the wand in upside down (camera facing wrong way) & was looking in completely the wrong area - all said in front of me. I felt a mixture of sorry for her and also a bit sorry for me. Luckily nothing was there when I got correctly scanned, but I’m not sure how i would have felt if she had given me incorrect information.

justasking111 · 21/01/2022 23:21

Thinking about it I've been wheeled into theatre twice already out cold so lord knows who was present there

EmmaH2022 · 21/01/2022 23:21

@SC215

How should patients be asked for consent about students? Genuine question.
We should be asked "is it okay if a student/s sits in on this session?"

It's very easy.

And the poster who got a group of students with her dying relative - that explanation should have taken place out of earshot of patient and relatives.

Spicez · 21/01/2022 23:19

This reply has been deleted

Post references deleted post Talk guidelines.

SC215 · 21/01/2022 23:18

How should patients be asked for consent about students? Genuine question.

AutomaticMoon · 21/01/2022 23:18

‘I do agree the patient should be asked for consent, but don't think it should be refused unless there is an extremely good reason.’

I don’t think that’s how consent works, surely?!?!?

Thirtytimesround · 21/01/2022 23:18

The NHS has been like this for ages. A friend trained as a doctor 15 yrs ago and the stories he told re consent were very depressing. Basically they are taught they no one is ever going to voluntarily allow students to practice how to do medical procedures on their body so they do it without consent. Oh

BungleandGeorge · 21/01/2022 23:18

I’m intrigued about the dental students as I thought they only practiced in designated training centres attached to hospitals and clinics which make it very clear students will do the work. I’ve never come across one at an individual practice.

I’ve always been asked for permission with students. I’m no ot particularly bothered about the wording and would feel fine saying no if I really needed to. I do think it’s a valid point that if the person is qualified it’s a totally different situation as they are part of the team treating you and different to a student.

JohnnyMcGrathSaysFuckOff · 21/01/2022 23:17

SC215 obviously I don't know what branch of medicine you practise but if you treat mental health issues I would say the same applies.

Anyhow, not going to get into a ding dong with you, and thankfully I have now got past my childhood experiences to a point where I can confidently say no. Some people can't and won't ever get to that place. I hope you can consider them.

AutomaticMoon · 21/01/2022 23:17

@GinIronic Good on you! I feel sorry for the women he encountered who had trauma or anxiety who didn’t feel confident enough to decline 😞

SquirrelG · 21/01/2022 23:17

I do agree the patient should be asked for consent, but don't think it should be refused unless there is an extremely good reason.

AutomaticMoon · 21/01/2022 23:14

@listsandbudgets I’m sure you’re aware of the issue of anaesthetised women undergoing pelvic exams from students without consent or being informed?

SquirrelG · 21/01/2022 23:14

You don’t know if they were medical students or junior doctors though. People have to learn and patients who refuse are in my view akin to the unvaccinated allowing others to bear the burden of risk while they enjoy the benefits

I agree. How are they expected to learn properly if everyone can't possibly have them in the room? I bet those who object would be the first to complain if someone had qualified without ever having seen the procedure done, or helped with it, and they were the "first" they had ever done it on!

LadyPropane · 21/01/2022 23:14

How do you think medical students learn? These are the cream of the crop intellectually and are the future of our health service. It’s disconcerting that so many of you think they can learn complex treatments from a textbook

Haha... They aren't ALL the cream of the crop intellectually... But I'll agree that many are.

Nobody is saying they shouldn't get this experience. All that OP is saying is that they should get the patient's consent first. Most of the students I've known and work with expect that not all patients will give consent on that day. It's fine.

GinIronic · 21/01/2022 23:14

I once had a scan for a DVT. I was sitting in the consulting room and a technician came into the room and said he was a student and he would be doing the scan. I refused and he got really shirty with me. I told him that if has asked for my consent first, I may have considered his request. There was something about his casual arrogance that really pissed me off. He left without saying a word and another member of staff came in a did the scan. I’m not a piece of meat to be used for practice.

AutomaticMoon · 21/01/2022 23:12

@NoRaceInThisHorse 😁 ‘But I’ve seen gajillions of fannies, is yours made of diamonds?’ - a probable quote from a HCP

Original poster
MarbleQueen · 21/01/2022 23:11

Do you think every health professional has the time to phone (and potential miss you involving pita redials ect) and discuss something that when you come in, can be said in 2 mins?

What a load of bollocks and excuses. It takes seconds to ask someone.

OP posts:
listsandbudgets · 21/01/2022 23:11

I think it jas changed OP. When I had dd a medical student came, politely introduced himself and asked if he could observe the borth as part of his training.

When ds was born 7 years later he was delivered without my knowledge by a student midwife. To be fair it wasn't a good time to ask me much since I was screaming that I needed a poo!! In the end it was a good thing and I am sure he's now a superb midwife - one of the calmest most reassuring people I've ever met. DS was his qualifying baby .. (40th delivery). It was such a lovely feeling when he told me that. 😀

I do think as a rule though patients should be asked rather than consent assumed. I wonder how many anesthetised patients are operated on by students without their knowledge or consent.

AutomaticMoon · 21/01/2022 23:10

@SC215 Ambushing people before they come in doesn’t sound good for the patients. If they have PTSD/cPTSD they can easily say yes as they feel trapped and expected to say yes. HCP should really have trauma informed training.

NoRaceInThisHorse · 21/01/2022 23:09

@Itloggedmeoutagain

You left without having a smear? What did they say when you said you were uncomfortable? What do you mean insinuated you were being silly?
Whats wrong with leaving? If I go for a procedure and decide not to go ahead at any point, for any reason, I can withdraw consent and leave. I've heard it before from HCPs "It's nothing we've not seen before" being a particular favourite. I don't care how many fannies they have seen, mine is not normally opened up and peered into by strangers.
AliveAndSleeping · 21/01/2022 23:09

I think there's mostly some sort of student there's but I've always been informed and if I remember correctly asked for consent.

I usually don't mind. The only time I refused was when I was in labour and the student was going to be male. I felt super guilty. Still do especially since I had quite a few male consultants look at me later during the same delivery when things didn't progress as they should have. Your thread has made me feel better about that so thanks.

shouldistop · 21/01/2022 23:08

[quote AutomaticMoon]@shouldistop I am disabled and don’t have a lot of energy, in 2020 I was busy working night shifts in a care home, my
Mother was dying from cancer, and I was living in uninhabitable housing. I didn’t have time to read the news everyday in case the NHS decided they’re entitled to my organs. The NHS have been exposed for organ theft already, so I guess they wanted to legalise it.[/quote]
But you know about it, so it proves my point that it was widely publicised. I believe it was actually published / talked about for years before any changes were made.