Nhs students and lack of consent.

I've noticed it myself, previously they'd always introduce themselves and ask if I was comfortable with their attendance, now they are just there in the room, or actually getting involved with no question of if I'm happy for them to be there or not. I'm personally not bothered by it, once had 20 of them in an operating theatre with me, they need to learn somehow and if it improves the level of care they provide and medical knowledge they have, I don't see the problem.

Ds had brain surgery when he was 3. What he had was very very rare in a child so young... His surgeon asked me about students visiting him for their case studies I said it was fine...we had a steady stream into his room ..all bought kids magazines small toys or smarties , his surgeon had told them not to come into his room empty handed :) boy was very happy at all his loot and all the nice doctors who wanted to chat with him.

I always like to have students present in any medical setting because it usually means the instructor will go into more detail and use more technical terms, which I find interesting. I also find the students have more interesting perspectives. I wouldn't necessarily expect to be told that a student was present, but it's usually obvious.

I'd also never refuse to allow a student to perform a procedure on me as long as the instructor was present (unless the student had been very rude or something).

There are two different types of consent. For any procedure you will be asked to sign a consent form. If you are in a teaching hospital then the form contains wording to the effect of 'this is a teaching hospital and as such nursing and medical students may be I attendance. Please raise with your supervising consultant If you have queries' the consent forms can be long and this can be missed by the patient. However if the medical or nursing or any student is to take part in the procedure this MUST be discussed with you and you must give explicit consent for this.

Them too @Warmduscher 😂

So utterly lacking in compassion and sensitivity for someone who says they work in the emergency services.

If it's the emergency service I'm thinking of it doesn't surprise me.

That post was to @ECLT.

It's not dismissive, people's feelings are very complex indeed and people feel this way for many different reasons. So complex in fact that there is no easy way of describing it in a way that would cover everyone. Whichever way I would have described it, it could have undermind someone or not met someone's circumstances or offended. I could have worded it better, of course, I have the experience in similar areas to have described it better but my post would have been very long, very detailed, and still would have not covered everyone's personal feelings because people's reasons for feeling uncomfortable are very complex, personal and unique to them.

[quote HacerSonarSusPasos]@eclt your use of the world "uncomfortable" in quotes is so disgustingly dismissive of people's complex emotions and anxieties. I would be ashamed![/quote]
So utterly lacking in compassion and sensitivity for someone who says they work in the emergency services.

How many times does it need to be said that it is not the responsibility of patients in need of medical care to compensate for deficiencies in the training of medical students?

@eclt your use of the world "uncomfortable" in quotes is so disgustingly dismissive of people's complex emotions and anxieties. I would be ashamed!

When i was pregnant with my first all my comunity midwife appointments there was a student there and i never got asked if thats okay. On my 'birth wishes sheet' (went out the window when i gave birth) i put that i dont wish for any student midwifes, its my first, i was unsure of how it would go, didnt want an audiance at my vagina or any extra hands up there and annoyed that im only allowed 1 birth partner but a student midwife is allowed to be there as an extra! When i showed my midwife my birth wishes sheet she made me feel so embaressed questioning (very harshly, she wassant a soft woman) why i didnt want students in the room, in front of the student midwife and made me cry. Then after my birth a student midwife come along to my bedside to remove my cathater (sorry if thats spelt wrong!).

The NHS is understaffed, underfunded, and struggling. People are struggling to access the services they need and to get the procedures they need.
These students are wanting to come into a service that is strained and they need to learn in order to support it but can't because people feel 'uncomfortable'. It will leave the NHS in a very difficult position.
I'm willing to accommodate the students at all times, anything to help the NHS get more staff, ease the strain and eventually improve services.

I work in the emergency services and have needed to train, people naturally have high expectations, and rightly so but it is a hard area to work in and not everyone is cut out for it. It can be thankless, stressful but many continue to want to do it. Please try and support the new staff coming through.

I was a student radiographer a few years back.
From my experience the staff would always ask the patient if it was ok for me to be there.
We always had to introduce ourselves as student radiographers and make sure the patient was ok with that.

I get that students have to learn, but ultimately it is down to the patient whether or not to have a student be present/perform the examination. Especially with more invasive treatments!
I know that I personally would not like a student to watch me have a smear test, however practicing to cannulate on me would be fine.

[quote Mothership4two]@Itsalmostanaccessory

I was induced when having my second child. The person who was about to give me the pessary popped her head in and asked if it would be OK for a student to observe. I said yes. She then came through the curtain and 6 of them walked in behind her. I felt like I couldnt say no after saying yes to one person so has to have my legs open with these 6 students all having a good look and having it all explained to them

My Dad had similar. During his radiotherapy treatment for testicular cancer he went to the hospital one time and was about to be examined first. He was asked if a student could be present and. like you, said yes, only for a roomful to appear - he was mortified but felt he had said yes so couldn't refuse and was too embarrassed to say no then anyway![/quote]
This is awful.

It needs to be understood that permission for a student to observe is permission for one student, not for every student in the department to troup through and have a look.

Some might not mind, but I do think multiple students is invasive in a way that one is not. It becomes about the students not the patient.

YANBU OP, it sounds like every time you go for an appointment there are students! When I trained as a nurse, I was obviously reliant on people's generosity in consenting to my observing/carrying out procedures (you have to get signed off for certain things as part of your practical assessment document-if you don't do it, you don't pass) but I would be horrified if a patient had felt forced into consent or unable to choose. If it is really the mentor that should be obtaining proper consent.
I allowed a student midwife to deliver my youngest child as I know they have to deliver a certain number of babies during training and mine was an uncomplicated labour and delivery. I offered though, I figured that I didnt mind too much, and it would help her training.

It is a difficult one in that of course students have to learn (and even trained nurses-for example taking bloods and cannulation, you usually have to complete so many under observation to be signed off as competent) but the person should always have the right to say no.

I suppose the problem would come if everybody said no-because the practical element of learning really is important and some things you cannot teach with just theoretical learning.

Absolutely YANBU!! Years ago when I had my otoplasty and I obviously had my ears visibly bandaged, 2 med students asked me: oh, what kind of surgery did you have? I told them I had a nose job and they happily went away. I often wonders if they're doctors now... 😃

Just to add with regard to me not wanting a student to watch anything private I’m referring to my own care and also if they say ‘a student’ it should be one so always exercise your right to say no! It’s your body! Your private life and your choice

I’m a qualified nurse and practice assessor so I have many students observing me. I have one student allocated at a time and it’s not all the time.

My take on your experiences is that you have been treated disgustingly! I would 100% report this behaviour through PALS because how dare they try to do a VE when there is no therapeutic benefit and you should never just walk in to an appointment (whatever it is) and just see a student sitting there. It’s one thing to walk in and be asked if it’s ok each time and for them to leave if it’s not ok with you, but it’s quite another to make you feel uncomfortable if you ask them to leave or to just walk in to see them sitting there like they have any right.

I ask my patients (usually Over the phone before the appointment) if they mind my student being there. Rarely do people say no but sometimes they do and it’s FINE with me and should be like this everywhere in practice.

Yea students have to learn, and they will because most people don’t mind but if you do mind say no! I wouldn’t want a student observing anything private. It’s hard enough as it is without being watched! They also should talk to you not the student all the way through. I usually do the medical bit and talk to the patient and then just briefly explain little bits to the student but involve the patient during this time so eg ‘I’m going to take this measurement so we can assess x,y and z’. After each patient I reflect with the student so they understand everything clearly and get them to do my admin! Because having a student is time consuming when we’re busy as it is.

Please report this. It is not ok!

@Itsalmostanaccessory

I was induced when having my second child. The person who was about to give me the pessary popped her head in and asked if it would be OK for a student to observe. I said yes. She then came through the curtain and 6 of them walked in behind her. I felt like I couldnt say no after saying yes to one person so has to have my legs open with these 6 students all having a good look and having it all explained to them

My Dad had similar. During his radiotherapy treatment for testicular cancer he went to the hospital one time and was about to be examined first. He was asked if a student could be present and. like you, said yes, only for a roomful to appear - he was mortified but felt he had said yes so couldn't refuse and was too embarrassed to say no then anyway!

I find it's a culture problem in the NHS. We're supposed to be eternally grateful for the fact that we're being seen and to humbly defer to them over every aspect of our health.

While I don't find this to be the case every time, I do agree that this does seem to be the case too often, and does seem to be getting worse.