to put this in my reply?

[creampie]

At the risk of outing myself I've changed a few details but the jist is the same.

I teach med students. One of their projects is a tutorial in which they interview real patients in a class room setting. This week is dementia week and I had a gentleman patient and his wife attend.

One of the female students arrived wearing an outfit that looked like she'd just come from the gym, Lycra leggings and neon racer back vest. They are more than aware that these are real patients, not actors, and that a degree of professionalism is required.

I should have turned her away but these are mandatory and she would have been in trouble with her tutor so I let it slide.

When it was her turn to interview the man made a few inappropriate comments. Nothing awful, no swearing, but along the lines of "you'll never drown" and "I can almost see what you had for breakfast"

I intervened and sent her back to her seat.

She has now formally complained about the patients attitude and that I embarrassed her in front of the class. I simply said, let's call it a day there, you can return to your seat. Nothing more.

I am livid. The formal reply I've written is along the lines of sorry you were embarrassed, but what the fuck do you expect if you have the disrespect to turn up dressed like that. Only in flowerier terms, obviously. I can't believe she's got the audacity and lack of insight to complain about this.

I really want to send it. However, I'm concerned some PC person in HR will accuse me of victim blaming. Would IBU to send this? What would you do?

there are two separate issues here. She dressed inappropriately for a patient interview. You should tell her that and give her some guideline on appropriate dress whether it be scrubs/white coat/ordinary work-appropriate clothes.

As a separate issue, she wants to complain about comments a patient with dementia made to her. I would explain to her that she can certainly complain but she needs to understand that a patient with dementia may well have lowered inhibitions etc and her expectations are unrealistic.

I think you could say that it is appropriate to wear clothes that indicate the job that you are training for. That this can help someone identify who you are. This could be the "what can be done in future" at the end!

I agree with pp about toughen up, but no idea how you write that in a rl reply! I really think that it can undermine trust by dressing in certain ways. This is probably not what I am supposed to say, but in work I dress for my patients. So I am not distracting, I am practically dressed, covering most of the skin areas that my male colleagues would cover and hopefully I inspire confidence with my boring cardigan/trousers combinations.

I completely agree with the good sense of OurBlanche and HoggleHoggle. Expat I am at having to exclude beachwear in a professional environment! I would seriously worry about anyone who would think it's appropriate. OP, perhaps show that student these responses and tell her to cop on to herself!

I am just confused as some people have stated that she wasn't handling the interview well but your op doesn't say anything about her performance.

Was she really, really bad?

First of all, to the posters saying that the patient should have been told not to be rude or that she shouldn't have to deal with sexual harassment at work...have you ever met someone with dementia? Losing the ability to filter what you say is a pretty major symptom and not the patient's fault, I imagine he'd have been mortified if he truly knew what he was saying, so please, have some compassion.

Secondly, communicating with patients with dementia and their families is an important part of the job and that's what she was supposed to be learning here. It seems she completely misinterpreted the situation and had little insight into how her own behaviour influenced the patient's. It sounds like you did the right thing by ending the interview when you did and saved her further embarrassment.

I wouldn't go in all guns blazing, no matter how tempting. I'd bring it up informally with whoever received the complaint or her personal tutor. She's a student and you're the educator and I would try and use this as an opportunity to help her reflect on how she could have done better, including her attire. If her performance is otherwise acceptable I would give her the opportunity to learn from this. At the end of the day, she's not a victim so I can't see how you could be accused of victim blaming. But she is a student and is there to learn and mistakes and misjudgements are to be expected. She needs a lot more insight and empathy for her patients and while you would hope she would have these skills by the time she reached clinical, not everyone does and she needs a firm push in the right direction. She also needs a thicker skin - she'll get much worse when she's out on the wards!

Betty do you have any experience of someone with dementia. I suggest you educate yourself on the condition before posting about it

Absolutely 100% this. Perhaps Betty will eventually come to understand this although, along with anyone else who has experience of this ghastly condition, I do rather hope not. In the meantime a little education perhaps. In a sea of stupid Betty really stands out like a beacon of ignorance.

The patient was inappropriate, as dementia patients often are. She wasn't dealing with it. You cut short the encounter. Nothing to apologise for.

I would say some version of the above, and mention her dress very much as a subsidiary factor. That way you cannot be accused of victim blaming. And just say something along the lines of dress how you want but own the foreseeable consequences.

There was probably an element of cause and effect going on in the consultation. If the student had been dressed conventionally it's likely to have given the patient some non-verbal prompts about their respective roles, and could possibly have avoided the inappropriate comments.

It's a fact of professional life that people do judge on appearances, and (rightly or wrongly) she's making it harder for her to be taken seriously. She wouldn't have been even allowed to attempt a mock trial dressed in gym wear if she were training to be a barrister for example.

I am no expert in this field but maybe both the patient and the student need to be spoken to. The student should dress appropriately and make allowances for odd behaviour from patients under stress. The patient could be advised to be more courteous to the staff. This might not make any difference in his case but at least the point will have been made. He must have some sense that these comments were too frank and slightly confrontatory.

I think if a med student cannot understand that someone with dementia will not always act appropriately, then maybe they need to rethink whether medicine is really for them.

I think it's hard now to mention the clothing without it feeling like victim blaming. It would have been OK to sensitively talk to her at the start of the session but anything after today will probably be taken the wrong way. TBH, her embarrassment at this situation may be enough of a lesson I'd imagine!
I would take the opportunity to open the discussion about how to deal with patients making offensive comments, particularly when you think they may be related to their illness rather than being 'their fault', I'm almost ST3 and still find this a tricky area, I wish I'd had more guidance on this as a medical student!

When my mum still spoke, you'd have got a lot worse than that if someone dressed like that was talking to her! My lovely, kind, gentle mum said the most awful, inappropriate things and HCPs never batted an eyelid.
I'd have made the student cover up in some way before the session - that outfit was not respectful or appropriate for patient contact.

The patient was not out of order, he had dementia.

You have to be really careful how you word your comments about her clothes, focus on how unprofessional it is to turn up in work out clothes to interview a patient rather than how tight fitting etc they were.

The clothing can't be ignored completely, the student knew she would be dealing with real patients in a controlled environment.

That's is absolutely true, but it shouldn't be the primary focus when the student is alleging misconduct from the patient who has dementia.

I think OP has enough go to stand on with the basic premise that the student was so flustered by the dementia patient that shethe studentneeds to swot up on what dementia is and be guided through strategies to cope with it in a professional manner.

I do agree with others who say patients can and should be made aware that their behaviour is out of line. In some cases, that can work wonders.

I do agree the student should have dressed for a clinical setting, not for the gym.

I also agree that no one should have to put up with sexist nonsense in a work (or any other) environment, but that is a different thread, and a different world. It is not based on reality, and the more help OP can give to this student to equip her with methods of dealing what will come her way as a doctor, the better.

I would agree with the posters who say tackle her dress as a separate issue.

She was uncomfortable about personal remarks made by a patient with dementia. This could have arisen if she were dressed differently - the patient could have made remarks about her being overweight, having noticeable acne etc. She needs to understand how to deal with this kind of disinhibited behaviour - and perhaps have a think about how much she has actually studied the symptoms of dementia.

She feels that you handled the situation poorly and embarrassed her in front of the class. I do think that this one needs some two-way dialogue. Maybe you could have handled it better and would benefit from hearing it from her perspective ; maybe she needs to understand why you reacted in the way you did and that you tried to bring things to a swift conclusion as you could see that she was flustered.

Appropriate dress in front of patients is an entirely legitimate concern for you to raise but I honestly think it's separate from the issue of the inappropriate comments. Presumably there is some kind of hospital dress code for staff which you could point her towards?

If you do face to face feedback then definitely have someone else sit in. She sounds like someone who could easily get carried away or take offence to something even if that's not what you said so it's worth having a witness, potentially from HR

...which is not to say that medical staff should put up with any old thing from patients, whatever their condition. But in this case, since you intervened, she should be thanking you, not complaining about you.

I'd leave talking about what she was wearing as an entirely separate issue, which it is. Introducing it in regard to the complaint will only muddy the waters, and may well give the impression of victim-blaming.

I used to send student nurses home when they 'tweaked' their uniform making it completely inappropriate.

She has no place near any kind of patient with such little understanding of dementia.

Tbh you should have turned her away due to her inappropriate clothes

Does the patient / wife know that she has complained ?

What a shitty thing to do with everything else on their plate

And if you have had a complaint made against you, seek independent advice (ideally from your union if you're a member), don't go to HR (who are not your friends/advisers).

Oh my previous message got lost somehow. I was going to say that if you've had a formal complaint made against you you should not be engaging in correspondence at all with the complainer. Write a note of your account of what went on. I would say though that you allowed her to participate in the class. If you thought she was inappropriately dressed, then you should have turned her away. You have the same duty of care to her to all your class members, so I would have thought that the "what did you expect" line will not put you in the best light: as the course leader the question has to be what did YOU expect.

What Keith said.

If she had been a black student and the patient had made racist comments would you have dealt with it differently? It's the same issue, pretty much. I can imagine she might feel undermined - because sending someone back to their seat could look to the rest of the class like sympathy with his attitude. Depending on how it was done (& in your position I'd have been flustered myself, never mind hers).

I think one learning is to brief them specifically on this issue next time and on the fact that it can't be treated quite like the same comments from a compos mentis patient. And remind them of the dress code again.