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?

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

Yeah, that right there. The days of "sexy nurse" are long gone, and while I fully support the idea that people can dress as they like and not be harassed for it...this changes when in a professional setting.

I'm not talking about programmers who aren't hired because of tattoos or long hair, I'm talking about jobs where it matters how the person dresses.

A doctor should be all about the patient, not all about herself. Obviously this can have some leeway, depending on the role, but it's very important that the professional is doing everything possible to make the patient comfortable, and confident, in the person providing care and expertise.

Complaining about a dementia patient being inappropriate is like complaining about a patient undergoing chemotherapy being sick on your shoes.

Hi OP

I work with medical students although not a medic myself. We have had trouble with professionalism and dress.

The clothing needs mentioning, it was totally inappropriate dress for dealing with patients. I'm not in a position where I would "discipline" a student and I think I would have let it slide if it was a lecture with me but would have told her to put scrubs on for patient contact.

I would only commit to email that you need to speak with her in person. I would seek advice from her university and refer her up to her clinical tutor. In terms of the dementia patient - yes I would expect her to have some compassion, why be in the role otherwise - but sometimes the students lack experience of dealing with different types of patients, she needs reminding that she will have to develop strategies to deal with situations like this.

Similarly, she may need reminding that as a student, the clinician (Dr or other healthcare professional) can step in whenever they feel it necessary, for the student's benefit and/or the patient's. She has no grounds to say you embarrassed her, she is not yet working as a doctor.

I'd cut her some slack. She's young (I presume?), she misjudged the clothing situation, probably because it was in a classroom setting. It happens (it certainly did several times in my medical class). She probably won't do it again.

I'd respond (either in person or by email - maybe get some HR advice on that) with the following points:

• acknowledge her distress - it's never nice to be on the receiving end of sexually offensive comments

• working with dementia patients can be very challenging

• disinhibition is a common feature of dementia and the patient cannot be held responsible for the things they say (mention how particularly distressing this is for family members)

• older patients especially expect doctors to be dressed in quite a conservative manner and this can affect how they interact with staff

• all patient contact sessions should be treated as professional encounters, and appearance and behaviour should reflect that

Surely the Op cut her some slack when she allowed her to take part & cut the interview short?

I'm sorry but even dementia patients can be reminded not to be so fucking rude! No, she shouldn't have worn that, but she shouldn't have to put up with sexual harassment either.

Have you ever looked after anyone with dementia? I hope not!

You cannot argue logic with someone who has lost their logic! It will only upset them and frustrate the person trying.

No way is sending her back to her seat sympathy with his attitude, it is sympathy with the patient and taking him (and her, but she is not the priority in a Dr/patient situation) out of the situation.

She should have dressed professionally. Simple as!

Oh, and while I am at it, a few words of advice directly for her 'Toughen up, buttercup'. She will get a lot worse in the future, and probably from people who have capacity!

I train HCPs.

I would respond to the complaint by offering a meeting to discuss the situation. Whilst at the meeting I would ask her to clarify what she is complaining about, I would ask her what she thought should have happened in the session (i.e. what should you have done differently) and what she wants to happen as a result of the complaint.

During that discussion I would be highlighting the impact of dementia on a person's inhibitions and boundaries. I would explain that whilst I understand that it was a challenging situation for her, she could use it as a learning experience and reflect upon it - what did she deal with well, what could have been improved.

I would also be explaining my perspective in terms of trying to optimise her chances at passing the assessment and balancing this with keeping her safe and preserving the dignity of her and the person with dementia.

Sounds like she is externalising all responsibility for a challenging situation rather than learning from it - is she quite young / new to the field? By which I mean, is she likely to have come across similar situations before?

I don't understand his comments at all,

That's victim blaming. Yabu.

The fact that she didn't wear suitable clothing is a completely seperately issue.

limon are you serious?!

I just can't get past that she is complaining about his attitude-the attitude that he has no control over due to his illness?

How seriously will that be taken?

limon - it isn't, it's professional behaviour and common sense when working with vulnerable people who have very few inhibitions.

I think the student's inappropriate clothing needs to be treated as a separate issues otherwise it does feel and sound like victim blaming.

The gentleman has dementia so his ability to self-regulate such comment makes this a different to a scenario where you should have overtly castigated him for making offensive comments. You did what you felt was appropriate by removing the student from the situation.

You need to ask yourself would you have handled it any differently if the student had been more professionally dressed. Perhaps checking she was OK at the end of the teaching session?

The other points that may be relevant is whether you are male or female (are you reacting with male privilege?), what year the student is, most medical schools have guidance for students about appropriate dress/behaviour when meeting patients or attending tutorials I would check what they are.

What Cel952 said

Victim blaming?

Have you read any part of the OP... the bit were it is explained that this is about the words of a man with dementia and a student who is supposed to be learning how to deal with patients?

I'll try to make it easy for you:

In this case her attire is what sparked the comments from a man whose illness disinhibits him. He is ill, he is not in control... that is why he was there, so she could practice her patient liaison - she failed.

It is now not to blame her for her dress, her attitude, but to try to explain it to her so that she comes to a mature and sensible reflection and learns from it.

She needs to learn about the importance of "dressing the part". The only way she will learn is if it is made clear. Or is she supposed to just try and guess this part of the course?

It sounds like there are two issues, the first has led pretty much directly to the second.

Probably, she shouldn't have been allowed to complete the exercise. If I turned up to work looking as you've described, I'd be sent home to get changed (I'm a doc). It's unprofessional and the fact that she dressed in this way makes one question her attitude.

This has led to a dementia patient making comments that a) flustered her, and b) she has complained about. She needs to get better at the management of inappropriate patients - they are a fairly frequent problem in medicine. Sometimes it's not their fault, other times you encounter not nice people. You have to learn to deal with it, she may need help with this. I did. She also needs to learn some more about people with dementia. It's simply not appropriate to complain about them in this way, and again, she needs to be sat down and have this explained to her.

If I was her tutor, I'd be very concerned about her and would want these issues addressing before she gets much further through medical school. It needs doing reasonably formally I would expect.

Also it occurs to me that if you are to be subject to a formal disciplinary procedure, posting about it online might not be the smartest move... Hopefully it will be resolved before things progress. But personally I'd want this thread deleted, for my own protection.

My great nan had dementia.

She was convinced that her son,my grandad, was her husband.

It meant we couldn't go and see her because in her eyes me and my sister was toddlers and my dad was still young.

Distressed her horribly when my dad turned up once and she couldn't understand why he was suddenly old.

I would address these issues separately. Firstly, I would say that I was sorry that she felt embarrassed. I would remind her of the issues regarding communication with patients, particularly those with dementia. I would ask her how in a clinical setting she would have coped with this patient, would she have persisted? Told him off? Got someone else? put some bloody clothes on

I would then also cc her into an email to her tutor about this issue, couched in ever so lovely language about attire and professionalism.

Fwiw, please do deal with Med students who come to clinical settings inappropriately dressed. I now have to deal with very junior doctors who come to work in the most inappropriate clothes (as the only female registrar it seems to be my role ). Some patients are elderly or you know what just want a doctor to look like a stereotypical doctor because they're ill and scared and need to have faith in the person who's looking after them.

If Ive understood this correctly, she has complained to you about your handling.

I would simply say that you could see she was flustered by his personal remarks and that you asked to sit down so yiu could fund a way to deflect them.

The priority here is to make it clear that you didn't do anything wrong so that HR or whoever knows that. Keep in mind that whatever exchange you have with her will be used if she decides to take it further. She has been very stupid but don't point that out in any correspondence, it's the wrong context to raise it. You need to defend yourself.