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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

Should a Dr have done this?

23 replies

Nicecupotee · 07/05/2018 20:46

Last week I went to hospital to have a mole removed. It was quite small, a few mm but the dr had been concerned about it and said I needed to come back to have it removed and have a biopsy within 2 weeks. Then the appointment didn’t come through for two months and it turned out he’d forgotten to refer me. Then when I got to the appointment for the removal, the person doing it was a nurse, not a Dr. I wasn’t sure this was normal but I assumed it was ok as I’m not the expert. She then told me she would be using an 8mm punch to take out the mole as she needed to get clean skin on both sides. I felt a bit uneasy, not knowing what a punch was (was thinking of a hole punch) and also that 8mm was quite large given that the mole was not that big. Anyway, it went ahead and was fine, not painful due to the anaesthetic - but during the stitching she had to call in a Dr to show her the right kind of stitching to do - and it sounded like to do something around the edges to hold it. All quite worrying as he showed her what to do and then left her to it. I felt a bit like I’d been left in the hands of a trainee. I’ve ended up with 6 stitches which seems a bit excessive. Would it be unreasonable to write to the hospital about this? Is it normal for a nurse to do this, and if they are, should they know how to do stitches well enough not to have to call in a Dr?

OP posts:

CaptainCabinets · 07/05/2018 20:52

I’m sure she was suitably trained to undertake the procedure otherwise she wouldn’t have been doing it.

There are lots of different kinds of stitches for lots of different procedures. The closure that the nurse was originally thinking of using might not have been appropriate following the removal.

Are you medically trained at all? If not, how would you know what is ‘excessive’ as far as stitches are concerned? And if you did complain, what would you say? That a nurse did your biopsy, didn’t make a mistake and sutured your wound appropriately after seeking another opinion?

Panda81 · 07/05/2018 20:56

It sounds like what you've had done is correct (speaking from experience of having moles and skin cancer removed) They do tend to take a larger area so if it was cancer then they would be more likely to have got it all out. Number of stitches wouldn't concern me either. It just sounds like they've not communicated things very well to you.

Tamsin82 · 07/05/2018 20:56

Are you medically trained at all? If not, how would you know what is ‘excessive’ as far as stitches are concerned?
As part if obtaining informed consent, it needs to be explained to the patient exactly what is being done. A patient querying something is part of that process. Medical staff are not Gods, and should be able to explain their actions.

KirstenRaymonde · 07/05/2018 20:59

This sort of procedure is exactly what nurses do, it’s pretty basic, no need for a doctor. 6 stitches isn’t excess and to be honest I’m not sure what difference you’d notice if it were 4 or 8.

DairyisClosed · 07/05/2018 21:02

I would complain. It doesn't matter whether she did it right or not. What matters is that you are not sure. That is not OK. I appreciate that the NHS is free at the point of access but medicine is an ethical minefield. I don't think that it is acceptable to say shut up and be grateful that you didn't have to pay for it

CaptainCabinets · 07/05/2018 21:05

@Tamsin82 Thank you for explaining informed consent to me; as a HCP I had no idea

As far as queries go, you’re absolutely correct, but surely such queries would’ve been best directed at the nurse at the time of the procedure rather than at MN?

agedknees · 07/05/2018 21:06

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Tigerpaws57 · 07/05/2018 21:06

Sounds like the nurse did explain the procedure. Did op ask the medical staff for a fuller explanation at the time or is she just asking the opinions of randoms on mumsnet?

Liara · 07/05/2018 21:10

Would you rather she had just done whatever she thought even though she wasn't sure instead of checking that it was fine?

What you've had is very, very minor. If 'trainees' don't do those procedures, then what are they supposed to do?

It sounds like it was textbook perfect to me: she explained to you what she was going to do, did it (checking when she needed to with a more experienced person) and you are fine - what is the problem?

Chickychoccyegg · 07/05/2018 21:12

I've had a few moles removed, some by a Dr, some by a nurse- they do always take a bit of clear skin around it, and I'm sure the number of stitches are fine too.
You could complain that you didn't feel properly informed about what was happening - previous to my removals I've been sent info saying exactly what to expect on the day, and was talked through the procedure every step of the way while there, so i was relaxed and reassured, although im not sure if it would be much use to you now

SubtitlesOn · 07/05/2018 21:13

If they are dissolvable get some Vaseline and put on them and they will dissolve quicker

DiddimusStench · 07/05/2018 21:13

It would be a horrible waste of very precious time for a doctor to perform a procedure such as this and quite rightly nurses are trained to do this. When you excise something that could be cancer, you have to leave clear margins around the site, so a larger area would be taken, yes. It’s not unusual to have a little guidance when stitching, even in theatre at large operations. It’s a skill that people have varying degrees of!

If you want to complain, you need to complain that you were not referred quick enough and seen within the 2 week period. That’s a big problem.

Tamsin82 · 07/05/2018 21:15

Thank you for explaining informed consent to me; as a HCP I had no idea
I thought you might be, as that's how you came across in your response

Tamsin82 · 07/05/2018 21:18

such queries would’ve been best directed at the nurse at the time of the procedure rather than at MN?
Quite often things do not occur to people at the time. This is why things need to be thoroughly explained by the HCP at the time of (or even better - before) the procedure

NotARegularPenguin · 07/05/2018 21:18

Now I don’t do mole removal but as a midwife I do a lot of suturing which I’m very qualified to do. Occasionally I will get mid suturing and not be sure of something and want a second opinion in the best way to carry on. This is after years of experience, I admit I don’t often ask these days but sometimes I might. It’s always best practice to get a second opinion if you’re not sure and it could be that there’s more than one type of stitch or method for what she was doing and she wasn’t sure which would be best....maybe the edges weren’t coming together well? Good for her for asking. It’s the ones who don’t ask when they’re not sure you ought to be more worried about.

Btw, I often see doctors asking for a second opinion from another doctor. Sometimes they even ask me for my opinion as they’re unsure what to do! A consultant even asked me if I thought we ought to section someone the other week! Team work.

MountainPeakGeek · 07/05/2018 21:18

You're right to not blindly trust, but I really don't think you need be concerned about what the nurse did. Sounds perfect.

I have a friend (who is himself a surgeon!) and he has been dealing with the aftermath of a dermatologist who was too complacent in deciding, purely visually, that my friend's mole was nothing sinister.

He agreed to remove it for analysis when my friend pushed for that, but he was obviously already sure it wasn't necessary, so he didn't take a deep enough margin - more lIke "shaved" it off.

Came back as melanoma and certain depth is needed to determine how advanced.

The nurse absolotely did the right thing. Your doctor forgetting to refer you after he'd stated that he was concerned about the mole's appearance is very bad!

clairethewitch70 · 07/05/2018 21:19

I had a mole removed last year, six stitches. It was done by a dr and I don't think a punch was used, I think it was cut out. I had internal and external stitches. I would not have been concerned if it was done by a nurse though - they would have experience in this sort of thing. Maybe it was the nurses first time - they all have to start somewhere.

FunkyHeroCat · 07/05/2018 21:23

Yes, I would be more worried about the GP not referring you than about a nurse doing a perfectly straightforward procedure (and, by the sounds of it, doing it quite well and asking for advice where she wasn't sure).

They do need to excise a margin (have worked in histology labs, they always should), but if it had a couple of extra months and was an aggressive melanoma that could potentially be disastrous.

SluttyButty · 07/05/2018 21:23

Meh, I've had moles and suspect skin lesions removed by docs and nurses. They were all equally qualified.
And my last one had way more than 6 stitches because of the margin required. The nurse was bloody brilliant.
You do know they only key QUALIFIED people do this don't you?

Lovemusic33 · 07/05/2018 21:23

I had mine removed at hospital by plastic surgeon but mine was probably bigger, I had already had a biopsy taken at the doctors surgery but because of the resaults had to had it taken off a few weeks later. Mine has left a large scar on my back, but surgery sounded similar to yours apart from a doctor and a nurse did the surgery, they like to make sure they a have removed it all in case it is anything nasty, in my case I was pleased they got it all.

I wouldn’t complain as long as all is ok now the there’s no reason too?

WeAllHaveWings · 07/05/2018 21:42

I had a mole removed from my forearm around 14 years ago by a doctor, they cutout with a scalpel. I also had 6 stitches. I know because I can still see the dots where each stitch was around the 1" long and fairly wide scar.

I doubt a nurse would have done a worse job of stitching it up.

slippynips · 07/05/2018 22:03

Perhaps the nurse needed help with closing? I had a mole removed by a Dr 3 months ago, but he required a nurses assistance to hold the skin together while he stitched it. I don’t see what you would be complaining about if there hasn’t actually been any problems

Original poster

Nicecupotee · 07/05/2018 22:54

Thanks for the reassuring responses - it does seem like I don’t have anything to complain about except perhaps the 2 month wait when it should have been two weeks - and then maybe because I was fitted in last minute, perhaps I didn’t get the information about what to expect - but glad to hear the procedure and stitches sound normal

OP posts:

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