To wonder why you would say 'No' to student doctors/nurses helping/observing your care?

[Whatsnextforus4]

DD has been quite poorly in hospital with bronchiolitis. She's on the mend now and We can go home today.
Since we've been in hospital the care has been fantastic were so so appreciative of the nhs.
We've been asked alot if junior doctors and student nurses can help and observe our daughters care and obviously have said yes. 4 doctors checked her over for discharge today and while it took longer it was 4 sets of ears and eyes ensuring all was ok all overseen by a qualified doctor.
DH got talking to a nurse and she said alot of people do refuse to let them in.
AIBU to wonder why anyone would decline as those are our future doctors and nurses and they will never learn if they can't see and do ALL of the illnesses and problems that they will have to deal with. You can only learn so much from a book.

I would say yes, but have chased off an SHO who failed miserably to take blood from everyone in the ward. I have poor veins, he couldn't use a tourniquet and didn't listen when I said he had chosen my worst arm. After poking and prodding me for about 10 minutes, he then commented that my hand was sweaty - and there was no doubt he was judging me for this, given his tone. That was the last straw. I told him that he if had had some inept twerp poking about in his arm fruitlessly for 10 minutes or so, he would be sweating too! He could bugger off and not ever come back near me. The other SHO appeared a short time later, asked which arm was best and got blood on the first draw, which is an accomplishment at any time. I developed cellulitis because of his ineptitude.

But other than that, I had student midwives at DD1's birth and a student doctor, called Douglas, who wanted to chat, at DD2's birth. There was a student GP who got blood out, but left a huge bruise and swelling; another SHO who left massive bruising before an op and the lovely student nurse who observed and then looked after me during my recent day surgery. She kindly didn't laugh at my clumsiness on crutches.

I always allow students as they need to learn to deal with everything, but I do struggle letting them take blood - even the most experienced person can only get blood out of my right arm (no idea why, my veins just hide in my left) and I have several students ignore me and insist on my left arm regardless of my protestations and the fact I know my body better than they do, inevitably it means multiple failed attempts and then they go to my right. Luckily I have no issue with blood tests but I do resent being bloodied and bruised because they won't listen

I am often admitted to hospital due to chronic conditions, when it comes to putting a cannula in or injections (subcutaneous, intramuscular and intradermal)

I always offer to let a student do it, be it nurse or medical student. I have awful veins that collapse as soon as they find them, I also will happily let them poke away, it doesn't bother me as long as they chat and have someone to guide them every so often

The hardest time ever getting blood out of me as I was admitted took 3 days before they finally got the samples they needed, it was taken from my hands, wrists, inner elbow, then went for feet, followed by groin then back of knees, finally got it in the neck. There were no students involved on that occasion, they were all SHOs / Registrars and it was Dr #13 who finally hit red. He was called from the children's ward to try, (medical, surgical, psych (the ward I was on). neurology, dermatology, phlebotomy, anaesthetist all failed)

I was seen by an anaesthetist for an infusion a few years and the consultant went to place the cannula, I warned him, they hide and then collapse. It needed done one way or another and he stated in all his years it was the most awkward canula he ever placed. He got it in a place where he said it shouldn't go and had to put it in a reverse position and I had the dubious honour of being the hardest canulation he had ever done. 30 years as a consultant. He got it on the 9th attempt. He felt he had failed me, no I have awful veins and so during that admission, I literally had every medical student in the hospital around to have a go when I needed another canula placing.

When I was pregnant, I had a student midwife doing a blood test... it took her ages and I almost fainted/vomited.

After that I was very nervous of blood tests, and said "no" to students doing them as it made me irrationally nervous.

I'd have no issue with letting them observe stuff, though, or doing injections or anything like that.

I might refuse if there were loads of them and it was going to make the room very quiet, but that's the only reason I can think of (unless I knew one of them or something).

I have not RTFT, sorry.

I allowed student observation on my first birth plan..... big mistake. So by the time it was a real issue I had been wishing I was dead for about 9-10 hours, I was in theatre with the consultant doing trial of forceps (Keilland forceps). Unbeknownst to me (until the next day when a midwife introduced him with precisely this title) he was the one who 'kept their CS rate down'.

It resulted in the consultant showboating. The initial 'move' resulted in him thinking I had a shoulder dystocia ("I think we have a shoulder problem" the actual 'move' gave me permanent issues with faecal incontinence and passing faeces and my DC's face is permanently scarred. It took months to recover from the initial procedure.

I will never be able to prove or know whether his decisions were influenced, even 1%, by the fact he had an audience but I wish to God I hadn't permitted that variable.

@WaterOff
Consent should always be gained, even when in labour, to have students presents. I would’ve complained to the hospital as that is simply not acceptable.

I allowed a group of 4 student docs (not junior drs but 4th year med students) to examine dd in nicu, and a student paeds nurse to do a "top to toe" discharge exam on ds.

I also gave an interview to a student dr so she could use me for a pres after an unusual twin birth.

But I would never, ever let a student do anything intimate, particularly a man. People say they are professionals - they aren't. They haven't completed training and some won't. I used to attend a v prestigious university and lived with some final year and postgrad medics. Some were doing an obstetrics rotation. One woman used to do imitations of women she'd seen in labour and say she didn't understand why they made such a fuss as she herself (also a very talented athlete) "smashed the pain barrier in the gym every day without screaming and moaning".

Several of the men had a "minge of the month" competition where they drew cartoons of women with "gross" or abnormal genitals they had seen on little post it notes complete with patient name and stuck them on the kitchen door in our shared house. Great hilarity ensued

This was 20 years ago and I know for a fact at least one of those men is now a "highly respected" senior gynae consultant at a major London teaching hospital. Lovely.

I have a student midwif for my first and fourth birth and a whole team of people for my third

I have no issue with students as long as they’re not in the way

@AliceGoot

I also have permanent problems from a keillands forceps delivery in theatre. I think at my hospital it is the general process they go through in a lot of instances of foetal distress (forceps trial then if fails a section)

I think the problem is most women don’t have an actual clue what this specific type of forcep is and what the risks are, and that most of the time a c-section is an alternative option. If I had known I don’t think I would have chosen that route. That’s a whole other topic of conversation though..

When I was 10 hours into my labour, I was asked if a male student midwife could examine me. I was horrified and said absolutely not. I now wholeheartedly regret this decision and wish I could turn back the time.

3 years later, a student doctor picked up during a paediatric appointment that my daughters collar bone was abnormal. He guessed it was caused during the said labour. But that started a 5 year journey, whereby it was discovered that my daughter didn't actually have a collar bone at all. Side then, she has attended seminars with student doctors, who have been asked to examine her to see if they could pick up the abnormality. This has come to an end now as she will be operated on shortly to create a collar bone, but I feel I've done a little bit to try make up for my previous mishap.id never say no to a student again.

With DS2 a student midwife examined me during labour and made a mistake which lead to problems as the qualified midwife never checked, with DS3 I politely declined to have a student just because I was very anxious after what had happened with DS2. Up until then I was always happy to have students and I think I would agree if they wanted to examine me or DC now if a qualified doctor/ nurse checked, but with DS3 I felt it would have just stressed me out during labour!

I had a very complex pregnancy and spent many months in hospital (which is a regional teaching centre) and you barely saw a doctor without an entourage of students trailing behind. I even got used for the doctors' exams, I would enter a room where a panel of doctors/examiners were seated and a doctor would be told my condition and they would be asked what procedures were applicable and had to scan/examine me. Generally I was fine but now I would probably say no to anything remotely intimate. What really bothers me is when doctors ask in front of the student 'oh I have a student here, do you mind...?' I would also refuse it I knew the student personally.

My mum had a room full of student doctors when she gave birth to me. I'm quite proud of that. I always say that I've been teaching professionals since the day I was born, lol!

@Johnny - that is a very sad and immature story re: minge of the month....actually it's mysognistic. My DD was fortunate to be allowed obs on gynae patients and this has been a deciding factor in her interest in womens health. What a shame a few idiots let the cause down.

I mainly say yes but have said no when I was going to find it difficult enough to discuss my things with the GP without someone else sitting silently watching.

@Larrythelamb84 can I ask why you have such a strong feeling of regret around not allowing a student to examine you? Chances are surely that they would have had the opportunity subsequently?

I'm a student paeds nurse. To the enormous credit of the general public, I've never once had a parent object to my involvement in their child's care. In fact, I'm entering my 3rd year now and have spent the last year taking my own patient load whilst on placement, even in some more high stress environments. Obviously not with the same number of patients as the qualified staff manage and I'm always very well supported. I think it's extremely important for our learning that we get to do this. I've built some very good relationships with children and their parents and always make it very clear to them that if I'm not sure of what I should be doing, I'll always seek help rather than pretending I know everything.

That said, my placements have never so far exposed me to a patient who needed an intimate exam and cannulation isn't one of our pre registration competencies. I completely get why that might be a sticking point for many.

I've only read about 70 responses so far but will definitely be reading the rest! It really is so important to allow students in all healthcare fields to get involved. If everybody stopped, we'd be left in a position where qualified professionals are expected to perform in situations they've had no exposure to.

Tink yep.

They were not "bad people" either. Just very privileged and sheltered and never done anything other than that career. Little life experience and thus limited empathy.

I am friends with some of them on social media and the woman with the imitations now has dc. I sometimes wonder what her labours were like and if she regretted her earlier attitude. The chap who is now a gynae was actually a pretty nice guy when not showing off for his friends.

But they were young and immature back then and I definitely wouldn't want someone like that involved in intimate care.

@Miyah I am in no way disagreeing with you that consent needs to be taken and nothing should be done without the appropriate consent. The patient should know what will be done and who will / potentially could be doing it. We are on the same sheet here.

@Leftrightcentre Apologies if you think I come off "sneery". you clearly havent seen my posts advocating that its a patients right to refuse. I just did not like your tone about "arrogance of the profession". They will have done extensive training on simulation models and on each other prior to doing them in real life, but someone has to be the first patient. Even when patients have normal signs nothing but practice will prepare them to mix the communication / empathy and clinical skills to deal with real life patients.

Absolutely, at my last smear test the nurse asked if a student could observe, he was male and she was very lovely and made sure to stress that I could absolutely say no if I wanted to - but I said yes as it was routine and I had nothing to be embarrassed about. And to be honest I’ve had 3 babies so countless numbers of people have been down that end now

I can understand in some situations you may want to say no though, each to their own.

The ONLY time Ive ever refused was just befire I was induced with DD

I had to have an internal examination nd the consultant turned up with a troupe of students, starting digging about and loudly announced "her cervix is tilted back and her anus is full, who wants a feel"

I almost pushed him off me and skmehow found the guts to say 'None of your are having a feel as he puts it"

I have also been a patient, and pretty recently had a very traumatic time as one. I let students be present at all stages. my personal choice of course, but they need to learn how to handle such situations and you cant learn that unless you are experiencing it.

@5SecondsFromWilding I hope you also recognize that it's really important that no one feels any compulsion to consent to students when they don't actually want to. There should be no pressure and no chiding of people who say no.

I wasn't talking about abnormalities. hmm There's been a litany of posts even on this thread about routine procedures like bloods and pelvic exams, epidurals and the like being performed by people who obviously haven't practised enough. It's arrogance to inflict someone on others until they're demonstrated competence in such basics by practising on one another and it's a lot of the reason you hear why patients are saying no. The tone of your post just exemplifies it. Are you this sneery in real life to people?

The ethics of giving someone an epidural when they do not need one are highly suspect. They actually have to be carried out on someone who needs one.

Lets take this a step further, practice doing a c-section on someone who doesn't need one, indeed is not even pregnant, because they are a fellow student. Somehow, I don't think so!

you clearly havent seen my posts advocating that its a patients right to refuse. I just did not like your tone about "arrogance of the profession".

So you responded by becoming defensive and implying that I am somehow incapable of reading comprehension . Nice. It's like you don't even have to pay out rope with some people, they do the job themselves.

I'm of the opinion, based on personal experience, that there is definitely arrogance in the profession, and from the posts on here, I am from from alone in this sentiment. I'm not at all surprised, for example, about the 'Minge of the Month' post. But rather than address it, you become even stroppier.