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 remember when I was about 11 and hospitalised with an asthma attack having an enormous gang of students observing me have a chest examination with no top on. My boobs were just starting developing, I felt very exposed and embarrassed and hated it but I didn't feel I could say no to it and I wish I had but I was too young to realise that.

Last time I saw my gynaecologist she had a young attractive male student with her and it felt bonkers showing him my bits. I went home and DH and we had a good laugh about it.

Depends on the concern.

GP often has trainee GP in the room. I'd not hesitate to say yes I the past. Plus when I'd just had my first child the MW came around with trainee HV. I had to show her my boobs and my torn perineum... that was ok (though I was delirious!)

In last few years I've been very ill with severe depression. Once having just been discharged from hospital, still v suicidal and the doctor asked me if the trainee could listen in.

Given I could barely speak to my trusted GP I said no but felt guilty about it when I could think clearer later on. I'd imagine my case would have been excellent example for a trainee but if felt like an added risk for me at the time.

When I was 25, I had my first melanoma. I was asked to undress to my knickers while the consultant examined me, then he popped out of the room for a minute. He returned with seven students who all stood there while I had my arms crossed across my breasts, discussing my youth, my condition, my skin tone, what would happen next. That was horrible - and in a teaching hospital.

Second time I can remember, I had a student midwife plus a qualified one at DD2's birth. They were both absolutely lovely, but I did refuse a student exam at one point - they asked me mid-contraction and I said no bloody way. once the contraction had passed I said she could if she wanted but she didnt by then - is there something about a mid-contraction exam which is different?

They might refuse for so many reasons...
Previous poor experiences with medical professionals
Being scared and emotional
Having experienced abuse or trauma
Being very shy or introverted just to name a few.
I was a student nurse once and I was hugely grateful to all the patients who allowed me to observe or practise care. Particularly to the very patient man who I did my intravenous cannula assessment on. I equally respected people who said no. I’ve always tried to be very open when including students in my own medical care and my IVF but who knows if I’ll ever say no.

I've always been happy to have students observe, even in gynolacology when I had 3 men peering into my vagina to observe my prolapse. I'm lucky I feel comfortable and relaxed in hospital and I hope my cooperation will help their studies.

I can however understand that many patients would not be comfortable with this!

I’d usually say yes for myself (though the parade of student midwives who asked if I’d tried ginger while in the second trimester with hyperemesis were bloody tedious.

But I think it’s different for kids. DS had a fair bit of medical stuff as a baby and toddler. A lot of prodding around his head and face, which he hated. I did decline students sometimes, because he couldn’t consent for himself and he already didn’t know what was going on without exacerbating it.

We were in a&e recently for something unrelated but he was very poorly and distressed. I was really grateful that the number of people we saw was kept as low as possible.

It would be a lot more productive to ask what medical professionals can do to make people feel more comfortable at the idea of students/observers. Just saying 'well, they need to be trained, so you should offer up your body as a practice tool' isn't enough.

Judging from the experiences here, many people are fairly willing, by default, to have various procedures observed - but that one negative experience will make them reconsider.

I don't think any student should be allowed to observe or participate until they've understood how their behaviour may affect the patient's experience and influence any future choices. The idea that you can somehow hover at a distance, observing but not really involved, is especially problematic. Judging from the experiences here, it would really help if:

• students are always introduced or introduce themselves from the outset. They are clearly indicated as students before they begin any procedure, however minor.
• consent is obtained in advance, ie you're not in a situation where students are already in the room (or on the doorstep) and the patient has to ask them to leave.
• students do not act as if the patient is a physical specimen or case study. Whilst in the patient's room, they don't discuss the patient as if she can't hear or understand.
• when students leave, they thank the patient and say goodbye: just a small gesture to acknowledge you're human, not something on a slab.

I'm sure all of these are already considered best practice, but it doesn't always seem to work out like that.

You seriously don't get why someone wouldn't be comfortable with 6+ trainees examining her vagina, in? Even if they were, say, survivors of rape, sexual abuse, have religious beliefs, or just don't feel comfortable with it? The mind boggles! How dare some women want their female space protected, eh ? That just makes them stupid and selfish compared to your amazingly virtuous self.

inTheBoredroom

Refusal has bugger all to do with stupidity, or selfishness, or any other reason where you see fit to attack those who say no.

I've said yes on occasions, but have also said no, when I wasn't feeling comfortable with the situation. That is my right. You can't just expect everyone to say yes when in doing so that patient could become distressed.

I always say yes - I was actually slightly proud, in a warped kind of way, when a consultant asked if he could send for more students to see how horrifically bad my colon was in the middle of a colonoscopy for a very severe ulcerative colitis flare! I totally understand that people might be anxious and not want extra people around, but it generally doesn't bother me (and the students who saw up my bum came to find me on the ward at the end of their shift to thank me, which I thought was lovely).

I’m very happy for students to sit in and observe appointments. However I would think carefully about allowing them to perform procedures after a bad experience during a smear test - 3 failed attempts to insert the speculum and rather a lot of pain and embarrassment for me. The practice nurse had to take over in the end.

DD did a week shadowing a consultant when she was16. Not one patient said they were not happy to be there even tough some had cancer. I would have thought patients saying no to be more the exception than the norm.

@kaitlinktm where was she? That is EXACTLY what happened to me, 18 years ago. I wonder if it was common practise.

All those who are more selfish need to remember what enabled them to be treated so well.

I once had a patient who had been gang raped. No one even asked if she consented to a student in the room, we kept the students away. We (NHS professionals) are human and don't mind anyone saying no for any reason, it is your body.

Depends what the medical issue, circumstances and medical setting is. We started refusing students in my mothers end of life care, as every time there was bad news to be delivered, the doctor would stride in followed by 5 students. They would all do the head tilt sad face while the doctor imparted the grim news, then all troop out of the room looking very satisfied once he had finished. Eventually it became a bit too much for mum and us too.

Quite happy for students to sit in on regular gp appointments though.

The people saying no to students at gyn appointments especially men, why shouldn't they also be trained? Some men go into the gyn field so how are they meant to learn if they can't be taught on real life cases?

Men who go into medical fields which exclusively deal with female anatomy should fully understand that some women will not be comfortable with them.

Any male doctor who feels his personal ambition to be an OB-GYN or similar is more important than silly women's feelings, and that all female bodies are his personal teaching opportunities, is in the wrong specialty (or at least the wrong century).

The short answer - stupidity.

WTF

I’ve only declined once. It was an issue that was stressful for me and I only wanted to have to have the conversation once.

My spouse often declines because as a child who spent much of his life in the hospital, he occasionally experienced more invasive or painful procedures being used than was absolutely necessary, simply because the student needed practice. Thankfully his parents caught on and learned to never leave him unattended under any circumstances.

I.personally woylsnt mind , i was once a student nurse , im.not sure i would want students practicing onbmy son though" he autism and learning disabilities and things can understandably take a lot longer with students which would up set him.

When I had my very premature baby I was asked if a student could do a case study on me. I said yes (before she was born) but didn't realise it would involve a 2 hour interview with her when I felt really ill then a further visit after the birth with so many questions about the baby. I was wishing I had said no.

For those saying it's not your responsibility to teach them, what will you do when there are not trained drs to help you, why should some and not others be expected to let them in.

I do however agree that some cases it's just not possible like knowing the students personally or a child with ASD becoming overwhelmed. That's understandable really.

I had a whole bunch of medical students come in when I was in the middle of labour. What with them and the paeds and the midwives and the anaesthetist and three doctors of varying ranks, it was like a march past at Trooping The Colour!!!

"The short answer - stupidity."

Stupidity would be allowing someone to be put in a situation where they become very distressed, are unable to be examined, hurt themselves and lash out at the people trying to examine them.

I would say no to someone carrying out a procedure on ds as a student unless it was something they are experienced in - he is autistic and can be a bit of a pain for blood tests after a bad experience so it wouldn’t be fair on anyone.

He spends a lot of time at hospitals and what I like is when they explain they are learning and ask him if they can watch/help etc - they will go a long way in peads if they can relate so well already!