To think doctors should ask before bringing students to talk to a patient

[thedaywewillremeber]

Ds saw a liaison psychiatrist in a&e this week. He brought along a medical student. Ds finds it hard to talk about his problems anyway never mind with an extra person. Aibu to think they should ask?

They normally ask, sometimes the student is already trhere so it,s abit hard to say no go away.

I’ve had some long-term health problems since young and have had a lot of hospital appointments, mostly at teaching hospitals. I’ve always been asked if I’m happy to be seen by a student BUT 95% of the time that’s been when the student is already in the room in front of me. (I’ve always said yes bar one time).

I had a blood test in hospital yesterday and the person taking my blood got me in position, sat down in front of me and as she picked up a needle said “I’m a student, do you mind if I do this?”

Well actually I did mind but she was right there. I said OK explained that my veins are sensitive and I bruise very easily with needles. She injected me, it really hurt but I said nothing and the person supervising said “you’re doing it wrong“. The student said “she [me] moved”. The supervisor said “no she didn’t, you put it in the wrong direction”. The student tried and failed again and the supervisor took over. They both apologised. I wasn’t mad about that as such but was about being blamed for moving and being put in a position where I effectively had to accept a student.

With your son OP, as it’s a psychiatric matter I think it’s even more important that the patient is asked without the student present.

IMO one of the most important things a prospective doctor needs to learn is empathy and respect for their patient. Giving the patient the dignity and privacy to make decisions about who treats and observed them models this.

Yes they should ask! @mummabubs I experienced similar and wonder why it tends to be in post/ante natal and labour care that women’s wishes are ignored. I’d never refused a medical student and a student doctor with whom I had a fantastic relationship with (I was an inpatient for 6 weeks before he was born) delivered my first DS. When I was in labour with my second the Dr asked if a student doctor could come in to observe and I said no, I’d seen her during my induction and didn’t really feel comfortable with her manner, she didn’t stay for labour/birth but appeared to watch my post delivery stitches. I was so vulnerable I didn’t feel I could ask her to leave.

Yes, they should always confirm consent.

When I was giving birth they asked for my consent to have a student nurse in the room, I said no.

I had one do my stretch and sweep didn't feel I could say no but they did ask.

Of course they should ask, it’s rude not to.

Tendays a doctor asked if he could bring students in. I thought he meant two there was about twelve they could hardly fit in the delivery suite. I was having a normal delivery after a CS. The nurse saw that I looked a bit aghast and ask me again and I said “ Well I didn’t realise he meant so many but they’re here now but does the window cleaner have to be watching?” She looked up to see him with a squeegee and quickly shut the blinds. I had DS2 about twenty minutes later. They missed it but the student midwife saw her first birth. She was lovely and so excited.😀

OP I have always been asked. In that situation I think he definitely should have asked. I would contact the hospital and query it and then go from there.

DD gets this a lot due to her medical history. She’s quite happy to tell them to leave! She’s had a lot of intervention (including mental health services - separate to her medical issues). Don’t get me wrong, she will engage with medical students usually but if she’s an inpatient and having an off day she doesn’t want to see anyone, so only essential staff is best.

It’s always been asked - every single time. And it’s even more important in mental health services, I’m shocked they didn’t ask. And assuming he’s under 16 they should ask DS and you if you’re both happy to for a med student to be present - with DS’s wishes taking priority.

I’m sorry he felt uncomfortable and shut down, that’s really the worst scenario when he’s suppose to build trust and rapport with the MH team. A word to the doctor directly or PALs if you think it appropriate.

Yes they should ask first

I've had this a lot with my eyes, I see a consultant Opthamologist regularly as I have several weird and random things wrong with my eyes that shouldn't combine that do. I just accept it as normal now that there will be a little group of students there when I get there,but and it's a very important BUT they're just looking in my eyes. It's non-invasive, doesn't require me to strip off physically or emotionally and I have weird eyes so I accept that it's useful and unusual for students to get a chance to have a look.

A psychiatrist is a very different matter, they should be very very aware that their patients may not react well to a student observing and should most definitely ask for permission.

Your son will benefit those that come after him

So what? Thats not up to him, his well-being and comfort is all he should be concerned about

They should have asked and NOT with the student present. Thats a form of guilting the patient as many are to worried or feel bad saying no when the person right there. .

Yup of course they should ask and its absolutely fine for you to say no, or just the women can stay, or only one of them, or whatever suits you. Obviously they have to train so if you feel like letting them stay its a great help to them, but if not, no worries.

@TenDays

Friend of mine, about to give birth, was asked if a student of some kind could attend. She replied 'You can bring the bloody window cleaner in for all I care!'

that would have been if I was asked, I am happy to have some students but I would not 50 all staring at me with a clipboard

So yes I am happy to have them but they should ask first

and if my son was happy fine, if not they would be told no

If you don't want the student/s there just say, "I'm sorry, I'm not comfortable with this. Could you leave." When you do that the doctor will always apologise as they know bloody well they should ask.

When in labour with 1st baby and it wasn't progressing fast (ended up emergency section) I was asked if they could bring a couple of students in. In my pethidine high state I muttered why not, every fucker else has been for a look

Agree it is standard practice to ask and very surprised if the Dr didn't.

I always ask permission and I do try to do it before the student is in the room if possible but sometimes that is a bit practically difficult eg in a ward round or back to back consultations where the student is already in the room before the patient arrives. I try to go to collect the patient and ask them on the way but it's possible I may forget until I see the student sitting there.

Another way to do it that I think is probably best is that some clinics will have the receptionist tell patients there is a student today and they should say at booking in if they object and a note can be put on the file.

I got asked a while ago at a doctors appointment and when I said i didn’t feel comfortable with it he said they really needed to stay as they were all sat down and he didn’t want to ask them all to traipse out of the room and upstairs. Made me feel bad for saying no and I don’t know why he bothered asking me. I guess most people just say they don’t mind.

Another way to do it that I think is probably best is that some clinics will have the receptionist tell patients there is a student today and they should say at booking in if they object and a note can be put on the file.

I disagree. Not all consultations are going to be sensitive and I'm fine with students 99% of the time. If it's marked down in notes then students would never be able to attend. The doctor is supervising the student/s and it's up to the doctor to request permission. Isn't that GMC guidance?

I thought the rule was to ALWAYS ask permission from the patient for a student to be present.

@Jonoula

Your son will benefit those that come after him.

His job is not to be a lab rat and he will benefit no one if he clams up and doesn't feel comfortable discussing his medical problem .

On the lab rat thing, I was treated for a rare and often misdiagnosed form of breast cancer last year so my motivation for always saying yes to the medical students was partly so they would be aware of it but of course you should always be asked and be able to say no,

Not all consultations are going to be sensitive and I'm fine with students 99% of the time. If it's marked down in notes then students would never be able to attend. The doctor is supervising the student/s and it's up to the doctor to request permission
It don't have to be on permanent file
Just when you go to reception to say your here for your appointment, they could just say the Dr your going to see has a student with them, is it ok they sit in. Postit note on front to say yes or no student.

Then both student and patient avoid that awkward no moment, patient is comfortable to say no too.

Yes squeekums has explained it better than me. Not a refusal for all time just a post it note on a file for that day that avoids any awkward conversations or pressure on patients as it is decided in advance.
It's true it is the Drs responsibility but they can delegate this to others.
In practice if a student is sitting in on a clinic it's logistically a bit annoying and disruptive to keep sending them out every time so you can ask the patient without them there which is why you often get asked with them there which many people have said they don't like. Asking in advance at reception resolves that issue.

Yes of course they should. Minutes after I gave birth I was told my son may have Down Syndrome. The following day we were both wheeled into a large room to see the consultant, the room was full of students and she proceeded to point out everything that was physically different with my baby compared to ‘normal’ babies, all the complications with his development that he might encounter. He was poked around like a specimen, I was too shell shocked to say or do anything at the time.

I remember as a teenager going to discuss mental health with my GP . Very small country practice . Issues I did not want to even discuss with my parents and had to be dragged in.

GP I’d never met says do you mind if x sits in, she’s on work experience - it was my next door neighbour that I’d known since I was a toddler . Absolutely I minded very much - but I was only fifteen and my mother had also invited herself in .

Thankfully the GP saw sense and kicked them both out . I think I clammed up and refused to speak with three people watching me !

I remember the next day at school another friend who’d been seen that same evening about period pain and she was equally mortified - also having known that lass for years . We had thought that the lass would have said something - i.e that she knew half the patients personally and perhaps she could do this at a different practice !!

As an adult receiving mental health support I was offered CBT - when I first attended man said he was a student, he was going to tape record our sessions so his class could listen later and analyse the session ... Told if I refused I’d go back to the bloody start of the waiting list . I remember just nodding and agreeing - now I think, wth!