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Nhs students and lack of consent.
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MarbleQueen · 21/01/2022 21:26

I’m wondering if something has changed within the Nhs. At one time you were asked if you minded having a student being present.In my area they are present at every appointment without any discussion and I’m getting fed up with it.

In the last two years these things have happened.

A student midwife was brought into my room and participated in my delivery without any discussion. She was instructed to break my waters and deliver my baby without any discussion with myself. The midwife focused on talking her through things instead of supporting me. I was alone because of covid restrictions. I later discovered it was the first baby she delivered. I felt like a piece of meat.

I went for a smear and when I walked in the room there was a nurse and 3 very young women present. When I asked who they were I was told they were trainee health care assistants. I objected and the nurse insinuated I was being a bit silly and shy. I left that appointment without it being done.

I had a dentist appointment for my first ever dental treatment. I told them I was nervous. Again when I went in, I was told, not asked that the 2 people present were dental students and would only be observing. The dentist focused on explaining things to them and actually allowed one to place the filling. I didn’t agree to this.

I went to a gp apointment for something intimate to find a man around 18 years old sat in the room. Again I had to ask who he was and was told he was a student. I had to ask for him to leave and it was really uncomfortable.

I had an apointment to have a very unpleasant procedure. There was the usual student perched in the corner without any discussion. Again I had to ask who they were and was told, not asked, that they would be observing. The doctor focused on explaining things to them and when the procedure was finished I actually realised 3 more students had been brought in to watch without me noticing.

I have previously had a type of abdominal cancer. I have checks with scans and have seen the same consultant for years. On my last visit there was the usual student perched in the corner without any discussion. On this occasion, and this occasion only, the surgeon suggested doing a VE. I asked him what information he was hoping to get from this considering he had a recent MRI scan in front of him and he simply dropped it. I strongly suspect this was going to be for the students benefit because it certainly wasn’t going to benefit me.

Each of these places have standard notices in their waiting rooms informing you that a student might be present but this is not consent. I think this is now something you have to actively opt out of instead of opting in.

Has anyone else noticed this happening? I worry about what these students are learning about consent in these circumstances.

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Jellycatspyjamas · 21/01/2022 21:47

I’d be deeply uncomfortable with that, and tbh would probably complain every time. I don’t mind students for some things but the practitioner should seek consent first. There are some things I just wouldn’t allow a student to observe - yes they need to learn but I also have a right to privacy.

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Globaluser · 21/01/2022 21:49

I personally wouldn’t mind students being present and don’t even expect to be told if they are.
But any of them actually preforming any procedure on me, well I’d like to be asked.
It should be written consent in my opinion, you know, in case something goes wrong.

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Diggersaursarethebest · 21/01/2022 21:49

You should absolutely insist on students being sent out if you are uncomfortable OP. You could even ask for something to be put on your file to avoid being continually confronted with students in the future.
But the thing is, if no one consents to being observed or allowing students to perform procedures under supervision then in a few years there won’t be any medical staff? Maybe your local hospital are having issues with not enough patients accepting students so they are having to be less apologetic/more pushy about them.

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MrsJaxTellerPlease · 21/01/2022 21:51

In my trust there are posters everywhere saying that it's a teaching hospital and students will be present. You are more than welcome to ask them to leave however. That said, I've been in both sides of this. I've never had any issue with students being present or attempting procedures. Everyone has to learn. In really appreciated all the women that let me try when I was training.

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ParkingDiagram · 21/01/2022 21:51

You’ve clearly been unlucky to have so many events of students observing. I’ve somehow managed to never once have that happen but it very much depends on the situation.

Dental - no problem.
Gynae - no way.
GP appointment - depends on topic but mostly ok.

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PearPickingPorky · 21/01/2022 21:51

I worry about what these students are learning about consent in these circumstances.

I feel the same as you.

And bring able to gain consent is an incredibly important part of being a healthcare worker.

It's very troubling.

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Coldilox · 21/01/2022 21:53

There has been no change, they still need to ask for consent. I was asked for consent yesterday for a student nurse to be present at the breast clinic.

I always say yes, regardless of procedure/situation.
I’m married to a nurse and know how important it is to be able to observe and learn.

But it’s ok if you don’t consent and there should be no pressure.

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Guavaf1sh · 21/01/2022 21:54

Message deleted by MNHQ. Here's a link to our Talk guidelines.

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1smallhamsterfoot · 21/01/2022 21:54

Why would you not tell them to leave?!?

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Shimmyshimmycocobop · 21/01/2022 21:56

That's not right imo, I work in the NHS in a clinical setting and always ask if patients mind if a students sits in or if appropriate carries out a procedure. I am always at pains to let patients know it is fine to not agree to this.

I was on the other end of this when having a gynaecological examination with a young male patient present. I was feeling particularly vulnerable at the time and wanted to say no but didn't. I wouldn't do that again.

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GrapefruitPink · 21/01/2022 21:56

Wow you've had a lot!
Only happened to me once at a MW appointment.
I was asked as I walked in if it was ok, I said yes.
My MW done what she needed to, listened to heartbeat and felt where baby was. She asked if it was ok for the student to have a go, I said yeah.

But I would always agree tbh. We all have to learn our jobs.

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parietal · 21/01/2022 21:56

you can still complain now. write to PALS at the hospital where you were treated with as much detail as you can.

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Just10moreminutesplease · 21/01/2022 21:57

I’ve always been asked if I was happy for a student to observe, including student midwives during my pregnancy last year.

It sounds like there is a problem with this in your area and I would have been deeply uncomfortable in your position.

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Shimmyshimmycocobop · 21/01/2022 21:57

*Young male student present

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CaptainCarp · 21/01/2022 22:01

Both the doctors I have been registered with have notices up that students may be in appointments & to let them know if you don't want them there.

I've had few appointments with students & couldn't care less as they've got to learn but if you want them to leave that should be OK & you shouldn't feel uncomfortable doing so.

I had a trainee midwife at my booking appointment.. I think she may have been past student stage though.

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Itsalmostanaccessory · 21/01/2022 22:01

I was induced when having my second child. The person who was about to give me the pessary popped her head in and asked if it would be OK for a student to observe. I said yes. She then came through the curtain and 6 of them walked in behind her. I felt like I couldnt say no after saying yes to one person so has to have my legs open with these 6 students all having a good look and having it all explained to them.

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Iwantcollarbones · 21/01/2022 22:01

I’m a student nurse and I don’t relate to what you’re saying. I’m pretty sure we are legally bound to ensure you are aware of our student status and gain consent to be present/provide treatment, or at least that’s how my uni drums into us.

I’m really sorry that you have been so disregarded. I have had one patient so far who consented verbally but it was clear from his actions that he didn’t really want to be cared for by me so I didn’t. You have the right to make those decisions for yourself and no one else gets to be upset by that.

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rjaksieh · 21/01/2022 22:02

Just ask for them to leave if you're not happy.

Mind you I do wonder how you expect all these medical professionals to be there to help you in the future if you don't want them to learn somehow 🧐

Personally I've found student nurses and midwives (both of which I've been very happy to have around) to be some of the very best care I have received. They always seem to still have enthusiasm and been happy to go the extra mile. Plus I love it when they explain loads of stuff to the student as I get to know so much more about the process, which fascinates me.

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Theunamedcat · 21/01/2022 22:02

In my practice the receptionist is the one supposed to tell you about the students and if you disagree they message the Dr and he clears the room

I usually don't mind students I have thyroid issues and in my area overactive is rare underactive is quite common but I'm always asked permission

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SweetPeaGirl · 21/01/2022 22:03

This is not OK. I am asked every time if they want a student to be present, outside the hearing of the student (so either before we go in the room, or the student waits outside). Lately I've noticed that every person in the room at an appointment is introduced even when students aren't involved (e.g. this is HCA Name and she's here to...).

Personally, I have always said yes to students but I would be very angry if I wasn't asked. There are times where for certain procedures or if I'm feeling vulnerable I would say no. You shouldn't be pressured to accept students.

When students have been present, the doctor or nurse has dealt with me as normal, then paused to explain to the student. E.g. conversation with me is finished, then they explained why they asked what they asked. Or with procedures, they ask me if it's OK to explain it first - so they do the explanation and THEN focus on me as they do the procedure.

This is about consent, but it's also a privacy and dignity issue for the patient. You should not feel treated like a piece of meat. The care you receive should not be worse because teaching is happening.

Personally, if I'd had your experiences I would complain each and every time.

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user1493494961 · 21/01/2022 22:03

Sounds like you've been a bit unlucky.

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Ponoka7 · 21/01/2022 22:04

For me it's the lack of interaction. They should be putting patients at ease as well. That isn't their fault. But it's awkward them just observing something that's intimate etc. It doesn't help that as you get older they look about 12.

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Isthisprivate · 21/01/2022 22:05

I understand everyone is different but in my eyes the student is under the same professional expectations as the qualified person in the room. They have a limited amount of time to complete their training and I would prefer they got as much practice in as possible before finding themselves alone with a patient and possibly unsure.

I have had students in with me before and when the doctor/nurse has demonstrated for them I’ve always offered for them to feel free to contribute where possible. Your doctor is only capable of their job because they did the training you are wanting to deny the students.

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draramallama · 21/01/2022 22:06

I worry about what these students are learning about consent in these circumstances.

I agree with you. Unfortunately these completely reflects the NHS's toxic culture around consent - or rather the culture of failing to seek consent and assaulting patients instead.

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shouldistop · 21/01/2022 22:06

When my grandpa was dying I was sitting by his hospital bed holding his hand when a doctor barged into the room with a gaggle of students and proceeded to tell them why he was dying etc.
The doctor hadn't even spoken to ME about why he was dying (although I knew from my mum).
He was so abrupt and clinical talking to the students and ignoring me sitting there that I burst into tears. A few of the students had the good Grace to look awkward and apologetic.

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