Nhs students and lack of consent.

[MarbleQueen]

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.

I agree with this. Unless they’re happy to have partially trained clinicians treat them (which is what many appear to be objecting to), they’re effectively saying that other patients should shoulder that burden. Seems pretty selfish.

It's not a burden for everyone though. I can't care less if students are present but I totally respect other people may feel differently.

We’ve had a lot of appointments where the students are already sat in the room and we’re either just told they’re there or told with “ if you don’t mind”. My daughter has autism and the fewer in the room the better but when they’re already settled it makes it really difficult to ask them to leave.

Uhm, no. Are you a clown?

I am however someone who was trained properly, who has trained many others and understands the importance of people being skilled adequately in order to go on to perform independently at the required standard

You clearly haven’t been trained properly if you don’t understand consent. How alarming you are involved in training others because your anger and contempt for people who decline students is quite obvious. I think you’re the sarcastic poster who suggested I have a card because I’m special.

For those people who think being bullied into having students doesn’t happen here it is folks plain as day. Who wants to be treated by this poster with her scathing contempt for patients consent.

Has it occurred to you that when people have a bad experience with a student they are far more likely to decline students in the future? Who does this benefit exactly?

Ive had students for years and there’s been no problem. I’m now done with being treated badly by some gormless student who can’t be arsed to even introduce themselves and who doesn’t grasp basic consent.

@MarbleQueen

Uhm, no. Are you a clown?

I am however someone who was trained properly, who has trained many others and understands the importance of people being skilled adequately in order to go on to perform independently at the required standard

You clearly haven’t been trained properly if you don’t understand consent. How alarming you are involved in training others because your anger and contempt for people who decline students is quite obvious. I think you’re the sarcastic poster who suggested I have a card because I’m special.

For those people who think being bullied into having students doesn’t happen here it is folks plain as day. Who wants to be treated by this poster with her scathing contempt for patients consent.

Has it occurred to you that when people have a bad experience with a student they are far more likely to decline students in the future? Who does this benefit exactly?

Ive had students for years and there’s been no problem. I’m now done with being treated badly by some gormless student who can’t be arsed to even introduce themselves and who doesn’t grasp basic consent.

Yes, it is the same poster OP. I reported her post saying you should carry a card because you think you’re special - it was nasty and judgemental. MNHQ agreed and deleted it.

I would be very surprised if that poster ever trains anyone in anything other than how to ride roughshod over a person’s genuinely held feelings about wanting consent before having observers present in their medical appointments.

@Witchcraftandhokum

I know it's not a popular opinion but I don't think you should be able to take advantage of free health care but object to people being trained to carry it out.

It's not free, it's paid by your taxes! How dare we ask to preserve our dignity and bodily autonomy in the process, right? 🙄🙄

I had a young student doctor conduct my breast scan this week, then the consultant came and done the same thing and confirmed the students findings. The student Dr thanked me for consenting to him performing the scan, but no one actually asked me. 🤣 It honestly didn't bother me in the slightest though. I'm pleased I can help with their learning.

I've had men previously take advantage of me and have the same hang ups as a lot of women. It's a health care professional though.

@Belladonna12

I agree with this. Unless they’re happy to have partially trained clinicians treat them (which is what many appear to be objecting to), they’re effectively saying that other patients should shoulder that burden. Seems pretty selfish.

It's not a burden for everyone though. I can't care less if students are present but I totally respect other people may feel differently.

So what about people who have a know health anxiety which is on their medical records.

Are they selfish too?

Honestly some people just want a stick to beat people with. Its ok to say no. It won't bother everyone but for others it will be traumatic. Why should those who will find it traumatic shoulder the responsibility for those who it doesn't bother?

@Witchcraftandhokum

I know it's not a popular opinion but I don't think you should be able to take advantage of free health care but object to people being trained to carry it out.

Well, in that case can I have a rebate on my taxes since the NHS is not 'free' to me as a taxpayer?

@Witchcraftandhokum

I know it's not a popular opinion but I don't think you should be able to take advantage of free health care but object to people being trained to carry it out.

So only people with the involve to afford private get right to informed consent? Those who can't pay for the privilege of private healthcare and who have very very good reasons for being unable to have extra people in the room during some appointments either be coerced or can go fuck off and suffer, deteriorate or die?

@draramallama

Posters advocating for a healthcare system that disregards patient consent are advocating for abuse.

I have to wonder why anybody would argue such an abhorrent position.

Probably the type of Tory voter who hates the poor and disabled.

Why would you object? Surely they will go through everything in more detail to show the students and you might even learn a thing or two! How else are we going to have doctors and nurses and HCAs in the future?!?!

NHS consent advisor here. You can and are well within your rights to only have the clinical person treating you present. Ive refused when distressed or have been feeling anxious. They know its nothing personal. Patients often decline.

@HopelessBlue192

Why would you object? Surely they will go through everything in more detail to show the students and you might even learn a thing or two! How else are we going to have doctors and nurses and HCAs in the future?!?!

You mean why would a woman object to having half a dozen young male strangers ogle her private parts and/or awkwardly stare while she undergoes an intimate/scary/painful procedure?

Are you seriously asking this?

@HopelessBlue192

Why would you object? Surely they will go through everything in more detail to show the students and you might even learn a thing or two! How else are we going to have doctors and nurses and HCAs in the future?!?!

Consent is important.

Can you really not think of any occasion where people might not be comfortable having multiple people in the room? For example my first smear after I was raped was an awful, awful experience because it was the first time anyone saw me exposed. You can’t see why I’d prefer that to just be one nurse?

Or that when someone has difficult questions to ask or nervousness they might not want to have the entire thing, their history explained to students rather than just quietly getting things done?

There are enough people who are ok with students that a small number of people not being comfortable with it isn’t a problem.

And a lack of consent is a huge issue with medical things, especially with women, and should always be highlighted

I had counselling (via a charity not NHS) over a very sensitive matter and was asked if I would mind if a student sat in the corner of the room to learn from the experience as it was what helped train new counsellors. I was really shocked and said no. I'm so glad they asked me, I wouldn't have had the confidence if they have sprung it upon me and I think the counselling would have been less beneficial.

@HopelessBlue192

Why would you object? Surely they will go through everything in more detail to show the students and you might even learn a thing or two! How else are we going to have doctors and nurses and HCAs in the future?!?!

Religious beliefs, PTSD, history of abuse, anxiety, being scared, being confused, feeling out of control in an already uncomfortable situation, past medical trauma, health anxiety, ASD, being overwhelmed, being overstimulated, not wanting to have to share a difficult medical history in front of more people that necessary.

There's loads of reasons why someone would say no.

Just because you would say yes doesn't mean everyone else would.

Does this happen to men? Like, would a man be led into the room for prostate exam to find a gaggle of students waiting for him to drop his trousers and have the doc in charge say, oh you don't mind if this lot have a go as well do you?

Warmduscher

HOW DARE YOU.

I've clearly fucking explained that my mum has an SMI and you dare say that. Seriously?????

The reality is. If you are that traumatised you can't speak on the day to refuse or give consent for a student. Then you ring up before stating i need only X person at appointment or you take an advocate or get an advocate to ring up on your behalf. I speak to every new service on my mums behalf before appointments and no doubt always will. I know the importance of informed consent.

My issue with OP is threefold

the tantrumming about the student daring to be in the room as the patient enters and how she claimed that wouldn't be consent despite clearly being asked by the health professional

The demand of a special phone call to them before their appointment (lol really they themselves can't have someone ring on their behalf or picking up phone themselves)

And her frankly, many unbelievable encounters with lack of informed consent (see my previous posts detailing why i think this is)

OP is factually wrong re consent + student initially in the room making it a lack of consent regardless. You are offensive.

Why would you object? Surely they will go through everything in more detail to show the students and you might even learn a thing or two! How else are we going to have doctors and nurses and HCAs in the future?!?!

Ffs what don’t you get?
Yes they do sometimes go through everything in more detail. A previous poster described how she had an intimate procedure unnecessarily done SIX TIMES for the benefit of students.

This obviously hasn’t ever happened to you and I don’t think you’d be happy if it did.

@powershowerforanhour

Does this happen to men? Like, would a man be led into the room for prostate exam to find a gaggle of students waiting for him to drop his trousers and have the doc in charge say, oh you don't mind if this lot have a go as well do you?

Obviously not. Their dignities must be protected at all costs.

@HonestwithHope1 Multiple people on the thread have expressed that the student already being there makes it difficult to say no.

Consent gained in that situation is not genuine consent.

If you don't believe the OP then report them, instead of having stroppy fits at people who disagree with you.

Just because you are ok with pressured consent doesn't mean everyone is. and just because you haven't experience multiple shitty experiences with this issue doesn't mean no-one else has.

Do one Honestwithhope with your gaslighting bullshit. I never said anything about demanding a phone call.Your lack of regard for consent is clear for all to see.

It seems you’re the one having a tantrum at patients daring to say no.

@JustLyra

Then you ring up before if it's that awful to say the word 'no' at a standard apppointment or you get an advocate/family member ect.

Simple.

Multiple people have also pointed out that it takes less than a minute to say yes or no, no excuses needed- and realistically the majority of people will happily answer the question honestly.

I don't believe OP fully. I believe there's elements of the truth and clear emotional hurt here. But no. I also don't agree with op demanding health professionals call her before appointment

I've had one experience in 28 years of life as a disabled person requiring numerous treatment, and I consented but didn't have full informed consent (see post) and never ever witnessed or done it myself re lack of informed consent. So yeah. multiple disregards in the space of a short time, for informed consent is strange.

JustLyra

Why? The post is an excellent discussion that's clearly needed

@MarbleQueen oh give over. We discussed this. You said how in the example of student sitting in room, when arguing with me re in consent, that you should have been told via phone call pre apppointment. Then argued with me how long phone calls take

I'm sorry you are emotional but having a different opinion is not gaslighting you. I don't entirely believe every experience is as accurate as detailed. Your posts and replies are very pedantic.

And i know entirely about informed consent, as patient, carer and professional.so don't worry :)

HonestwithHope1
1- Family members have not been allowed to accompany people for at around 2 years now, although of course you know that.
2- Multiple people have explained why it may be traumatic or difficult to say no, especially if it's worded like "oh this is James, he is a medical student and will be doing your procedure today. Is that OK?"- you'd have to be a fairly confident person to say "actually no, it's not OK"