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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Nhs students and lack of consent.

805 replies

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.

OP posts:
CherryPieface · 21/01/2022 23:36

I remember being a student with heart issues and being asked if students (at medical school at my university) could observe. I said no, I see these guys in the Union etc and I don’t want them to see me with my top off etc. doctor was really pissed off and I felt terrible but I still think it was the right thing to do.

OrlandointheWilderness · 21/01/2022 23:36

I'm a student nurse. Every time I meet a patient i introduce myself and ask if they are happy for me to be there during whatever I'm there for. I wouldn't think twice if they said no, and I wouldn't think any the less of them for it.

AutomaticMoon · 21/01/2022 23:37

@shouldistop I found out I’m an organ donor almost 2 years after I became one, completely unacceptable.

MargaretThursday · 21/01/2022 23:37

I've always been asked.

I will say that the student midwife when I had dd2 was absolutely amazing. She also gave me some knitted bootees her mum made for all the babies she delivered. I've got them in dd2's memory box.

Spicez · 21/01/2022 23:38

[quote AutomaticMoon]@shouldistop I found out I’m an organ donor almost 2 years after I became one, completely unacceptable.[/quote]
Were you planning to do something else with your organs? Would you accept a donated organ if you needed one?

AbandonedCharacter · 21/01/2022 23:39

'Apart from your birth story which does sound awful I think you're being a bit of a drama queen'

I'm going to assume that you missed that OP was a victim of abuse.

Wardrobes123 · 21/01/2022 23:39

I have seen a couple of incidents where a student has been present and no consent obtained. I also had to make a formal complaint when a junior doctor attempted to take blood from my needle phobic teenager while he was asleep (my son had a detailed care plan due to phobia and other issues - so obtaining consent from him was an absolute before any procedure). These things do happen.

My DS had regular hospital stays and used to love entertaining the students and answering all the questions they had about his medical condition. He was used as exam practice for several years as the doctors knew they could trust him.

But he had a difficult couple of years medically, during his teenage years. He quickly started refusing students as he felt very exposed and self conscious. On more than one occasion the students didn’t leave - DS told them to leave or he wouldn’t co-operate. For him it was so much more mentally than he could cope with. And that should’ve been respected during a difficult time.

I understand all students have to learn somewhere but when it is medical it is more sensitive and so a patients consent should be obtained and the patient able to refuse without any awkwardness.

superking · 21/01/2022 23:39

Personally I'd far rather be treated by a student doctor under the supervision of a more experienced colleague, than the same student doctor a year later, newly qualified and with no one else observing/ advising. Obviously the ideal would be for everyone to be treated by experienced doctors but that's impossible!

Yes legally consent is important, but except in extreme cases I think it's pretty selfish to refuse it - how else are students meant to learn? And if they don't learn, we will run out of doctors. It's basically saying it's fine for them to practice on other people but not on you!

Zombiemum1946 · 21/01/2022 23:40

I work in the nhs and usually consent is asked for at least 2 times. I will ask before taking the patient in and the doc will ask when the patient comes in. If the student is going to examine the patient the specialist will ask for consent and so will the student. Make a point of saying you want it made clear that you don't want students present at any apps. I've only had 3-4 people say no one the course of 20+yrs so it may be being taken for granted that you'll be fine with it. I'm so sorry you've been through this.

NoRaceInThisHorse · 21/01/2022 23:40

Were you planning to do something else with your organs? Would you accept a donated organ if you needed one?

Not at all the point.

HonestwithHope1 · 21/01/2022 23:40

@NoRaceInThisHorse. Nope. Informed consent between health professionals/patients then depending on area of work we may ask admin/receptionists to do that or we ourselves would make a note.

Think we'd be hung if we took only our admin staffs sayso for consent. (Only kinda kidding)

Obviously for future appointments it's not an issue if that's on the system (remember not many places are joined up)

I find it laughable that someone is raging about a first/or one off service appointment getting agro about consent being asked not in the exact way she'd like.

Consent or no consent. That's pretty simple ask and I have never seen anyone ignore consent like that and as often as OP is apparently experiencing

The one experience I had was personal and i 'only' lacked full informed consent by a surgeon giving me medication he shouldn't have. (I consented but didn't know it was against nice guidelines for my disability until i looked it up after as i had bad effects)

Informed consent is vital obviously. No one is saying it isn't and I'm sorry to see others have had the rare (individual wise for them) bad experience with this.

I'm disabled all my life surrounded by health professionals and surgeries. I've worked/trained//volunteered in healthcare for 10 years. Never ever witnessed non consent of anyone sitting in on appointment or doing any type of procedure.

So i do take skepticism with OP.

Sandyjag · 21/01/2022 23:40

The gp once left the room and I asked the students if they had done any study on consent and they said no and they didn’t know much about it. A friend trained as a midwife and had to stay an extra 6mo to complete her studies because she insisted on getting consent from each mother she worked with during their birth. Which you’re meant to do! But ppl just don’t.

CherryPieface · 21/01/2022 23:40

I’ve also had several situations with students, my doctor’s surgery is attached to a hospital/school of medicine. Only time I’ve been happy is when I first tried the pill as an 18 year old and my blood pressure went through the roof. My GP brought in loads of students to see that and I was happy to help.

EmbarrassingHadrosaurus · 21/01/2022 23:41

For the PPs who affect to be unconcerned about this—I wonder how many of you ask what the young people are students of?

There's a distinction between someone doing an internship (UK sense, not the US medical sense) or work experience, and somebody who is an actual healthcare assistant/medical, nursing, or affiliated healthcare student.

I quite understand why people would be OK about a student in a teaching hospital but that is not the same as an A level student doing work experience at the local GP practice to fill out their application to medical/nursing school.

www.bma.org.uk/advice-and-support/studying-medicine/becoming-a-doctor/getting-medical-work-experience

MarbleQueen · 21/01/2022 23:41

I’m intrigued about the dental students as I thought they only practiced in designated training centres attached to hospitals and clinics which make it very clear students will do the work. I’ve never come across one at an individual practice

Me neither. And I’ve been at this practice for 20:years. I probably should have complained but then I worry about getting kicked off or having a funny atmosphere next time I go. I’m pathetically grateful for having an nhs dentist.

OP posts:
Xmassprout · 21/01/2022 23:42

I have always been asked. I had my smear done in the last few months and i was asked if someone training could watch

NoRaceInThisHorse · 21/01/2022 23:43

HonestwithHope1 Admin can ask and flag a clear "no" surely? Doesn't affect the treatment in any way as they would still see their HCP for what they came in for. Doctor/student can then double check the others.

Dinosauratemydaffodils · 21/01/2022 23:43

You walk in, see 2 people instead of 1.

You are asked if you will allow student to observe (however way they phrase the question you are still being asked)

You say no

Or you have a diagnosis of ptsd and had a childhood which left you terrified of conflict so you say yes and then end up retraumatised/miminising why you are there because you can't discuss it in front of an extra person/a male.

When I was in labour with dc1, it was phased in such a way that the poor student would be kicking about with nothing to do all night if I said no. I was already 60 odd hours into back labour with no sleep for 4 days and didn't feel I could say no without coming across as a total cow.

StoryOfANewName · 21/01/2022 23:44

If you do not feel comfortable being asked by the receptionist when booking, or in the clinic at point of care or wherever, I wonder if there could be a solution like flagging on your notes in all these different settings that you do not want to be asked at any point if students can be present as you do not consent to it. I can imagine must be worrying now with each upcoming appointment about who else is going to be there, and whether or not you’ll feel you have a realistic chance to say you don’t want them there.

From the points of view of students, it should be like water off a duck’s back to be asked to leave by a patient, but I appreciate a patient’s perception may be different.

Blossomtoes · 21/01/2022 23:45

but that is not the same as an A level student doing work experience at the local GP practice to fill out their application to medical/nursing school

That wouldn’t happen.

Sub1required · 21/01/2022 23:45

I'm a more the merrier kind of patient.

Students need to learn and they are curious, in my experience more caring.

I actually stated in my birth plans that I was happy with to have a student midwife present. I was lucky enough to have one too, held my hand while I pushed. I apologised to her for having been at the wrong end 😁

I'm currently undergoing tests for something very often misdiagnosed and if it's that hope there are students present so I can explain how it feels and they can take that away for future patients. Even if it helps one other person, not suffer the pain I have for along time.

Chouetted · 21/01/2022 23:46

Completely normal to have a student in on most appointments if you live in certain areas. I always said no in case they were someone I knew from uni! Outside of those areas they're much rarer, so understandable some people might find it unlikely.

HonestwithHope1 · 21/01/2022 23:47

@MarbleQueen

You literally said you didn't want to see any students.

Look. If admin/receptionist started asking you invasive stuff on your first visit, you'd probably kick off at that!

For healthcare. Healthcare staff. Not admin. Not reception.

On your first appointment need to ask consent for treatment also re their students THEN

IT CAN BE ADDED TO YOUR FILE.

And you'll never have to lay eyes on a student unless god forbid they qualify and have to treat you

What is the bloody big drama??

MarbleQueen · 21/01/2022 23:48

That's a huge list of appointments all with all these students milling about?

No it’s not huge at all. As the op explains 4 are standard. Do you not have smears and dental appointments? Do you think I should have had the baby in the woods?

A dentist appointment
A smear test
A go apointment
A birth

2 appointments regarding an ongoing condition.

OP posts:
NoRaceInThisHorse · 21/01/2022 23:48

@Blossomtoes

but that is not the same as an A level student doing work experience at the local GP practice to fill out their application to medical/nursing school

That wouldn’t happen.

It quite clearly does, and a simple Google would tell you that.

www.hee.nhs.uk/our-work/work-experience/north-east/opportunities-primary-care