To complain about this hospital procedure.

[Ostryga]

TLDR: jr dr does lumbar puncture horribly, AIBU?

Yesterday I had to have a lumbar puncture to check for blood in my spine. I had a jr dr come to explain the procedure and to do my consent. At no time did she tell me she was a jr or that she was learning, but she had come in earlier with the consultant to watch the consult, plus with her scrub colour it was obvious.

I could tell immediately she was very nervous, she was explaining the procedure and it was making me nervous with how she was acting! She was measuring where to put the needle from my hip bone etc and this took 25 mins. All fine I don’t mind. Happy for her to learn.

Eventually I asked if she could go get a more senior colleague as her hands were shaking as she was getting things ready and tbh if someone is putting a great big needle in my spine I want someone who is steady. But up until this point she was going to perform the procedure on her own.

Senior consultant comes in and watches. They still haven’t told me that the jr is still learning. Im still fine and happy for the procedure to go ahead. She numbs the area, then pokes me with a needle and says can you feel that? And I said yes it’s still sharp. She injects again and I can still feel it. So she injects again. I was finally numb.

She started placing the spinal needle and my god the pain. She was hitting my spinal cord/nerves/whatever it was making horrific shooting pains from my spine to my leg to the point i started sweating, shaking and eventually was sick. I’d asked her to stop at least 3 times until she finally did. She only just got the needle out before I threw up.

The consultant then did the procedure on the next vertebrae up and whilst it was unpleasant it was bearable and not painful.

ANYWAY. Is there any point complaining about this? My main issue is at no point was I told she was still learning/hadn’t done many and there wasn’t going to be anyone senior watching. I still would have let her attempt it as I know drs have to learn somehow and I’m pretty relaxed about things like this but it was a pretty horrid experience all round ending up in me having to have 2 lumbar punctures and it taking over an hour. I felt horrendous afterwards and have a bloody sore back now!

That’s really tricky but it sounds like the jr needed more support. I think it is worth informing patient liaison service so that the chances of this happening to another patient is reduced.
There is a real chance of the most horrendous headache, requiring a blood patch, if the procedure isn’t right. Thankfully it sounds as if this hasn’t happened to you but be aware that a blinding headache needs medical advice.
Hope you feel better soon.

You make it sound like a junior doctor has just started after completing their a-levels. Not ALREADY spent 5 years training then another 2 years working before going on to specialise. You can be a junior doctor all your career, right up to retirement.

HOWEVER, yes it should have been explained to you that they were learning/practicing this procedure under the consultant's supervision, and they should have stopped when you asked.

I think they should have been clearer with you and I think it's worth mentioning. That said, I've had lumbar punctures done twice, once by a junior doctor and once by someone considerably more senior and they both made a bit of a hash of it and needed multiple attempts, so no guarantees either way.

That’s honestly what it felt like though. I understand she may have been nervous, but as a dr it is up to her to put me at rest and be reassuring even if she doesn’t feel like it. It’s not a blood test, she was about to put an 8cm needle into my spine!

A “junior doctor” is a very broad term. Any doctor who is not a consultant is classed as a junior doctor, even very senior registrars
Also, having yourself said that you still would have let the doctor go ahead with the procedure even had you known she hadn’t done many (?), I’m not really sure what you would be complaining about.
And I do genuinely believe that in cases of actual poor care complaints should be made.

I’ve had lots of lumbar punctures/spinal injections & plenty of newly assigned f1s doing the procedures (they seem to always be in August -October). They’ve all been well supported by an f2 or registrar/consultant, and I was asked to give consent to them if it was their first time.

It’s never a comfortable procedure, and like all skills I’ve accepted a bit of fiddling as it’s one of those skills that gets better with practice. I’ve noticed with several there is almost a white hot electric shock (especially if there’s sciatic nerve involvement on an injection for pain relief/steroids) if guided by CT which the radiologist warns about (if anything, it reassures everyone they’ve hit the bullseye!). I’ve had the same with unguided lumbar punctures too.

It may be worth bringing up the situation as a learning experience about mentoring rather than a complaint, and they should definitely have been reassuring you as well as receiving their own guidance & reassurance if it was truly their first time (see one, do one, teach one, if that still applies). And definitely should have stopped if you were in extreme pain & sought advice from their superiors.

(That’s superiors including other f1s that may have more experience in a procedure as well as f2s, regs, consultants. They’re all qualified doctors after all!).

Maybe complain isn’t the right wording. More like raise it as an issue going forward. Or just ask them to be more clear in the future.

@CentrifugalBumblePuppy thank you for all the info! Wish I could have talked to you yesterday before it, would have settled my mind!