Reasonable professional behaviour-Internal examination

[Sunnywithchanceofshowers]

Today i had a gynae appointment with an internal examination. The trainee decided to answer her bleep with her fingers still inside me. I’m not keen to ask my friends this so I’m asking all of you!
I am quite surprised she thought this was ok and trying to decide whether to give some feedback to the department. If i do, i would prefer to do it in a constructive way. The rest of the appointment wasn’t good either as she clearly hadn’t read my notes, but i suppose i did get the information i needed in the end.

Was the trainee being shadowed or alone?

That in itself is a red flag for me, let alone answering a bleep while carrying out an invasive investigation. Definitely feedback, this was not OK.

Thanks for your reply. Chaperoned by a nurse. She didn’t seem to understand why I looked worried- I was there for follow up after investigations into an abnormal ultrasound. Her attitude seemed to improve after she went out and probably read my notes.

I’d assume that mid-procedure (any procedure really but especially that kind) was entirely inappropriate to be doing anything besides the procedure. I’d think it was very rude to answer a pager just during a medical conversation much less an exam. And if it really was so essential to pause she should be respectful enough to apologise, “exit”, take her gloves off and make sure you’re re-covered before answering phones. Apart from anything else the hygiene aspect would concern me - I don’t want hands/gloves simultaneously on my body and her phone/pager!

I doubt anyone’s life depended on a trainee gynaecology student answering right that very second though, and if it did then the hospital or department is at fault for ridiculous staffing.

Edit - was she definitely a medical student/trainee? I’m surprised they were only chaperoned by a nurse and didn’t have a doctor supervising.

I did consider that approach if I write in- what is wrong with staffing if she needs to answer a pager instantaneously? She will be a qualified doctor on a rotation, most likely doing a rotation before becoming a GP so training in Obs and gynae.

A trainee Gynecology student ? What world are you living in ?
That is a fully qualified Dr that may have 10 years + post graduate experience. And yes, a gyn registrar may receive pages multiple times a day for emergency situations.

OP, did they answer a call or just silence the pager ?

Ah I see. I had assumed by trainee you meant medical student. Yeah, I can see if she’s a registrar she’s probably going to need to respond to emergency calls, but I still don’t think taking a few moments to stop properly is unreasonable!

They answered the pager and had a conversation while I was lying there waiting. If she had paused the examination to answer the call and removed her hand I wouldn’t be asking the question.

Surely it's not particularly likely a gynae trainee will have 10+ years of qualified experience. Most StRs will be in years 1 - 7 of specialty training, so 3 - 9 in total.

I probably would have said "get back to what you were doing, and answer that later"

and then complained afterwards. It is not on. When you are being examined you should be the doctor's (or nurse's or whoever's) number one priority until the examination is finished. And if something happens? they don't have one hand up you while they do something else.

I was actually having a cervical smear some 5 years ago, and was behind the curtain (on the little bed.) The nurse shoved the speculum in, and went to get the cytology brush off her table in the room. Someone knocked the door just as she was coming back to me, and she answered the door and said 'oh yeah, OK Sue.' Then said to me 'won't be a minute.'

Then she left me, legs akimbo, with this fucking thing shoved in me, naked from the waist down (on the bed.) Nurse was still not back after some 3-4 minutes! Someone came in. I said (loudly) PLEASE can someone bring the nurse back? I am halfway through a cervical smear with the speculum in my vagina, and she's disappeared.

Nurse came back 2 minutes later. She didn't even say sorry or anything, and just shoved the cytology brush in, swept the cervix, and then said 'off you pop then. Results in 3-4 weeks.' I was so pissed off and angry about this, that I never went for another smear. I was early-mid 50s then, and probably should have gone for a few more, but never did. Put me off for life. And yes I know I should have complained. But I didn't. Then Covid happened!

tlr;dr @Sunnywithchanceofshowers I would complain!

Brefugee Thanks, that is my feeling. I do want to believe that most people are doing their best and so I do feel reluctant to complain. But I do feel that it is fundamental to treat people with more respect than this

Zov I’ve had a similar experience to this too, but not as extreme. And I can well understand why it put you off a repeat smear. I’ve been putting that off too.

Really???

Sorry, she had a full phone conversation while her hand was inside you? I’d not accept that from a sexual partner in an intimate relationship much less a health professional. Surely it’d common courtesy to excuse yourself and ensure your patient is covered. Apart from the discourtesy to you, the conversation may have needed her full attention and possibly some privacy.

Really? What are you questioning?

if she's doing a training rotation she simply MUST get feedback like this.

I would have been absolutely fucking furious. And she would have known it.

Thank you , I will write in. I’d rather no-one else be treated like this

I turn into a weirdly passive version of myself in doctors appointments. Even though I am a healthcare professional and would never treat anyone like this myself.

I would feedback to the department. We all do things without thinking when busy/stressed, but I think it would be good for her to reflect on this situation.

I think you should give feedback. It’s rather dehumanising, treating you like a specimen instead of a person.

@Northernbrightlights

Clearly out of touch with how training works these days. Competition rations means that many are working for 3+ years prior to commencing specialist training. Then many IMGs come over with years of experience.

@Sunnywithchanceofshowers

Agree it was inappropriate, many Dr’s go “hyperefficient” when close to burn out. I reckon you should feed back, might help Dr in question, future patients and staffing!

if you're an HCP that may help, so from professional to professional? and you can reiterate that patients shouldn't be left in that kind of position.

Yeah feedback
They start to see people as objects so forget they have their hand up a person.

When you are being examined you should be the doctor's (or nurse's or whoever's) number one priority until the examination is finished

Lucky you are not awake during surgery then. Not uncommon at all for the surgeon to take calls, provide instruction to others, in some me institutions/situations even pause what they are doing to pop into another theatre for urgent management, then come back and resume etc. Most people are competent multi-taskers when needed, you just don’t complain about what you don’t know about😊.

well @HoppingPavlova that is disingenuous twaddle.

I hardly believe i have to specify: if a doctor has a hand up your lady parts and you are even 1% conscious THEY SHOULD BE PAYING YOU 100% ATTENTION.

FFS.

(was it you? next time don't be so rude)