Nurses refusing to do contraceptive injection - trigeminal neuralgia

[Contraceptiveproblem]

I don't know if my name change has worked but if it has and anyone has an issue MN can confirm this is real and I've spoken about my exemption before, I idn't put about face covering exemption in title as I don't want a pile on. I regularly (including throughout lockdown as I cannot switch to the pill due to interaction with meds I'm already on) have the contraceptive injection. I called to book it for next week to be told nurses are refusing to see any patients without a face covering and that it would have to be a doctor - that's fine. I am exempt from wearing a face covering as I have a brain tumor causing severe trigeminal neuralgia so can't have anything touching my face, and cannot wear a shield because I have a scar from brain surgery up the right side of my head which I cannot have any pressure on. I have posted about this on threads before. It's very difficult and I rarely go anywhere that would require one if I don't desperately need to as I know what people think. I've received a phone call this morning from the nurse who advised they won't be doing it. I can't wear any type of face covering even though I would much prefer to. Any pressure on my face or head can cause me to fit, wet myself, at worst and at best leave me in agony in my face and head for days and weeks afterwards. As it happens the meds which mean I can't change my contraceptive are actually the ones that treat the neuralgia so they are fully aware of it, they were my GP throughout my tumor and other diagnosis'. I'm happy for a doctor to do it as was suggested yesterday - but for some reason they told me that and went to speak to their manager to arrange it, but all I have been given is a call back from a nurse to tell me the nurse won't do it. I couldn't actually speak to the nurse as they were busy so they read the notes which said that they won't do it, it wasn't clear if this means the nurses won't (fine) or nobody will (not fine). I have extremely heavy painful periods which made me anemic and faint, and the injection stops them completely which is why I'm on it in the first place as it was the only option that wouldn't be affected by my current meds. Surely they can't refuse me access to care because I am legally exempt? I don't know what I can do about this?

Sorry, not sure if this should be in women's health.

Ask for an appointment with the GP to discuss the options. Likelihood is they will just do it.

I have been told that the gp is not giving any contraceptive injections at the moment. I was due one in April but was not able to have it. I was offered the pill but have declined it. I was very stressed at the beginning as I have found the injection really life changing with no periods and no pmt, however on reflection I am glad I am giving my body a break from it. I would call again and talk to them, I was told that the gps were not able to give it only the nurse but that may be different in other surgeries.

That's appalling, I'm a Practice Nurse and would never refuse care for a patient just because they aren't wearing a mask. If you had symptoms then I could maybe understand and they'd delay it but to just refuse?
Not even sure it's legal.
I'd contact the CCG and see if this is being done on their advice, because if it isn't then they will in trouble because the CCG commissions the practice to provide a service and excluding people from that service who can't wear masks isn't OK.

I know our CCG advised during the first Lockdown that we could swap people to the pill instead of depo, but that was more to prioritise care in case we were busy with covid patients (we never got any!) and that was understandable as a contingency if no appointments were available. As it was, we were super quiet for a month and never stopped doing injections for anyone.
However, it was very varied and other practices were stopping all kinds of things. It seemed to be a case of interpretation because we read the guidelines as 'if things get crazy busy with covid, you can stop doing X, Y, Z to prioritise' rather than other practices interpreting it as 'don't see anyone for any reason unless it is absolutely essential.'

Trigeminal neuralgia is agony, any HCP should know this, and should also understand there is no way of wearing a face-covering.
Can you request a telephone consultation with your GP? If not I'd raise it with the practice manager.
I'm sorry op it sounds like you have been through the mill with your health, and you really don't need this aggro

Thanks everyone. They didn't ask, but definitely no symptoms. They did tell me at first back in March/April that they weren't able to do it but once they spoke to the doctor and found out I couldn't switch to the pill they were allowed to do it. If I could switch to the pill I would temporarily, it would be easier all round, but it would weaken the pill itself and my pain meds. The receptionist who first told me yesterday that the nurses are refusing to see patients without masks (for whatever reason) said she would talk to the practice manager but now I'm not sure why that hasn't happened or I've just been passed back to a nurse who is refusing. Like I said I also have no problem with it being done by a GP. I understand it's difficult for them as it's really difficult for me as well! I had no problems with this other times I went (think I've had it twice in covid time now), I just told them I was exempt when I went (I wear a lanyard as well which I hate but I digress..) and it was fine. I mentioned this to the receptionist who said 'this is new and was decided a few weeks ago' what's new? Masks aren't. My exemption isn't. My injection isn't. I really don't understand. I would think my GP would be one of the more understanding places. I will try to contact the CCG.

Is the injection you do yourself (sayana press) an option? It's been out of stock for a while but has recently come back into stock and is v easy to administer

Thank you @firedragon101 it's appreciated. I'm just fed up! Yes, about telephone call with GP I'm awaiting a further call from a nurse, presumably to tell me again they're not going to see me? I don't really see the point in this but I will ask if a GP can call me afterwards. Contacting the practice manager is a good idea I don't want to have any issues in the future. I just have so much already on and knowing that there wouldn't be any issues with this was a relief at the beginning of lockdown, this is just another stress I don't need. I'm not the complaining type (unless I absolutely have to) I just want to have my appointment and leave :(

Good question @muddledmidget I've actually never heard about that. I'll definitely ask. Thank you!

Some surgeries are very unhelpful to those unable to wear face coverings, others are great. My own GP won't let anyone in, but I see a nurse at another surgery and they even have a sign up saying "Some people are unable to wear a face covering. Please be respectful of this.".

The first thing you need to do is call back and clarify if they've referred your request to a GP. If they've not, ask them to do so, and if they can't book you an appointment, ask that they call you. If still no joy, speak to the practice manager and after that PALS at the CCG.

The nurses are just trying to keep themselves safe. It's not an ideal situation but we are in a pandemic and this is the reality.

Masks don't offer a great deal of protection to the wearer but they protect others from you. The nurses are being expected to see a lot of patients in one day and this is the one thing they can control to attempt to protect themselves.

@Hayeahnobut thank you! @supercalifragilistic123 I know, I'm not sure what made you think I don't know this or how you have actually answered my question in any way in your response? I'm not refusing to wear one by personal choice. Wearing one causes me (and believe me, I know because I've tried!) severe problems, including but not limited to extreme pain. I would prefer to wear one and not get comments and stared at. My question isn't about masks, exemptions, whether the nurses should be allowed to refuse or why they are doing so, as I said before I'm happy for a GP to do the appointment instead. I have a disability which I cannot help. It's hard enough without healthcare providers refusing treatment which I need.

Well I'm not really sure what kind of response you were after then.

By insisting somebody treats you without wearing a mask you are asking them to potentially put their health before yours. That's a massive ask and I can understand why they might not want to.

I hope you get the help you need from your GP

I suppose I wanted (and got, thanks everyone!) advice from people who know more about it than me - I'm sure they're not legally allowed to refuse me medical treatment based on my disability but I don't know how I can actually action getting the treatment if they flat out refuse. I understand why they might not want to too, but we all have to do things we don't want to in the course of our jobs and we can't discriminate against people, I would think this particularly applies in a caring role. I haven't insisted the nurses treat me in fact I've stated several times on here and also advised them over the phone that I am happy for another practitioner to do the appointment. I don't think I'm wrong to expect to receive necessary medical care from my GP, whether that is my contraceptive or anything else that I need. I specifically didn't mention anything about the exemption in the title because people pile on like you have, with little to no compassion or understanding or even an attempt to. I'm glad you don't understand how badly this affects people - I wish I didn't. Thank you, I appreciate it.

This is absolutely discrimination. I have trigeminal neuralgia & I hope you find the strength to fight this one out Hugs!!

I cannot understand the nurses here. They could wear proper PPE to do this, if you can't wear a mask. I'm very upset and annoyed on your behalf.

I was on depo. It was stopped during the initial lockdown and a similair thing offered but you would pick it up on prescription and self inject. Is that an option?

See its not about doing things that they don't want to. It's about following guidelines to keep everybody as safe as possible. Full PPE is just not available to everyone and is not as simple as it sounds as you need to be fit tested first.

What you are asking for is outside the realm of what the clinic can provide. Therefore you need to talk to your GP

I don't disagree that it is unfair, but there are a lot of things that are unfair about our health system at the moment. It is a real balancing act between keeping staff safe and still providing a service.

For the vast majority who can wear a mask for at least a few minutes, the clinic can still look after them. For the small minority who can't, they will need to find help elsewhere.

Its not about not having compassion, the vast majority of nurses I know have oodles of it. It's just a shitty situation for everyone involved.

Everybody is just scared still. Have you seen how many healthcare workers have died or been hospitalised from covid? Can you imagine how difficult it is to do the job at the moment. Everybody is just trying their best.

Ask to see their policy. If this is the case then they should have a written policy. I'm still calling bullshit though, nurses have to do procedures on people who aren't wearing masks, if it is high risk then the nurse wears a better mask (fit testing was scrapped and we just watch a video now!). For the few minutes it takes to give your injection it isn't necessary. Sometimes I have to take off the patient's mask (eg giving flu nasal vaccine or removing sutures from the face) and that's fine because it's for a few minutes, I'm wearing a mask and the room is ventilated.
Some of my patients can't wear masks due to respiratory conditions, that's fine. I accept the small increase in risk. Which is very low for short exposure to someone without symptoms.
We have teachers crammed in rooms of students with no masks! The optitician had to get DD to take hers off for part of the exam yesterday and said it was OK as it was only a few minutes.

I really would push this with the practice manager and then the ccg. I'm pretty sure it's not allowed for them to refuse on these grounds (if you simply refused to wear one, without a reasonable exemption, that would be different, however if harm came to you because of it they could still get in trouble).

Thank yo everyone for responding.

@Cookies47 thank you, I hope you're doing okay

I got nowhere yesterday, just the nurse calling me, telling me no, (and self injection not an option apparently) and getting sent back to reception who referred it back to another nurse... I pushed for a GP to call me, but instead the practice manager called today and is going to let me know if there's a GP willing to do it apparently. At this point I'm just happy that someone seems to actually be doing something rather than the cycle of reception- no I'll get a nurse to ring you, nurse- no we won't do it, reception -no a nurse will ring you to discuss it... and so on. I had 6 phone calls with nurses yesterday all telling me the same thing!

@supercalifragilistic123 I'm not sure if you misunderstood but this IS my GP surgery that I am contacting. I can't call a doctor direct I have to call reception who was only referring me to/allowing me to speak to a nurse Following guidelines also means accepting that some people are exempt for a good reason - in fact it is the law. I'm not sure why you're still replying here. What is your point - what do you want me to say? Fine, I'll just accept the pill and have neither it or my pain meds be effective? Fine, I'll come off my contraception and become seriously anaemic again causing other side effects? There is no alternative. Its extremely difficult for everyone right now, this is their job. It is not unreasonable for me to expect necessary medical treatment from my primary care provider. I wonder if you would have replied in such a dismissive way if it was other important time-restricted medical treatment and not female contraception.

@supercalifragilistic123 - can't you show some empathy or just shut the fuck up. OP has a clinical need that her surgery should be finding a way to accommodate especially given how much she is suffering.

I’d be really; really pushing for the self injection version. You shouldn’t have to, but at least you’ll know that you can stay on it throughout Covid and won’t have this stress recurring all the time.

I don’t know if anyone had suggested it but is there a sexism health/family planning clinic anywhere near you that might help?

Or could you afford to pay privately )which would be a disgrace that you had to) bit just to get it done?

It’s terrible you’re having so much trouble with something so simple after all you’ve been through .

Ask if you can sit behind a curtain/screen and just stick your arm through the opening?