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?

Could you not take the progestogen only mini pill, if the oestrogen in the combined pill reacts, since progestogen is what is in the depo provera injection.

It's not OP's job to make reasonable adjustments for the surgery, it's their job to make reasonable adjustments for her.

It sounds like OP has complex medical issues and has found a treatment that works for her. It's not reasonable to expect her to change that treatment for the convenience of the surgery when they could instead put very simple adjustments in place in order for her to continue her current treatment.

OP won't be the only patient at the surgery who is unable to wear a mask. Should they all have to change their treatment to work around the surgery's failure to meet their legal obligations?

I think thats quite mean though tbh. It sounds like a difficult situation. Healthcare workers deserve to be protected as much as possible, and if there is a way that someone can use a treatment that doesnt require putting others at risk, then surely thats the way forward?

Except Branleuse dentists are able to work with patients with no masks on and much longer and closer contact with a dental patient than a quick injection - so healthcare workers can have patients with no masks!

'so healthcare workers can have patients with no masks!'
Really- they have to do they? - put their lives at risk when there are alternatives- find a different clinician, try different meds, gently cover face with a soft cloth!!!
Would you risk your life like you are suggesting?

Hi OP I am a dentist and I really understand about your TN. I’m so sorry your practice aren’t finding solutions for you.
You could point out to them that dentists are working IN MOUTHS wearing only surgical face masks and visors. Obviously our patients are not wearing masks during treatment. And that is the recommended level of PPE required by Dep of Health Infection Control Guidance. We wear an FFP3 mask if we are doing a procedure that creates aerosols - if they want to feel safer they could wear one of those but it’s not necessary.

It's not mean to expect the surgery to comply with equality legislation.

There's always a risk. Masks help mitigate the risk somewhat but there are other measures that could easily be used instead that would more than compensate, e.g. additional PPE for the nurse, arranging a suitable outdoor space.

Surely that's the way forward, rather than disrupting the treatment of someone with complex medical issues - or any other patient who is unable to wear a mask, because OP will not be the only patient there who can't. There also may be times when a HCP needs to see a patient's nose / mouth and they won't be able to unless the patient removes their mask.

It's not a difficult situation, they just need to come up with a sensible policy - 'Where a patient is unable to wear a mask / needs to remove a mask for medical purposes, HCP will be provided with the following additional items of PPE ...' or whatever.

HCP is protected, nobody is denied treatment, nobody's treatment is disrupted, the surgery complies with the law. I can't see what the problem is with that.

I genuinely can't understand the mindset of someone who thinks it's fair to deny medical care to someone with a brain tumour, which is what it comes down to. I honestly cannot imagine thinking like that (and I'm in the clinically extremely vulnerable).

There are many many people receiving medical care and even in hospital who cannot wear masks for various reasons (and are legally exempt and Lang has linked the clear guidance re the Equality Act).

I know in this case it is contraception but where does that mindset end up taking you? People who cannot wear masks collapsing with heart attacks or strokes etc and not allowed access to A and E. I am epileptic and obviously couldn't wear a mask having a seizure - would I not be treated? Have people heard of status epilepticus?

As a CEV person of course I would prefer everyone to wear a mask but I recognise they can't. These people are still human beings and just as entitled to medical care as everyone else. What is wrong with people that, apart from an ability to assess risk, they have no compassion whatsoever.

And please don't say it's contraception not a heart attack etc, health is health (and god knows women's health is at the bottom of the pile anyway). You shouldn't have to be dying to gain medical care FFS.

[quote PhilCornwall1]**@Contraceptiveproblem* @WouldBeGood*

It's not been great. The only way I can get my bloods done now is if they come out to me in the car park, I have to phone when I arrive an stay in my car.

The one place I thought I would get some understanding and I was wrong.[/quote]
I have had my B12, and flu jab and blood tests outside because I can't wear a, ask.

They told me wait in my car. I'm registered blind and don't have a car. 😢

Wow OP. I can't believe the basic level of care you are being denied. Health professionals should know better. I hope this gets sorted.

Also aghast at the attitude of some posters on this thread.

Have a look at the code of conduct that nurses and midwives must follow (the NMC code of conduct). The nurses refusing to treat you due to your disability are in breach of their code of conduct and should be reported for it. You could raise this in a complaint to the surgery, it may even be worth calling the NMC for advice.
As @DottyWott says, dentists are treating patients in their mouths with standard PPE and only using an FFP3 mask when they are doing an aerosol generating procedure - which this clearly isn’t.

@mon21 as the poster who is a dentist replied, yes there are health workers in close contacts with patients with no masks on. Dentists spend much longer than a few minutes very close to patients with no mask. If you yourself have a dental emergency would you get treatment? Or say no, I will be in agony for months as I cannot wear a mask when having dental treatment?

Obviously where patients can wear visors and masks and treatment can be done over the phone, it is being done.

Would I risk my life? Is that a necessary question or an attack? I was merely saying that some medical staff have to treat patients with no mask. The same as in some essential operations as well as dentists.

Well I have to as a teacher with no mask or visor or PPE with a large bubble at work. And 1hr with a class of 30 pupils with poor ventilation, multiple times a day, plus supervising a dining room etc is significantly more contact that a few minutes necessary to do an injection.

@mob21 you can't cover your face gently with a cloth, that's kind of the point. Even having a draft on your face can set it off. I kept all my interior house doors open when I had tn, because opening them could lead to an attack. And an attack isn't a bit of pain for a few moments.

So considering they could sit 3/4 metres away while talking, and ask her to turn around before they approach her, yes they are being unreasonable, and they are not putting their lives at risk. This isn't some sort of killer virus that lies in wait to seize an opportunity. They would be more at risk going to the supermarket from what I've seen of it. It's ridiculous. I'd be kicking up a hell of a fuss, and I've toed the line all the way.

I haven't read the replies since my last reply because I don't want to feel like I need to justify why I deserve medical treatment to be honest. I've got enough on without that. I had another phone call this morning from the practice manager and now have an appointment with a GP to have it done on Friday. I'm 'lucky he was willing to do it' apparently. I won't be coming back to the thread but thank you to everyone who has given me support and helpful suggestions x

I hadn't read the replies but I have now and some of the replies were exactly why I didn't want to come back, but most of the replies have made me feel so much better, thank you again to everyone who is understanding, it's really not easy and I'm trying my very best, I've been following the guidance 100% the whole time since original lockdown so please know I'm not out to harm anyone and I appreciate everything health care workers are doing. I'm not sure what interacts with my other medications but they are the ones who told me switching isn't an option so I'm guessing no to the other pill or they would've said that. Thanks again I hope everyone stays safe x

I am so pleased you have an appointment booked and so saddened that many posters cannot see everyone is entitled to essential medical care Covid or not.

I'm glad they've found a solution.

This is shocking though:

I'm 'lucky he was willing to do it' apparently

If you felt up to it, it would still be worth a formal complaint. If not, I hope another patient complains.

I'm absolutely disgusted that Primary care practitioners feel they can 'opt out' of providing patient care. Thank heavens the rest of the NHS doesn't have the same attitude!

I'm glad they have found a solution but you still deserve better💐

You may well find on Friday that the GP doesn't know what the fuss was about. The front of house staff may have been sticking to the script without using any initiative.

Hope you got it all sorted today, @Contraceptiveproblem!

Thank you so much to everyone who has replied since I last posted.

@BigFatLiar you were absolutely right. He was very apologetic and understood how serious contraceptive access is. Didn't really seem to know what he was doing with the actual jab though and had to ask me whereabouts it goes! Think he was shocked when he realised it's not in the arm but it was all fine. I did ask him why the nurses had suddenly changed their minds - in that they'd seen me as normal since the start of lockdown - and he had absolutely no idea what had gone on and was going to ask! The only concern I had was that if someone wasn't comfortable with a male treating them that could be a problem as he was the only one 'willing' to do it in the entire surgery.

Thanks so much for checking in @TheSmallAssassin I had to wait outside for a bit - no car as not allowed to drive for the medical reasons already mentioned - and when I went in they have built a new room right in the doorway as you go in, where chairs and bikes used to be stored. It was set up as the other practice rooms, chairs, bed, sink, computer, bins etc so people don't have to walk through reception to get to one I suppose. No weight or blood pressure taken (which is fine) so I was in and out in under 5 mins. There really was no need for the issues I've had with them.

Fantastic that it’s all sorted x

So glad you got it and I hope the GP gets things sorted out for all the other patients sake!