patient privacy - page 3

by naftali216

during my career i always did whatever i could to protect the patients modesty regardless of gender or age. i was recently a surgical patient at a VA hospital and had what i feel was a disrespectful experience. without... Read More


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    Me? I don't care if students observe. I figure if they want to see a round little woman get whatever done, more power to them. However, I remember clearly my mother being horrified that "gobs" of people were brought into the room to observe her give birth to my little sister in 1966. (Oops, told my age, now I guess I am a Crusty Old Bat as well.) She carried on about it for literally years. So some people are not pleased with observers, and everyone should be given the chance to approve or disapprove of who sees them during a procedure.
    StayingFit likes this.
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    A patient has an absolute right to refuse any and all observers, trainees, residents, intern or students of ANY kind to be involved in any facet of his/her care..surgery,exams or anything else...blanket "consent" forms signed before a procedure or surgery or inpatient amission mean nothing if the patient say: "no students (includes all residents, interns, med students, srna etc)... I'm a "bad" patient; I get really selfish when I'm sick or having surgery..I do not want observers/students involved..and I work in a university medical center teaching mostly med or health science students. I get my care at the university med center because it's high quality (and because it's free for me and for my family). Upon admission/outpatient surgery, I always cross out the part of the consent allowing ANY observers/students to participate. It's my right. During my recent endo procedure, a srna tried to start my IV with her crna "supervisor" instructing and I objected asking her to review my consent. A melee insued with the endo doctor going ballistic on the anesthesia nurses; the endo doctor was apologetc that my consent had been violated and the crna and the srna were given a written counseling; which I thought was harsh but necessary. I had no confidence in this "team" that was about to perform my colonoscopy and my endo doctor was livid....she called in an anesthesiologist to do my case, but I didn't trust them at that point. Nobody would. I had the colonoscopy done 1 hour later at another hospital, with an anesthesiologist, no students or crna involvement and the university med center paid for the entire thing. Patients have the absolute right to refuse student involvement in their care; my endo doc said that she would not want a crna much less a srna involved in performing her own colonoscopy.
    ImAnORnurse likes this.
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    At our hospital, the consent form for all procedures includes something along the lines of "agree to the presence of nursing students" and something else about observers. Patients are able to cross out and initial this if they wish to refuse this or any part of the consent. I am not saying this was the case with you, but before signing anything people really must read the paperwork thoroughly.
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    Does everyone who's going in to observe read the PTs consent form to see if they've crossed out that part?


    edit:
    Quote from medresearch2011
    During my recent endo procedure, a srna tried to start my IV with her crna "supervisor" instructing and I objected asking her to review my consent. A melee insued with the endo doctor going ballistic on the anesthesia nurses; the endo doctor was apologetc that my consent had been violated and the crna and the srna were given a written counseling; which I thought was harsh but necessary. I had no confidence in this "team" that was about to perform my colonoscopy and my endo doctor was livid....she called in an anesthesiologist to do my case, but I didn't trust them at that point. Nobody would.
    Pretty much figured consent forms were frequently ignored... you just happened to catch yourself being violated.
    Who's to say what happens when a PT is out.

    if I ever need surgery, I'm going to insist on a trusted loved one be at my side the entire time with a cam corder.
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    Quote from Andy Droid
    Pretty much figured consent forms were frequently ignored... you just happened to catch yourself being violated.
    Who's to say what happens when a PT is out.

    if I ever need surgery, I'm going to insist on a trusted loved one be at my side the entire time with a cam corder.
    Good luck finding (1) a hospital willing to allow non-hospital personnel in the OR- even reps not employed by the hospital are required to do all inservices/computer learning modules that staff must do in order to be granted access; and (2) a surgeon willing to agree to those terms. Visitors to the OR who know nothing about the OR are more of a hassle than a benefit both to the patient and the staff- worries about them passing out, contaminating the sterile field, interfering with care, the list goes on.
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    When having my son, I was asked if medical students could observe and participate in the birth. I told the Dr, "You can have 1 student observe, the same student this is not a parade. He/she is also only allowed to observe. When it comes time for any stitches or checking the cervix, only you can do that." The doctor was OK with that. The next day, the medical student came in to ask questions and that is when I found out that he was an idiot. He asked questions like, "Do you have any vaginal bleeding?" and was very concerned when I said yes... well duh, I just passed a 9lb baby out of it. Then a series of other questions that were ridiculous. He also stood on the other side of the birthing suite like I had the cooties. This was my second child and knew that most of the questions he was asking were not needed. Being extremely tired, I kicked him out of the room. The nurses came running in my room laughing after about 10 minutes, this med student evidently had been irritating patients all morning and thought that I wasn't allowed to kick him out of the room. He wanted the nurses to call my doctor. They made him do it and my doc was equally irritated with him. I wish I could have been a fly on the wall to hear what the doc said to him.
    monkeybug and poppycat like this.
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    Make sure when you sign your consent, that you cross out and initial the "students can observe" part. When you then give consent for surgery, again indicate no observers/students. Unfortunetely, because it was a VA hospital, you have little choice on not getting the procedure done and going to an alternate hospital. (Well, you do, but at your expense). As an outsider looking in, it is a shame that vets seemingly have little choice.

    Most people will observe a surgery such as yours for learning purposes. And I would hope that whomever the surgeon would choose as observers would be mature in the dignity and respect department. But it is your body, your choice.

    Thank you for your service to our country, sir.
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    I'm actually kind of shocked that more folks don't think this is a big deal. I don't mind (usually) having students when I'm hospitalized. I will let them observe or try a great many procedures (on me). However, I will not allow them to start an IV or draw blood. I have very poor access and I've had three ports. It would be traumatic for me AND for the student to have one of their first blood draws on a pt in which they were unsuccessful.

    Same thing with observers. No way I would have let observers in when I had my son. That was just too sacred. Other surgeries/situations I would be ok with it. It is something I ask about prior to surgery because I understand that at teaching hospitals sometimes you can get into the situation where the surgeon lets a student do some of the surgery. I am not comfortable with that (sorry) and I state so on my consent in writing prior to surgery. Also had a doc sneak in that he wanted photos for his website and I crossed that one out too.

    Oh yeah. Also had a physician try to bring a pharm rep into an exam with me once. Yeah. Not so much doc. Said no to that one too.
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    All of this makes me appreciate the fact that every time an observer appeared I was asked if it was OK for them to be there. I do wonder about ORs and weird comments, though. As my OB was sewing up my C-section incision he was bragging to the rest of the staff that it was so low I would look great at the local nude beach. :/


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