Pelvic exam during general anesthesia ??

[Flamen04]

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Wow. Just no. Don't do that. Think it, but don't do that.

I'm sorry if you fell for the troll

 

[DrCharlemagne]

I'm sorry if you fell for the troll

I'm glad you think such a thing is impossible.

 

[PregnantAt51]

Ok, at least if you're going to troll, try not to make it so obvious.

DermViser, I can hook you up to my FB page. I'm real, and so are my experiences. You would not be the first person in the medical field to insist that my experiences never happened. 12 years of PPD resulted.

What would make you stop trying to discredit me? Attending's name? Hospital? Date? You are in the field, I'll allow you to pull my record if you'll email me a consent form.

 

[DermViser]

she's a troll no way this **** happens in real life.

The woman was ready to cause herself deep soft tissue tears by telling the resident she's okay with tears (wanna bet she would have sued if it did?). An episiotomy is done when there is a serious risk of 2nd/3rd degree tears. An episiotomy is not done for ****s and giggles or for the heck of it. And there is an attending always on staff. Hence showing she's a troll.

 

[DermViser]

Sad to say it does, and sad to say your reaction is not uncommon.

Thank you, medical student (accepted).

 

[MediCane2006]

Just....wow.

 

[DrCharlemagne]

The woman was ready to cause herself deep soft tissue tears by telling the resident she's okay with tears (wanna bet she would have sued if it did?). An episiotomy is done when there is a serious risk of 2nd/3rd degree tears. An episiotomy is not done for ****s and giggles or for the heck of it.

Episiotomies aren't standard of care anymore, they don't necessarily prevent tearing, nor do they heal any better.

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000482.htm

Sorry, can't get to UpToDate right now.

And yes, I am accepted. I'm also one of those nasty feminist trolls who researches these things.

 

[Priapism4tooLong]

I was awake and vigorously refusing while three students took turns jamming their fingers up my vagina to feel my cervix. One actually stood with her fingers in my vagina while I was saying "get your hand out! Get out, this is my body." and proudly said "Nine! She's nine!", then stepped aside and her colleague inserted his fingers to verify the nine. The colleague turned and said to the attending "I'm going to get a rectal..." and stuck a finger into my rectum. I don't care what they were learning. I don't care what they needed. I was being violated, and they were doing me great harm. I finally gave up protesting and just cried until my child was born.

The questions that the adolescent girls in my group posed included wanting to know if doctors can/will violate them in the name of medicine. I hoped to find more to reassure them.

Sad to say it does, and sad to say your reaction is not uncommon.

This case does not happen. No doctor would ever let a student touch a patient without consent. And a student would not leave their fingers in a woman after being shouted at.

This would be a law suit if this actually happened.

 

[DermViser]

Episiotomies aren't standard of care anymore, they don't necessarily prevent tearing, nor do they heal any better.

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000482.htm

Sorry, can't get to UpToDate right now

I didn't say they prevent tearing. I said they keep the tears from becoming worse and tearing thru soft tissue.

 

[Priapism4tooLong]

Episiotomies aren't standard of care anymore, they don't necessarily prevent tearing, nor do they heal any better.

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000482.htm

Sorry, can't get to UpToDate right now.

And yes, I am accepted. I'm also one of those nasty feminist trolls who researches these things.

they aren't standard anymore but still quite a few are done. Its a lot less than the past but it's still prevalent.

 

[Flamen04]

If this troll was actually as traumatized about the experience as she claims she is, she would've sued the hospital / doctor afterwards. No one that is this vocal about such an event and such a pain in the ass would give up the chance to sue the hospital. Also, besides the medical technicalities, this troll's supposed husband must be a chum to sit back and not enforce his wife's wishes.

 

[DermViser]

This case does not happen. No doctor would ever let a student touch a patient without consent. And a student would not leave their fingers in a woman after being shouted at.

This would be a law suit if this actually happened.

Read her episiotomy story. Didn't know patients knew words like "perineum" and "platitudes" and had such vivid memories of every quote said. At least if she's going to troll, she should use it to write trashy romance novels like Danielle Steele.

 

[DrCharlemagne]

they aren't standard anymore but still quite a few are done. Its a lot less than the past but it's still prevalent.

Okay, I am chastened. But I guess I would rather fall for the troll than deny that a patient was abused out of hand.

 

[DermViser]

Episiotomies aren't standard of care anymore, they don't necessarily prevent tearing, nor do they heal any better.

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000482.htm

Sorry, can't get to UpToDate right now.

And yes, I am accepted. I'm also one of those nasty feminist trolls who researches these things.

Episiotimies are still done, genius.

 

[DrCharlemagne]

Episiotimies are still done, genius.

Yes, but they are not as common as they used to be, nor should they be performed for ****s and giggles, as you indicated. Doctor.

 

[DermViser]

I am trying to find a way to give the youth group girls a balanced view.

Yes, balanced view indeed. If this is what you consider balanced. You should work for FOX or MSNBC.

I don't like the resident harpies on OB-Gyn much either, but this is just ridiculous.

 

[PregnantAt51]

I'm very sorry that you had this traumatic experience. You are right to be horrified by what happened.

However, I think you are very unlikely to get the response or closure you seem to be seeking from this site.

Your experience seems to have very strongly jaded you against the role of learners in medicine, which is understandable but very unfortunate, particularly given your role of influence over others. What was discussed on this thread seven years ago is not what you experienced or what people have been defending.

You bring up an excellent point, re the difference between what I experienced and what his being discussed on this thread.

While I realize this thread is/was old, I thought it might contain information to teach the girls in my group (14-17) how to avoid the situations that I encountered. I am very concerned about giving these young people a false sense of safety, but do not want to discourage proper health care.

I do apologize for going off topic. My experiences could have been shared with less detail, which would have made them less inflammatory.

 

[DermViser]

Yes, but they are not as common as they used to be, nor should they be performed for ****s and giggles, as you indicated. Doctor.

And like I said - they AREN'T and no resident would do that for that reason unless they wish to be terminated.

 

[DrCharlemagne]

And like I said - they AREN'T and no resident would do that for that reason unless they wish to be terminated.

My phrasing was inappropriate, I was trying to indicate you were correct at the outset.

 

[Priapism4tooLong]

A lot more than that happened. For instance, no one said a word about the episiotomy until I saw a long needle for the saddle block. The students or residents or whatever they were gathered around staring into my crotch while the attending pierced my perineum. I screamed, arched my back and tried to scoot away, saying "No! No episiotomy! I'd rather tear! Don't!". One of the boys between my legs patted my thigh and said 'We're just making the opening a little bigger." I said "No, you can't do that without cutting me!". Somebody shoved their finger down into my the muscles just inside my vagina (sorry, don't know the name) to stretch the tissue. The pressure caused intense pain and I arched again and said "Ow, oh stop that hurts..." The student/residen/boy said "One minute..." then I felt a burning pain and heard flesh being cut with scissor. I wasn't numb yet. My husband said I screamed "what are you doing?", my eyes rolled back, blood fell onto the floor and I began sobbing. The boy looked up and said "See? All over." like he was putting a band-aid on a toddler. I tore another inch as my child's head was born.

Any protests I gave were either ignored or I was placated with platitudes like "You're almost done". They never addressed anything that I said or asked them to do or not do.

There was one moment when the three were between my legs touching and staring at my vulva, which felt so humiliating. I remember feeling that getting pregnant was a terrible mistake and I was paying for it. A woman should not feel guilty for giving birth!

One of them said "Look, I see hair!" as though this would cheer me up. I snapped "Well I guess you do. Haven't you ever seen one of those before? They have hair."

I was not a welfare patient, btw. I had full insurance and was paying for the services of a private physician. One of the residents/students even poked fun at my husband, saying " well, if you want the pros, don't have a baby at 6pm on a Friday. They've all gone home."

My point here is that it seems doctors have forgotten that pelvic exams, gynecological procedure, breast exams, giving birth, those processes can feel terrible, and in a lasting way. To you, it's routine. To some of your patients, it's like being stripped and penetrated against our will, in the middle of Wal-Mart. Our feelings are valid.

I am trying to find a way to give the youth group girls a balanced view.

Read her episiotomy story. Didn't know patients knew words like "perineum" and "platitudes" and had such vivid memories of every quote said. At least if she's going to troll, she should use it to write trashy romance novels like Danielle Steele.

who explains an episiotomy like that? especially if you are too "shy" to let medical students touch you.. so detailed "STARING AT MY VULVULA?" LOL, this is a joke.

 

[pkwraith]

The student was NOT standing in the corner observing. The student walked in with the NP, and said to me "Hello, Mrs. H. I'm going to be observing your [pap test, bi-manual, rectal and breast] exam today as part of my training." She decided that she could invade and contaminate my paid visit. Yes, contaminate. I did not feel comfortable having anyone staring at my breasts while a practitioner palpated, then staring into and inside of my genitals, and I would not have discussed all of my health concerns with this stranger there. There is such a thing as a desire for privacy, and to be naked in front of no more strangers than absolutely necessary.

I'm not sure how this is supposed to be a horror story. In this description, the nursing student was quite appropriate, polite, and professional. Unless she refused to leave when a patient declines her participation, she is doing exactly what she should be doing for her role as a student nurse on a gyn service.

 

[Priapism4tooLong]

Yes, but they are not as common as they used to be, nor should they be performed for ****s and giggles, as you indicated. Doctor.

what he never said it was done for ****s and giggles

The woman was ready to cause herself deep soft tissue tears by telling the resident she's okay with tears (wanna bet she would have sued if it did?). An episiotomy is done when there is a serious risk of 2nd/3rd degree tears. An episiotomy is not done for ****s and giggles or for the heck of it. And there is an attending always on staff. Hence showing she's a troll.

pretty sure he said its not done for ****s and giggles.

 

[Siggy]

Quote from glorytaker<<When I was doing OB/GYN as a med student, the attending would have me do a pelvic right after the patient was under and before we started surgery. Of course, we were doing GYN-related surgery and he wanted me to note the difference before and after a cystocele or rectocele repair. We didn't exactly get permission but it was for teaching purposes.>>

It says here that the attending wanted the student to note the different before and after the surgical procedure. That states that the med student was doing the pelvic exam to familiarize him/herself with the particular anatomy and how it felt before and after the procedure. That is of no benefit to the patient if the attending also does a pelvic as part of the surgical procedure.

Would you rather the student acquire the knowledge of what a cystocele or rectocele feels like after the student is out of their training and out from the instruction of someone who knows specifically what to feel for? A student on OB/Gyn is there to learn the basics of OB/Gyn. Some things either can't be taught, or are taught very poorly, using models (i.e. cervical dilation exams for women in labor), and every exam has to eventually be done on a live person. I'd much rather that exams, especially exams that tend to be more invasive of a person's personal space, be perfected while a student, than by someone who is out in practice and without a safety net.

As a patient, I do not have an obligation to be a live dummy for any person to hone their skill of feeling organs. It seems that medical professionals become desensitized to the fact that a patient deserves respect. Inserting an object or a part of your body into another individual's body for purposes beneficial only to the first party without express consent is a violation. That it's the least invasive procedure to happen to the patient that day does not make it any less of a violation.

Part of the admissions paperwork, as well as procedural consents, at hospitals includes language to the effect that students and residents will be involved. While yes, the patient can refuse to have students and residents work and examine them, it is up to the patient to refuse residents and students, not the other way around.

Also, every time you see a physician, you benefit from the fact that the physician gained knowledge on real patients as a student. Provided the exam is indicated (i.e. vaginal exam on an apppendectomy? No. Vaginal exam on a gyn surgery patient? Yes), then it isn't an "invasion." It's an indicated exam.

 

[DrCharlemagne]

what he never said it was done for ****s and giggles
pretty sure he said its not done for ****s and giggles.

And as I already said, I phrased that incorrectly, and meant to indicate he'd already said it was not a procedure done flippantly.

 

[PregnantAt51]

If this troll was actually as traumatized about the experience as she claims she is, she would've sued the hospital / doctor afterwards. No one that is this vocal about such an event and such a pain in the ass would give up the chance to sue the hospital. Also, besides the medical technicalities, this troll's supposed husband must be a chum to sit back and not enforce his wife's wishes.

Wow, now you are name calling?

The husband was as powerless as I was. What was he to do, start hitting people and get arrested for assault?

Again, it's easier to attack me than to think this may have happened. I offer name/date/hospital/ if you want to pull the record.

 

[Priapism4tooLong]

Wow, now you are name calling?

The husband was as powerless as I was. What was he to do, start hitting people and get arrested for assault?

Again, it's easier to attack me than to think this may have happened. I offer name/date/hospital/ if you want to pull the record.

ok tell us the hospital

 

[PregnantAt51]

Would you rather the student acquire the knowledge of what a cystocele or rectocele feels like after the student is out of their training and out from the instruction of someone who knows specifically what to feel for? A student on OB/Gyn is there to learn the basics of OB/Gyn. Some things either can't be taught, or are taught very poorly, using models (i.e. cervical dilation exams for women in labor), and every exam has to eventually be done on a live person. I'd much rather that exams, especially exams that tend to be more invasive of a person's personal space, be perfected while a student, than by someone who is out in practice and without a safety net.




Part of the admissions paperwork, as well as procedural consents, at hospitals includes language to the effect that students and residents will be involved. While yes, the patient can refuse to have students and residents work and examine them, it is up to the patient to refuse residents and students, not the other way around.

Also, every time you see a physician, you benefit from the fact that the physician gained knowledge on real patients as a student. Provided the exam is indicated (i.e. vaginal exam on an apppendectomy? No. Vaginal exam on a gyn surgery patient? Yes), then it isn't an "invasion." It's an indicated exam.

I agree that it's indicated to be done by the physician who is doing the procedure. It's not indicated to be done by any trainee just to give them experience, unless consent has been given.

 

[Flamen04]

I saw an episiotomy done yesterday. It was done for a medically relevant reason. Patient understood risks and consented as she was unable to deliver the baby just by pushing alone. I'm sure most women would rather have episiotomies than c/s if the baby can't get out.

Wow, now you are name calling?

The husband was as powerless as I was. What was he to do, start hitting people and get arrested for assault?

Again, it's easier to attack me than to think this may have happened. I offer name/date/hospital/ if you want to pull the record.

You are a bad troll. Your husband could have started screaming, made a scene, ask the students himself to leave the room, or even better.. talk to the doctors like a real person and prevent them from doing anything to you unless you consented.

You are painting doctors in a negative light for no reason just like many news articles on the news. Doctors would not carelessly disregard the patients wishes. Doctors truly care for their patients. Doctors strive to do no harm. Those that don't get sued. OB-GYN doctors are EXTRA sensitive about being sued so I'm sure most of them try their best not to do anything that would be an easy lawsuit against them.

 

[PregnantAt51]

I'm not sure how this is supposed to be a horror story. In this description, the nursing student was quite appropriate, polite, and professional. Unless she refused to leave when a patient declines her participation, she is doing exactly what she should be doing for her role as a student nurse on a gyn service.

It wasn't supposed to be a horror story. It was to illustrate that consent is a requirement before a student or resident assumes that they are welcome at a patient's procedure.

 

[Siggy]

I agree that it's indicated to be done by the physician who is doing the procedure. It's not indicated to be done by any trainee just to give them experience, unless consent has been given.

Those trainees are often "doing the surgery" as well. It's not like we're just sitting in a corner looking over the shoulders of everyone else. Those trainees are, more often than not, active participants in the surgery.

More importantly, what's scarier. "I'm a student who's going to be doing an invasive exam so I can know what ___ feels like" or "I'm a physician who is going to be doing an invasive exam for ___, but I've never felt one before"?

 

[PregnantAt51]

I saw an episiotomy done yesterday. It was done for a medically relevant reason. Patient understood risks and consented as she was unable to deliver the baby just by pushing alone. I'm sure most women would rather have episiotomies than c/s if the baby can't get out.


You are a bad troll. Your husband could have started screaming, made a scene, ask the students himself to leave the room, or even better.. talk to the doctors like a real person and prevent them from doing anything to you unless you consented.

You are painting doctors in a negative light for no reason just like many news articles on the news. Doctors would not carelessly disregard the patients wishes. Doctors truly care for their patients. Doctors strive to do no harm. Those that don't get sued. OB-GYN doctors are EXTRA sensitive about being sued so I'm sure most of them try their best not to do anything that would be an easy lawsuit against them.

So you are declining the opportunity to view the file yourself? You are able to order it directly from the hospital with no possibility of tampering.

 

[PregnantAt51]

Those trainees are often "doing the surgery" as well. It's not like we're just sitting in a corner looking over the shoulders of everyone else. Those trainees are, more often than not, active participants in the surgery.

More importantly, what's scarier. "I'm a student who's going to be doing an invasive exam so I can know what ___ feels like" or "I'm a physician who is going to be doing an invasive exam for ___, but I've never felt one before"?

Consent is the issue. I would hope that a trainee would not be doing surgery without the patient having consented.

 

[Flamen04]

So you are declining the opportunity to view the file yourself? You are able to order it directly from the hospital with no possibility of tampering.

No. Even if I called the hospital to get the medical records, I WOULD BE UNABLE TO DO SO WITHOUT YOUR WRITTEN PERMISSION TO GO ON FILE. You should know hospitals don't give out HIPPA protected information as easy as you are saying they do.. Are you willing to give me your real name and phone number? I'll call you right now. Let's do this.

 

[DrCharlemagne]

So you are declining the opportunity to view the file yourself? You are able to order it directly from the hospital with no possibility of tampering.

Without trying to put my foot in it again, what did you do afterward? Did you sue? Did you do anything to ensure this never happens again? Did anyone apologize?

 

[PL198]

Lol if my kid is being born and and a flock of medical students are essentially assaulting my wife and shes screaming in protest, they're all going to get launched and the hospital is going to have a serious legal case on it's hands. You realize if that actually had happened, this would be national news? If so, then I'm sorry for an unfortunate situation and hope the reparations were sufficient in your opinion. That must have been horrible and I can't imagine what that would be like. That's literally the worst patient to physician/student story I've ever heard.

If not, then stop trolling.

 

[PregnantAt51]

ok tell us the hospital

Stamford Hospital, Stamford CT 06902. 1o/4/91

 

[Flamen04]

Stamford Hospital, Stamford CT 06902. 1o/4/91

What's your MRN? Your name? We can't get your file just by the date. Is 10/4/91 your birth date?

 

[Siggy]

Consent is the issue. I would hope that a trainee would not be doing surgery without the patient having consented.

Did you read the admissions paperwork, or just sign it? Did you read the consent, or just sign it?

 

[Psai]

lol...

 

[DermViser]

What's your MRN? Your name? We can't get your file just by the date. Is 10/4/91 your birth date?

Maybe the date of service?

 

[PregnantAt51]

Without trying to put my foot in it again, what did you do afterward? Did you sue? Did you do anything to ensure this never happens again? Did anyone apologize?

You didn't put your foot in it at any time.

I complained to hospital administration and was told that "residents often assist". I pointed out that they didn't assist, they literally were practicing on me in full view and without regard to how it was impacting me. I was told that we were not injured, and that their job is to make sure the mother and child are healthy. I pointed out that the epis was a procedure I refused, and I was told that the attending makes the decision about that.

We consulted an attorney. I was told that "birth doesn't feel good" and you can't sue it the outcome was favorable, meaning baby and I were alive and well.

 

[DermViser]

Consent is the issue. I would hope that a trainee would not be doing surgery without the patient having consented.

If you didn't consent, then why didn't you sue????????

Edit: saw post above.

 

[PregnantAt51]

Maybe the date of service?

Date of Service 10/4/91
Date of Discharge 10/6/91
What's an MRN?

 

[DermViser]

Date of Service 10/4/91
Date of Discharge 10/6/91
What's an MRN?

MRN usually stands for medical record number.

 

[SouthernSurgeon]

What's your MRN? Your name? We can't get your file just by the date. Is 10/4/91 your birth date?

Dude, seriously stop.

I would also point out that 25 years ago...there was a lot less regulation, a lot less supervision of students, and a lot more paternalism...

 

[DermViser]

Dude, seriously stop.

I would also point out that 25 years ago...there was a lot less regulation, a lot less supervision of students, and a lot more paternalism...

I'm surprised he didn't ask what the resident's name was. OP - don't say it here.

 

[DermViser]

Dude, seriously stop.

I would also point out that 25 years ago...there was a lot less regulation, a lot less supervision of students, and a lot more paternalism...

It was just the 1990s. Not that much different.

 

[Flamen04]

Dude, seriously stop.

I would also point out that 25 years ago...there was a lot less regulation, a lot less supervision of students, and a lot more paternalism...

If the medical field has changed so much in 25 years with increased regulation, more supervision of student, and less paternalism, arguing about such old practices TODAY makes little sense as they are less widespread.

 

[PregnantAt51]

MRN usually stands for medical record number.[/QUOTE

We non medical sorts don't know about that.

Are you really going to pull records? If so, you'll need to email me a consent form.

Or were you just trying to see if I'd run when you asked me for proof.

 

[DrCharlemagne]

If the medical field has changed so much in 25 years with increased regulation, more supervision of student, and less paternalism, arguing about such old practices TODAY makes little sense as they are less widespread.

She did say elsewhere she was trying to see if attitudes had changed between then and now...