Rectal exams

[588442]

Bit of a fix right now. I did a DRE on this patient 1 month ago, and put my finger in her urethra by accident, instead of her anus. I couldn’t visualize properly due to body habitus. Then apologized, changed my gloves and the kit. Asked if she was okay, reassured her that I was very sorry. She seemed nice the whole time. Then going in the second time, I made sure with her that she wasn’t in any pain, that she was okay with me doing the procedure. I visualized and completed the exam. She didn’t complain to me of any pain or discomfort. I also kept everything sterile the entire time. Now, a month later, she reported to the hospital that the student wasn’t supervised. She never got any infection from it. I wasn’t supervised bc this was my second DRE in the ER, although I was nervous doing it. I did make a mistake, I promise it was innocent, and I tried my best to keep the patient comfortable.

My attending said that it won’t be reported on my evaluation and that he never thought this would be a big issue, since I am still learning and these mistakes aren’t as uncommon. He did suspect the patient perhaps doesn’t want to pay for the exam, and that the committee is looking for my input. He also advised me to reassure them that I didn’t have any malicious intent, to which both him and I were surprised that it was an argument made by the patient, a month after the incident. Now I am worried if this is more like my input to the committee, or if they are looking to get me in trouble? I am a girl by the way, been told I look like a 16 year old, patients seem to really like me. I just don’t see how I came across as someone who would sex offend. Did plenty of pelvic exams, never had any issues. Had excellent eval from every attending on that month.

As for now, I will apologize to them, tell them the whole story, that it was an innocent mistake. Do these mistakes with DREs not happen at all?

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[588442]

Deleted by moderator

Thats also what the patient said, but I think it was her urethra not vagina. Thanks for responding though.

 

[NVO]

How do you put a finger in the urethra?

 

[588442]

How do you put a finger in the urethra?

I am sorry that I am not the most intelligent student. I also apologize for this mistake that I made, during the entire month bc it was my second time doing it, and that I was so nervous about the whole thing, and that the lady was 4 times my size. I did quite well on the other procedures, patients quite liked my work. But I know that I made a mistake.

I was extremely apologetic the entire time, which in my position most students would be. Like I said it was an innocent mistake made out of nervousness. I have come across students that make the same mistakes on their first couple procedures, and do alright. Going up the wrong hole isn’t as uncommon as I had thought. Per my attending these mistakes are understandable by most patients. Thankfully my attending was supportive of me. The issue is also more of whether we receive adequate supervision, rather than she is a crap student.

Thanks for making my day though. I should have remembered that the sdn folks don’t make mistakes.

I have asked for my account to be deleted, so that kids such as yourself won’t have to suffer through listening to my not very intelligent concerns.

 

[588442]

Big urethra I assume?

Yes, I already said she was a big lady. It looks like they want my input on whether we are supervised. And that this won’t be one of those things that shows up on my eval. But I am concerned, so this is not funny to me.

 

[samac]

There is no damn way you went into the urethra instead of the vagina when doing a DRE.
I could see accidentally slipping into the vagina, but the urethra is no where near the anus. It’s also not exactly external. Cmon now.

But it shouldn’t be a huge deal if your preceptors aren’t making it a big deal. Take this as a lesson, in the future never do a sensitive exam without someone else present to back you up.

 

[588442]

There is no damn way you went into the urethra instead of the vagina when doing a DRE.
I could see accidentally slipping into the vagina, but the urethra is no where near the anus. It’s also not exactly external. Cmon now.

But it shouldn’t be a huge deal if your preceptors aren’t making it a big deal. Take this as a lesson, in the future never do a sensitive exam without someone else present to back you up.

Ya, I don't know anymore. You are probably right. It probably was her vagina. I just wish she made a big deal then, instead of after being discharged. I was surprised by the fact that she was so calm and cooperative. Happy the whole time. Had she said anything, I would have had my attending come in. I was staying late that day, and would have been happy to stay longer to resolve the issue. It is certainly a lesson, I am not afraid to learn. I am just confused about why someone would report an incident a month later. I have personally seen students make this same mistake, and this has never been an issue. It is stressful to think about.

 

[samac]

Ya, I don't know anymore. You are probably right. It probably was her vagina. I just wish she made a big deal then, instead of after being discharged. I was surprised by the fact that she was so calm and cooperative. Happy the whole time. Had she said anything, I would have had my attending come in. I was staying late that day, and would have been happy to stay longer to resolve the issue. It is certainly a lesson, I am not afraid to learn. I am just confused about why someone would report an incident a month later. I have personally seen students make this same mistake, and this has never been an issue. It is stressful to think about.

Yeah if you discuss this with hospital folk don’t say urethra. That’ll make it seem like you don’t know the anatomy and that’s why you messed up.

But yeah sometimes people just suck. This me particular person saw a possible payday and wanted to try and jump on that. I’m sorry this is happening to you.
I had a preceptor who was burned so I’ve had it drilled in me, anytime exams are of a sensitive area someone else is in the room. That way you always have another voice.

 

[588442]

Yeah if you discuss this with hospital folk don’t say urethra. That’ll make it seem like you don’t know the anatomy and that’s why you messed up.

But yeah sometimes people just suck. This me particular person saw a possible payday and wanted to try and jump on that. I’m sorry this is happening to you.
I had a preceptor who was burned so I’ve had it drilled in me, anytime exams are of a sensitive area someone else is in the room. That way you always have another voice.

Ya, at our rotation we are expected to do them properly after the first time. I will mention all of what I wrote above to the committee. I don't even know if there are looking to pinpoint me personally or just making sure that we receive some supervision. I meet next week, I do wish it was a little sooner.

 

[spacegun]

Bit of a fix right now. I did a DRE on this patient 1 month ago, and put my finger in her urethra by accident, instead of her anus. I couldn’t visualize properly due to body habitus. Then apologized, changed my gloves and the kit. Asked if she was okay, reassured her that I was very sorry. She seemed nice the whole time. Then going in the second time, I made sure with her that she wasn’t in any pain, that she was okay with me doing the procedure. I visualized and completed the exam. She didn’t complain to me of any pain or discomfort. I also kept everything sterile the entire time. Now, a month later, she reported to the hospital that the student wasn’t supervised. She never got any infection from it. I wasn’t supervised bc this was my second DRE in the ER, although I was nervous doing it. I did make a mistake, I promise it was innocent, and I tried my best to keep the patient comfortable.

My attending said that it won’t be reported on my evaluation and that he never thought this would be a big issue, since I am still learning and these mistakes aren’t as uncommon. He did suspect the patient perhaps doesn’t want to pay for the exam, and that the committee is looking for my input. He also advised me to reassure them that I didn’t have any malicious intent, to which both him and I were surprised that it was an argument made by the patient, a month after the incident. Now I am worried if this is more like my input to the committee, or if they are looking to get me in trouble? I am a girl by the way, been told I look like a 16 year old, patients seem to really like me. I just don’t see how I came across as someone who would sex offend. Did plenty of pelvic exams, never had any issues. Had excellent eval from every attending on that month.

As for now, I will apologize to them, tell them the whole story, that it was an innocent mistake. Do these mistakes with DREs not happen at all?

I am sorry that I am not the most intelligent student. I also apologize for this mistake that I made, during the entire month bc it was my second time doing it, and that I was so nervous about the whole thing, and that the lady was 4 times my size. I did quite well on the other procedures, patients quite liked my work. But I know that I made a mistake.

I was extremely apologetic the entire time, which in my position most students would be. Like I said it was an innocent mistake made out of nervousness. I have come across students that make the same mistakes on their first couple procedures, and do alright. Going up the wrong hole isn’t as uncommon as I had thought. Per my attending these mistakes are understandable by most patients. Thankfully my attending was supportive of me. The issue is also more of whether we receive adequate supervision, rather than she is a crap student.

Thanks for making my day though. I should have remembered that the sdn folks don’t make mistakes.

I have asked for my account to be deleted, so that kids such as yourself won’t have to suffer through listening to my not very intelligent concerns.

Ya, I don't know anymore. You are probably right. It probably was her vagina. I just wish she made a big deal then, instead of after being discharged. I was surprised by the fact that she was so calm and cooperative. Happy the whole time. Had she said anything, I would have had my attending come in. I was staying late that day, and would have been happy to stay longer to resolve the issue. It is certainly a lesson, I am not afraid to learn. I am just confused about why someone would report an incident a month later. I have personally seen students make this same mistake, and this has never been an issue. It is stressful to think about.

You come across as extremely apologetic in your description of the events. I can't imagine how much more apologetic you would seem in person. You keep saying things like you apologized, you're apologetic, you're sorry, you made an honest mistake, etc. I say this with gentleness, but you don't need to keep saying you're sorry! That could make a lot of people, especially patients, feel uncomfortable. Just apologize once, then move on with confidence. If you're constantly saying sorry to people, then people are going to start thinking you really did something serious. In fact, I wouldn't be surprised if part of the reason (in addition to the other issues you already mentioned) the patient reported you and wants something done about this is because you were so excessively apologetic. Not saying any of this to rub salt into your wounds, but just saying this so that you can change your strategy and avoid this sort of thing next time. I'm in no position to know, but I doubt you have to worry too much about here because it sounds like the committee is on your side. In any case, whatever happens, just be confident, you already apologized, now just relay the facts as they are, and go on from there.

 

[samac]

Ya, at our rotation we are expected to do them properly after the first time. I will mention all of what I wrote above to the committee. I don't even know if there are looking to pinpoint me personally or just making sure that we receive some supervision. I meet next week, I do wish it was a little sooner.

Yeah. We’re expected to do them properly, but I’m saying having someone else in the room (Nurse/CMA/Tech) whenever you do a vaginal or rectal exam in the future so you don’t have patients trying to claim you touch them inappropriately without someone else to back you up. I’m talking in your career as a physician.

 

[deleted480308]

Yeah. We’re expected to do them properly, but I’m saying having someone else in the room (Nurse/CMA/Tech) whenever you do a vaginal or rectal exam in the future so you don’t have patients trying to claim you touch them inappropriately without someone else to back you up. I’m talking in your career as a physician.

Agreed. Op, never ever ever do a DRE without a chaperone present. You just don't. It's never so urgent that you can't get a chaperone, then always document who was in there as chaperone

Also, I think you are either trolling (funny by the way) or really really bad at anatomy. If you don't know the difference between an anus and a urethra you stop sticking your finger in either until you figure it out.

 

[NVO]

I am sorry that I am not the most intelligent student. I also apologize for this mistake that I made, during the entire month bc it was my second time doing it, and that I was so nervous about the whole thing, and that the lady was 4 times my size. I did quite well on the other procedures, patients quite liked my work. But I know that I made a mistake.

I was extremely apologetic the entire time, which in my position most students would be. Like I said it was an innocent mistake made out of nervousness. I have come across students that make the same mistakes on their first couple procedures, and do alright. Going up the wrong hole isn’t as uncommon as I had thought. Per my attending these mistakes are understandable by most patients. Thankfully my attending was supportive of me. The issue is also more of whether we receive adequate supervision, rather than she is a crap student.

Thanks for making my day though. I should have remembered that the sdn folks don’t make mistakes.

I have asked for my account to be deleted, so that kids such as yourself won’t have to suffer through listening to my not very intelligent concerns.

Wow what a strange passive aggressive response. I mean my question literally. Like how does a finger physically fit into a urethra? Even extremely obese females dont have large urethras. That doesn't make much sense at all, so I wanted to understand. There is no way any normal person, especially a medical student, can confuse a urethra with a vagina anatomically, so I know you can't be mixing the two names up.

 

[CherryRedDracul]

It was probably the vagina. I've heard stories like this happening.

 

[GoSpursGo]

Closed by request of the OP.