As a medical student you may well encounter incidents that make you feel uncomfortable or unsure and while there is no perfect way to deal with every situation there are common approaches you can take. Do not feel you have to agree to perform procedures that you do not feel confident or indeed competent to do. Explain your level of ability and ask doctors or nurses to help you or ask whether you can observe this time before doing them yourself under supervision another time. You should balance a possible reluctance to do something new with the need to learn under supervision when the opportunity arises.
ALWAYS make sure the patient has consented to you doing a procedure. This can be a difficult area when the patient is under general anaesthetic. Remember the patient has consented to the team carrying out procedures/examinations that are necessary for care during this period. Therefore, if they have consented to a rectal exam or urinary catheter because it is required for the operation, this is fine, since you are a member of the team and will be supervised. If the examination is for teaching purposes only, the patient should have given consent specifically for that purpose. If you feel unsure, explain to the staff that you do not wish to partake in this procedure at this time unless consent has clearly been given. If the patient has not given consent, you will need to assert that you are not able to do this since this is clearly against existing Medical school guidelines
Try not to be too fearful of attempting procedures. We all need to learn at some point and make the transition from rubber arm to living, breathing patient. This takes an inevitable leap of faith, so be confident. There is nothing basic a student can’t learn, within reason, provided they are instructed by someone capable who can take over if the student can’t manage the task, and the patient has given consent. The student’s skill lies in knowing when to bite the bullet and learn a new skill and when to explain they are not prepared to do this for a clear reason, such as patient not given consent. Otherwise the problem is perpetuated and no-one learns, with a chain of not-being-competent. Students have a duty to learn as quickly as they can, but they also have a duty to the patient and to colleagues. You must never feign more knowledge than you have when someone asks you whether you know how to perform a procedure, since this puts patients at risk.
There are a number of sources of help on these matters. Communication skills sessions throughout the 4th year will help you to deal with breaking bad news or with anger and aggression by providing useful tips and advice. The skills lab has sign-up slots to further practice practical skills for added confidence.
Please contact the Welfare Officers Sam or Siân or Academic Rep, Jamie Wells for any advice with incidents you have experienced.