Student doctors are vital to our hospitals
IT sounds appalling. Sue Claridge, of the Auckland Women’s Health Council, has told of a woman undergoing a gynaecological procedure at North Shore Hospital in 2019 who, before being anaesthetised, ‘‘was lying on the operating table, naked from the waist down, legs spread, and looked up to find an operating theatre filled with medical, midwifery, and nursing students, none of whom she had been told would be there’’.
Assuming the procedure was indeed gynaecological, rather than an obstetric emergency, it’s hard to imagine any reason for putting a woman in such a situation before she was anaesthetised, students or no students.
And there’s no excuse for not telling her that students would be present.
Arising from that incident, the Health Ministry, Health & Disability Commissioner, Waitemata DHB, and Medical Council agreed that informed consent (mandatory under the Code of Patient Rights) is relevant to the presence not only of students, but of doctors in training, up to and including advanced specialist training — all patients had a right to know who was operating on them and who was in the room getting training.
The Medical Council then produced a ‘‘clarification’’ statement: ‘‘If a doctor in training or medical student will be performing or assisting in any part of a surgical procedure, then this should be discussed with the patient as part of the informed consent process.’’
Ms Claridge questioned the council using ‘‘should’’ rather than ‘‘must’’. She’s wrong. If anything, the ‘‘clarification’’ is overkill. Patients in a public hospital will almost always be cared for by doctors in training. The hospitals couldn’t function efficiently without them, and they, and students, often assist (e.g. by holding retractors) during surgery.
Sometimes it’s impossible to give consent. Surgical complications, with a need for immediate help, can occur without warning. Would Ms Claridge want an anaesthetised patient woken to consent to emergency assistance? A further thought.
New Zealanders get free hospital care, funded by taxes. 60 years ago almost every patient in a teaching general or maternity hospital had a student allocated to them, as an essential part of medical training.
Now patients choose whether to have a student.
There’ll always be some who should be excused student contact: a sexually abused woman having a gynaecological procedure, for example. But there should be a general assumption that, unless there’s a contraindication, hospital admission automatically means having a student allocated.
Future health services depend on student and junior doctor training.
It was the celebration of ‘‘The
Birth of our Lord Jesus Christ — Christmas Day’’, as the calendar in A New Zealand Prayer Book He Karakia Mihinare o Aotearoa lists it, with a bigger congregation than usual at the 10am Choral Eucharist at St Paul’s Cathedral. The ‘‘Bright Lights’’ Sunday School children were up in church, a cluster of small children sat round the craft table in the south aisle (supervised, at one point, in a happy reversal of traditional roles, by three men), and incense billowed.
The congregation clearly enjoyed singing traditional Christmas hymns, and the choir music was, as usual, very good — Richard Madden’s ‘‘Archbishop’s Service’’, composed for the visit of then Archbishop of Canterbury Robert Runcie (the one who incurred Margaret Thatcher’s ire by praying for Argentinian as well as British soldiers who’d fought and died in the Falklands) in the 1980s, a lovely Madden setting of Balulalow, Ledger’s haunting Still, still, still, and Wood’s cheerful Ding dong! Merrily on high.
The expected musical feast.
Then, after the final hymn, a surprise, as the choir launched into a sparkling arrangement of the (almost completely secular) carol We wish you a merry Christmas, figgy pudding and all. A timely reminder that the church is part of the world, not, as some would prefer, a holy ghetto, that the good things of the world are to be shared and enjoyed, and that while (as Longfellow put it) ‘‘Life is real! Life is earnest!’’, it should also be fun.