Friday, October 14, 2005


In school, we often receive 'pearls' about patient care. NewFNP is more of a diamond type of girl. A little flashier, a little less 1950's housewife. So I'll offer a couple of diamonds from my week.

1 carat: When you have a patient with a low hemoglobin (see 'I hate it when I'm stupid'), re-check the measuremrent in no more than a week. One reading doesn't tell you if they are actively bleeding, but if the result drops then you know that something is rotten in Denmark. Sure, this seems utterly common-sensical, but sometimes when you are new, even the most pedestrian of logical thought processes eludes you. I'm sure you all smarter than me, however....

2 carats: I am screening so frequently for depression and having so many patients disclose that they are depressed. That is not the diamond; just hang on a second. The reason I am screening so much is that I realized that a lot lot lot of my patients had non-specific complaints and an affect that bugged the shit out of me. Now, newFNP understands that that is neither replicable nor sensitive, but the truth smarts at times. So these patients bug, baby, bug. I can't find anything wrong with them, which definitely has the potential to be chalked up to my new-ness. However, I started to think that the headache, back pain, abdominal pain and bone pain, coupled with 10+ annoyingness might be something else. I swear, I pose the question, "Do you think you are depressed?" and watch out! Grab your galoshes and rain caps because the water works start. Then, of course, I feel like a big fucking asshole for my insensitivity and for being annoyed with them in the first place. *I* was the problem, after all, or at least part of the problem. It did, however, reinforce that I need to truly be aware of mental as well as physical health screening *and* that I need to need to trust my instincts.

No more diamonds! Except for Boston FNP, who should check out "The Girl's Attractive" by Diamond Nights.

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