I think that when I'm overwhelmed, I have that whole "forest through the trees" problem. I saw a patient this week (several times) who I diagnosed with Type 2 Diabetes. Her blood sugars were in the 3- and 400's. I was diligently attempting to decrease this number when I noticed that she also had a Hgb level of 6.3. I provided the following to her:
- diabetes education regarding meds, sequelae, dietary changes, exercise
- prescriptions for appropriate meds and insulin in the office
- Ferrous sulfate 325 mg/day
- referral for colonoscopy
- stool cards x3
And, in all of that, I also provided utterly inadequate care. Why? I didn't get a fucking CBC! How did I miss that? Total cholesterol? Check. Hgb A1c? Check. CBC? Nope, not so much. Ugh! Why am I still a jackass? The beauty is that every time I feel like an ass, I know that the shame of missing something so easy will cause me to never make that rookie mistake again. And I am a rookie, after all. I just don't like to play like one.
1 comment:
so...did someone else ask you why you didn't order the cbc or did you catch it yourself??? :-)
Eryn--FNP student
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