Tuesday, January 10, 2006

Don't send me back

There are days when newFNP is simply unable to dodge all the shit being thrown her way. Today, of course, was one of those days. From 10 AM on, I had nothing but problems. Here they are.

One. Depression followed by PTSD. The depression was just sad. The PTSD, on the other hand, wasn't entirely convinced that he wanted to live. Clearly not an easy appointment. At least now I know how to write a 'safety contract' in Spanish. Oh, and when you are telling me that you think you'd be better off dead in one sentence, the next sentence sure as shit had better not be 'why do you think my throat hurts?'!!

Two. Hi, my new diabetic patient. I see you are 39 and have already had a below-the-knee/above-the-ankle amputation. I see that your burn wounds, affecting both hands, are not healing after 1 month, are slightly smelly although not infected and that your sugar is 'HHH.' Oh, you say you're peeing all of the time and that your vision is blurry? I can't say that I'm shocked.

Diabetes. Damn! Did everyone read the special in the NY Times about Spanish Harlem and the 20% prevalence of Type 2 amongst the residents there? Read it. It actually gives some good insight into how people cope (or don't) with the illness.

Three. It's 4:35. You're my 55-year old 3:30 complete physical and pap. It's not your fault that you're in my room late. I'm sorry you had to wait for me. Blame it on the diabetic guy.

Four. Prescription nightmare. Not my fault, but my mess to deal with nonetheless.

Five. My two incorrectly scheduled pediatric physicals, both scheduled at the same time, both 30 minutes late. Yes, your mom was pissed. I'll tell you what: next time be on time or call and let us know that you're late. Don't tell the receptionist that you didn't know you had to be on time. Have common sense and don't be mean to the front desk staff. This happened while I was with the patient who wanted to die, trying to get the social worker on the phone. So, no, I won't leave my patient to explain to you why I'm not seeing you today.

Is it any surprise that I cannot remember the other 18 patients I saw today? None of them were really 'easy,' many of them were new.

As I looked at charts in the hall before entering the patients' rooms, I was very conscious that I had to keep my frustration with my day to myself. I had to tell myself that Sra. X deserved the best of newFNP, not the frazzled and borderline tearful newFNP. That is a tactic I haven't had to employ frequently, but it was indispensible today.

And, thankfully, it worked. Yes, I was miserable with stress. Yes, I thought of requesting a phenobarbital-induced coma. Yes, I was thinking of ways to avoid ever going back to work again as long as I live. But I treated my patients well at the end of the day.

Even the one whom I saw at 5:15.

1 comment:

Nurse Practitioners Save Lives said...

Of course, you know about the "time" issues by the Spanish and Native American cultures.. They are never on time because it doesn't seem to be important. They live in the present. Sorry to see that you had a bad day. I'm sure that I will have many, but am looking forward to them being mine as a FNP!!