Friday, September 14, 2007

Happy 5768, Jewish Style

Shana Tova, newFNP readers!

Nothing has been very exciting in newFNP's world, except that she did go to a yoga class this week with her friend CDCMPH and got her ass kicked. Jump back into plank? No thank you. NewFNP will step into plank and will pretend that she and her pal are not the only yogis who are sweating like wild boars!

Clinically speaking, newFNP has been recently plagued with the mind-numbing "same old-same old." The potentially interesting cases have not followed up and, thus, newFNP is in the midst of several clinical cliff-hangers. Does the seven year-old with B-cups rivaling those of that 'High School Musical' nude-internet-picture-girl merely drink too much hormonally-ridden milk or is she in the dangerous clutches of McCune-Albright syndrome? NewFNP would love to tell you, but this young lady has not returned for further evaluation. NewFNP hopes that she has followed up on her endocrine referral.

What newFNP has noticed of late is that she is spending an inordinate amount of time educating her patients on something that she herself has taken for granted for years, no - decades: the medication refill. NewFNP expects that when she gets her Retin-A prescription, it will damn well come with a year's supply of clear skin and wrinkle prevention, all with a simple automated phone call to her friendly neighborhood pharmacy. To newFNP's patients, most of whom hail from countries where over-the-counter meds are the norm, the concept is foreign. "What?!?" they say with raised brows, incredulous that they could have more than one month's worth of hydrochlorothiazide! Ah, yes, newFNP explains. All you have to do is call. Then newFNP reviews why it is important to, therefore, use the same pharmacy for all prescriptions. This interaction takes significantly longer than one might assume.

NewFNP is a joker, but she is not joking about this. Patient after patient, newFNP must review the concept of a refill. Swear to God. No fucking joke.

The other thing which newFNP finds striking is the all-too-common answer to a question posed by newFNP during each and every well-child visit: What kind of milk do you drink at home? To newFNP, it is as relevant as the presence of smoke alarms, medication allergies, asthma and if there is a frigging TV in the three year-old's bedroom.

And how do the vast majority of newFNP's patient's answer?

"De galón."

Oh, no shit? You get your milk from a gallon container? As opposed to, say, drinking directly from the teats of the many cows freely roaming the streets of newFNP's urban metropolis! What the fuck? NewFNP is not sure if she is missing something in the translation, but, in writing this, allows that she could simply ask if the 50-pound toddler is still drinking whole milk.

But shit, where's the fun in that?

"De galón." L'chaim!!


Anonymous said...

Glad you are blogging again! Missed your posts!

that big girl said...

It took me the entire med-surg rotation to recognize that the reason that I was getting frustrated when trying to assess my patient's pain was related to my own diction...

On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain you can imagine, where would you say your pain is right now?

My belly.

Oh. I see. Yes, ma'am, I see here that you have multiple abscess caths and even a PBD* or two, so I imagine that your pain is centered in your belly. What with the bile duct cancer and all. But how bad is it? Because, as the staff nurse who sent me in here to ask you so kindly pointed out, you won't be getting a single speck of your potential 15 mg of PRN oxycodone until you give me a number.

*It took me forever to find out that PBD stands for Percutaneous Biliary Drain, and then an equally long time to realize that I would actually be draining plastic bags of bile hanging off of this woman 3x/day. Doesn't bile digest its way through plastic? Shouldn't these things be glass or silicon or something?