Monday, November 19, 2007

Get me out of this thing!

NewFNP infrequently finds herself in the position of being a patient. Yet she found herself dialing the on-call physician for her practice last night, her wrist pain registering an 8 on a 10-point scale. She had fallen earlier in the day while hiking, thinking only her pride wounded, but as she palpated her very own anatomic snuff-box and brought a tear to her very own eye, she knew that something was woefully awry.

NewFNP patiently waited for Dr. On Call to call her back and was pleased when he did so promptly. NewFNP often feels a bit guilty when she is on call and attempting to do over-the-phone triage. It requires the patient to make a decision about their needs, to weigh the benefits of emergency room care over waiting for a clinic visit. Sometimes the answer is clear cut, others fall into the category of "art" rather than "science."

NewFNP's on call provider essentially told her that, yes, she needed an x-ray. No one wants to miss a scaphoid fracture, what with all its risk for avascular necrosis and non-union even when frigging treated! But did she need to go to the ED right then? NewFNP struggled with this.

For one, her ED co-pay is a Benjamin, whereas her office co-pay is a Hamilton.

NewFNP is all about the Hamiltons, baby.

For two, what was a trip to the ED really going to do? X-rays, maybe a splint. Was newFNP going to see a hand surgeon at 10PM on a Sunday? Was she going to get casted? No, she would be instructed to follow-up with the appropriate provider the next business day.

And finally, would newFNP be entirely truthful if she omitted the momentary thought of leaving work early in order to see her own primary care provider? She would not and newFNP is nothing if not honest. And fashionable. And stuck on this Sunday's NYT crossword puzzle.

In the end, newFNP decided that her x-ray could wait. But newFNP has years of education and practice under her belt and had the requisite knowledge to really weigh her options.

She was, however, unsure in her decision as she struggled to unhook her own brassiere prior to retiring. Can you imagine the panic - frantically struggling to unleash one's heaving bosoms from their support in order to repose without wires and cleavage? Agonizing. In the end, newFNP was able to shimmy her arms out, rotate her band around and unhook in front just like her 92-year old grandma does.

NewFNP is in great hopes that the humiliating extraction from her t-shirt bra will not be replicated in the upcoming weeks (months?) if newFNP is in a fucking spica cast. To her moderately-trained eye, the x-ray looked fine. To her internal med (handsome yet pleated pants wearing) doctor, the films were lovely. Now we wait for the radiologist to keenly examine newFNP's scaphoid and deliver the real diagnosis.


bradley said...

At least you know the internist was straight.

I see your struggle. If it were me I would have probably gone to the ER, but ER visits are free and we have several around here that are good and with reasonably short waits (and I used to volunteer in one). On the other hand, I may have used it as an excuse to hop up on vicodin for the night.

FNP student

Anonymous said...

Just a quick note to make you feel a little less old. I have been unleashing my boulders from their restraints the way you described since I was 16 and I am now 50!! It is not just for old ladies!! It is just much easier-even for thin girls like me. Why become a contortionist?

Ohio FNP