Sunday, January 17, 2010

S-A-TUR-D-A-Y! Clinic!

When newFNP was in public health school and was discussing access to health services, she recalls evening hours and weekend hours being touted as one option the system provides in order to increase access to care. All these years later, it is exactly those two things that newFNP likes the least about her schedule.

Nonetheless, as she was seeing patients yesterday during a very busy Saturday, she was reminded of a few lessons in patient care.

It is not uncommon that when newFNP asks a patient how they are, they answer "Mal." Bad. Truth be told, it is newFNP's least favorite way to start a visit (although she completely acknowledges that this reaction is completely her own baggage). Can't we just pretty please have a moment of pleasantries before we delve into the nitty-gritty of the visit? Alas, newFNP has found that when people answer in such a way, it generally is because they are doing badly and probably have taxed each and every ounce of their resiliency reserves to the point of complete bankruptcy such that they can't even fake it anymore. It is always a tip off to newFNP that she must screen for depression.

It is also not uncommon that as patients are waiting to be seen at newFNP's clinic, the waiting room is frequently SRO. It is loud. It gets dirty. The temperature is never just right. It sometimes smells not-so-fresh. The time spent in that room can accumulate into hours. Being a competent and kind provider goes a hell of a long way to ameliorate the effects of that hellish wait. As she was finishing up a prenatal visit yesterday -- one which truthfully felt a little rushed to newFNP -- her patient told newFNP, "Can I see you again? I like the way you take care of me." It made newFNP feel proud and guilty at the same time, feeling good that the patient felt well cared for and feeling mal knowing that this patient didn't really receive the best care newFNP could have offered her.

It is really wonderful to take a moment to reflect upon these lessons. And it is so much sweeter as newFNP reflects upon them while in her dining room, drinking French Roast, Sunday NY Times by her side, decidedly out of weekend clinic responsibilities.

1 comment:

Mary said...

On the other side of the coin: for my old PCP, replying "fine" to such pleasantries would invariably lead to the lowly patient being scolded "Then why are you here, then?!?".

I believe in the more sophisticated circles, that would earn him the title Asshat.

Wait, Dr. Asshat.