"I'm a Nurse Practitioner!"

Specialties Emergency

Published

Patient comes in by ambulance for Unspecified. On the way in, EMS throws in an 18g and draws blood for labs. Patient looks good, is completely with it, condition seems pretty benign, but need to check a few things. Order CBC, Comp, EKG, do orthostatics, send blood to lab, hang 2nd liter of NS. New ED Doc That I've Never Worked With Before picks up the chart. Orders something that makes sense (but I couldn't order it myself), and something else that seems unnecessary. But whatever. I don't have "M.D." after my name, so I don't question, I just do, and order the test that seems unnecessary.

A while later, Family Member comes out of room, interrupting report I'm giving to Esteemed Colleague so I can go to my federally mandated meal break 6 hours into my 8 hour shift (and I'm starving).

Family Member: "Um, yeah, I was wondering if anyone is ever going to come in and take some blood?"

Me: "They took blood in the ambulance on the way in. It's already in the lab."

Family Member: "Oh, okay, well I was just wondering because the doctor said he was going to order XYZ test, and I'm a Nurse Practitioner, and nobody ever came in and got blood."

Me: "Yeah, they got it in the ambulance. It's in the lab. XYZ test is being done right now."

Family Member: "Okay, well I just thought I'd check, because I'm a Nurse Practitioner...."

Me: Blank stare.

Family Member: Goes back into room.

I finish report and go for a latte since nothing's open at this hour, and I didn't bring a meal.

While I'm on my federally mandated meal break drinking my Latte Dinner, New ED Doc That I've Never Worked With Before apparently tells patient and Family Member that he's going to keep the patient for overnight observation, and Family Member goes home. NEDDTINWWB then asks me to do orthostatics and order another unnecessary test.

Me: "I did orthostatics already (pointing at the chart where I had clearly documented orthostatics on arrival, which were negative), his pressure was rock solid, but I guess I can do them again if you want..."

NEDDTINWWB: (Seeing my documented orthostatics for the first time and barely glancing at them) "Yeah, I think we should repeat them, and get ABC test."

Me: "Okay, but he's not on any blah blah blah medication for his blahbitty blah blah, because yadda yadda, so are you sure we really need this test?"

NEDDTINWWB: (Looking irritated) "Yes, the admitting doctor wants it."

Me, to myself: "Yeah, but if the admitting doctor knew what I just told you, he would think this test was just as unnecessary as I do."

Me, in reality: "Sure, no problem."

Sigh. So, I repeat orthostatics and order ABC test, a bit surprised that this A&O, reasonably healthy, middle aged, walkie talkie patient is going to be admitted for observation of his Benign Condition. This should be a slam dunk treat and street. There is nothing to observe.

Admitting Doctor Genius (really, no sarcasm here; he is brilliant and I'd let him take care of me and mine any day) comes and sees the patient, and says the patient does not need to be admitted (surprise). He does a great job of explaining the Benign Condition to the patient, and the patient is satisfied with the explanation and his disposition.

Next thing I know, my phone is ringing.

Me: "Hi, this is Stargazer."

Voice on Phone: "Yeah, this is the Family Member for Patient X. I want to know what's going on, because I thought he was going to be admitted and he just called me to say he's being discharged, and I'm a Nurse Practitioner, so..."

Me: "I'm sorry, but I can't give out personal medical information over the phone. I can tell you that we've run some tests, everything looks fine, and he's being discharged."

Voice: "Well, I'm not satisfied with that. Did they do Test X? I'm a Nurse Practitioner, so I know they should do Test X."

Me: "I'm sorry, I can't give out specific medical information over the phone. All I can tell you is that we ran some tests and everything looks fine, and he's being discharged."

Voice: "That's not good enough. Did they do Test X or didn't they? I'm a Nurse Practitioner and..."

Me: "Ma'am, I can't give out confidential medical information over the phone. I can let you talk to your family member if you like."

Voice: "I already talked to him. I want to know why he's not going to be admitted. I'm a Nurse Practitioner and I know he's "At Risk", plus I just had surgery."

Me: "Two Medical Doctors have examined him and have determined that it's not medically necessary to admit him. All of his test results are normal. He is being discharged. That's all I can tell you."

Voice: "Blahbitty blah blah Nurse Practioner yakkity schmakkity blah blah blip blip."

Me, to myself: "I don't care if you're the Queen of England, I'm not divulging PHI. You can go jump in a lake."

Me, in reality: "Well, maybe when you come pick him up, the doctor will still be here and you can ask him your questions."

I then very efficiently discharged the patient to the lobby. :D

Specializes in Best care giving possible.

By the way, what part of "took blood work in the ambulance on the way in" didn't they understand. Whether or not they are a nurse practitioner or not doesn't really matter. Should have sent them to the audiologist for an exam.

The other day I walked into a pt's room.

Me: Hi, I'm elthia, and I'll be your nurse tonight.

Wife of pt: Aren't there privacy laws!!!!!!!

Me blinking in confusion: I'm sorry, is there a problem?

Wife: Aren't there privacy laws? Why is it my cousin who we never speak to, that just happens to be a nurse from another state can call up here and find out all about my husband's condition and medications, and I am his WIFE and I KNOW NOTHING!!!!!!!!!! AND I FIND THIS OUT FROM FACEBOOK.

Me: Yes, there are privacy laws, and it does sound like we have a problem.

Yep...that was one big mess, and I had the pt's visit made anonymous from thereon in. Of course, it was like closing the barn door after the horses were out. Sent it on up to risk management.

Specializes in ED.

I have had that SAME EXACT family member!!! I got so sick of her telling me she was an NP I finally asked her where she worked. Her answer, and I kid you not, "I work PRN for Dr. Dermatologist."

Me: :uhoh3: "Where did you work before Dr. D? You kind of look familiar.

NP: Oh, I went to XYZ nursing school and NP school and went to work for her right after I finished.

Me: :uhoh3: again.

I had that NP's sister or cousin a few weeks ago too. Patient's daughter was a huge PITA. Disregarded / questioned everything we told her, refused the saline lock for her mom, told us we should have been admitting her mother and "how was she supposed to take care of her now?" Kept coming to the desk asking for pain meds and ginger ale for her mom. I kept telling her that I asked the doc for the meds, etc. About 30 mins later when I got the med order and ok for PO fluids I went in to tell mom we didn't have ginger ale but we did have 7up. About that time the doc walked in and the lovely daughter totally threw me under the bus and told the doc "SHE won't let my mother have anything to drink." I guess she tried to make me look bad but whatever. Little did she know the doc's kid and my kid have been BFFs for 10+ years. Again, :uhoh3:

And of course, she got ticked when I asked her to move her laptop, book, and cell phone with charger off the work table so I could actually bring the meds and drink to her mother. AND questioned why I was giving her a shot. Ummmm, because YOU refused the saline lock for your mother and this IS what YOU asked for.

I swear, too many times it is the patient's family member that really compromises patient care sometimes. I cannot do my job if you are questioning me and telling me how I should do my job.

I welcome legit questions about your meds or treatments but don't be condescending or rude, or if you don't like my answer, don't try to throw me under a bus. And while we are at it... don't ask me a question and then say, "well, so-and-so (book, website, doc, whatever) said that THIS is what I should do." When you do that, don't be surprised when I answer you back with, "Then why did you come here and why did you ask me if you were just going to immediately contradict my answer."

Sorry, I have highjacked your thread. You can have it back now.

m

Hijack away! It helps us to know we're not alone in our frustrations.

Specializes in Emergency Dept, ICU.

I would have lost it long before the phone call myself and prob said something that would have ****** off blah blah blah I'm a nurse pracact blah blah blah and left me in my manager's office again....

Specializes in Emergency, Trauma, Critical Care.

Excellent and Hilarious vent! Loved it. :)

We had a patient who was a nurse, and all of her nursing buddies kept calling expecting us to give information on how she was because they were her friends. Seriously,....how could they think we'd give them info?

They actually got really rude over the phone, then they would want to talk to our manager, etc, the house supervisor. All of us were in disbelief. It was a county hospital that kept calling no less....seems like they would want to follow the laws.

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