I am a locums FNP working mainly ER/UC.
Currently i'm in a family practice clinic but only for 1 month.
They don't have a provider after me except for 1 day/week and they were lacking a provider for a few months before. It is a rural area with no other healthcare and closest hospital/clinic is 45 min away from one clinic.. also I staff another clinic 1 day week, which is 1.5 hrs away from nearest healthcare and they were without a provider for 2+ months.
I want these patients to have as adequate healthcare as possible but am wary about starting some medications due to lack of follow up.
For example, Chantix, has black box warning esp. for SI. I really don't want to start this in someone without adequate f/u and close monitoring, especially since I don't have a lot of experience with this medication.
Another one is Ambien, also r/t the SE.
Others including antidepressants, these people need f/u.
i went ahead and prescribed for one pt but a limited amount, and she will have to get f/u somewhere in order to get it refilled.
Another example is that I don't write for hydrocodone 10s. I think it is higher risk for overdose, there is a lot of drug seeking/abuse that happens in the ED. And if someone truly is in pain they can take 2x of the 5mg.
Do any of you have similar experiences.
Or other reasons that you won't/don't prescribed certain medications?