I have an issue that I would like to have some insight on from practicing nurses since I have two years to go before I get to claim that honor.
My mil received a copy of lab work via mail from her endocrinologist that stated (hand written) she was in third stage renal failure last week. There has been no contact from the FNP or physician at the endocrinologist's office other than this lab work. No phone call to request a visit to discuss the lab work or even explain the labs, nothing. When I contacted the office this morning to ask about the lack of follow up, the FNP told me that since my mil was "non compliant", she was trying to 'scare' her into getting things in control. When I asked about her needing to get into to see the nephrologist, I was told that they didn't normally do that until stage 4 and dialysis was imminent. According to the labwork and the FNP, my mil's eGFR has gone from > 60 to 46 since her initial hospitalization r/t the spider bite in late February. Despite repeated attempts to see the Dr. she keeps getting the FNP and while I normally hold FNP's in high regard, this one has me wondering where her head is.
While I am not arguing the fact that my mil is non compliant, I question the way in which this was handled. My mil has lost her father, been in and out of the hospital due to a spider bite (she was dangerously close to being septic), and has had ongoing cardiac issues, all in the last six months. I am not making excuses for her, however it does affect how she handles things. She is fragile (there is depression there already) enough that many more situations like this and she is liable to say "the heck w/ it, it doesn't pay to try anymore". She does try to stay in compliance, she's just not incredibly consistent.
My questions are as follows:
1. Am I right in thinking that news of this nature should have been presented in person?
2. Why on earth would you give someone news like this in the hopes of scaring them straight and not offer education, support and follow up?
3. What would be the best way to handle this?
My intention is not to go in there guns a blazing, however my job not only as her dil, but her advocate as well is to ensure that she gets the care that she needs.
I don't want to come off as the idealistic nursing student or the pain in the rear family member, but this seems wrong on so many levels.
P.s. I realize that I have a unique view of my 'patient' by being her dil and that I can't expect everyone else to know what I know. If I have left info out that you feel would help you help me then by all means ask me, I could have easily left something out with out realizing it.
Jun 17, '10
first, i want to express my sympathy for what your family is going through. i can only imagine how difficult this is, and this event has not made it better.
second, i am not a practicing nurse. i'm a nursing student and volunteer nurse aide at a hospital.
1. am i right in thinking that news of this nature should have been presented in person? i would think so. i don't think a person should have to read their diagnosis on a lab note. i would be very angry if a loved one had to learn about something like this on paper.
2. why on earth would you give someone news like this in the hopes of scaring them straight and not offer education, support and follow up? the only thing i can say is that there is a lack of compassion and true human connection in many medical environments. for every compassionate and caring nurse or doctor, there seems to be an uncaring one. people need to know what options they have and they need to be able to ask questions. they can't ask a piece of paper questions. even if the fnp lacked compassion in person, at least your mil could've gotten answers.
3. what would be the best way to handle this? the only thing i can think of is to speak with someone above the fnp or doctor. but i'm sure others will chime in with more advice.
there are too many people in the field who lack compassion like you. you will be a great nurse. don't ever think you shouldn't be compassionate for someones circumstances.
Last edit by happy2learn on Jun 17, '10