I'm an APN in a peds practice. Saw a 7 year old girl for a routine medication follow up, we do every few months and give refills.
Hadn't seen her for 4 months and the MOA triaging her says, by the way, she lost some weight. I pull up her growth chart and she has lost 14 lbs! She is small to begin with (only 8th percentile for height and 13th percentile for weight) but now she has fallen off the growth chart. I went to my MOA and said she is only 30 lbs, are you sure that weight is right. She assured me she double checked it.
So I did a thorough history about diet, appetite, any abnormal symptoms, everything seems to be going well. She doesn't even look terribly thin, but again, she is a small child.
Did a lab work up and fingerstick glucose in the office, everything comes back normal. I said again to the MOA, "you are sure about that weight?" and she says yes. I'm thinking diabetes, cancer, any number of horrible things.
They came back the next day to review labs and a nurse weighs her. She is miraculously back to her previous weight (actually up 2 lbs)!
So the entire ordeal was due to a triaging error.
i know this was technically the MOA's error but I am also feeling very guilty. Her extreme weight loss did not sit well with me but I trusted the vitals I was given (as I feel I should be able to)...but should I have just weighed her myself if I was skeptical? How many of you take a "if you want something done right" approach to things like this? I am so frustrated by this, for not just myself but the patient's family. I didn't make the error but I feel that I am ultimately responsible for what happens with patients. Some peers are saying no way, it is on the MOA. Thoughts? Opinions?
