case scenario -ER /URGENT CARE NP'S

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Urgent care ER nPs

I have a clinical scenario, I work in urgent care

had a patient come in for ankle pain- man about 55 y.o. BP was 197/114, 208/102 manual.

pt. did not want any pain medications (prescription tylenol 3), as he doesn't take them. Discussed elevated blood pressure reading/recommend to stabalize in ER as if they drive home they may stroke out. He did not want to go so signed AMA.

x-ray showed fracture- displaced-patient already left because he wanted to go home and take BP meds and come back

now if this patient comes back in 2 hours to discuss the x-ray and get splint placed they would need to be checked in again as a new office visit correct?

What are your thoughts

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Specializes in Nephrology, Cardiology, ER, ICU.

Yes of course, new visit. However, also needs f/u appts with PCP for BP management and ortho for fx care

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ok thank you- I know it sounds silly but I am walking on eggshells with this job.

I am a great NP but since I am in a new job I am a bit nervous and also I have to see more pediatric patients which isn't my expertise so I am slower with them and a lot more cautious.

I feel my staff aren't supportive of me and give me attitude- all MA' s are backed up by the manager.

Anyone have any positive outlooks on this?

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