Do you feel resentment when a pt. refuses to be seen by you?

adria37 · Jul 14, 2008

No not at all, it is their loss :) but so far I have had positive responses from patient's. I think it is because NP's in general are not as rushed.

Trauma Columnist · Jul 15, 2008

Nope, not at all. However, that said, it happens only rarely in the practice where I'm located.

JDCitizen · Jul 15, 2008

None at all the patient has the right to refuse treatment and/or provider.

I guess in my first days as a RN it bothered me some but my beliefs in patients' rights won out...

allnurses Guide · Jul 15, 2008

Not at all and I before I start with my patients I always explain I am a nurse practitioner and not a doctor and offer the patient the opportunity to see the doctor.

The only time I did get frustrated when I had apent ages and explained in detail to an elderly patient what a nurse practitioner was and that I was also a nurse prescriber, she asked lots of questions and seemed to be very happy with being seen and treated by a NP, she was very pleased to see that told me she was an ex nurse and was very please with how the profession had progressed and of course she was happy to see me, I examined her and she had a post op urine infection proven on CSU, I explained that I wanted to start some abx and her reponse was "that's nice dear but shall we wait for a doctor to make those types of decisions"

What is nice is that I get my consultant in those situations and present the patient and my findings to him, his response is always the same, that's great Sharrie but you know what your doing with this type of thing so go ahead with your plan, any other problems let me know

DaisyRN, ACNP · Jul 17, 2008

actually,

with me being the new np to a group that has never had mlps, you can imagine many of our patients being unfamiliar with mlps as well, so i do encounter this from time to time. generally speaking, people will say something along the lines of "i really need to talk to dr. cardiology about my xyz." and they don't realize that i review their charts and health histories... they think they will have to repeat everything a thousand times and that i won't know what to do for them. it's a huge learning curve... 99% of the time they simply just do not understand what i can do nor that i work very closely with the doc.

i usually tell them that dr. soandso asked me to see them, but that he may pop his head in to say hello before they leave. i reassure them that i will update him after we have visited and want them to know that i can help them with many of their needs, if not all of them in the clinic setting. basically, i try to make friends... today, this lady was hesitant to see me, but then when i asked her if she would rather see the doc, she said... "well no, you are already here. thats okay... i'll see if you can answer my questions." needless to say, i answered her questions and she left before he even had a chance to say "hello" to her. *lol* i also make it a point to give them my card personally and remind them that if the doc is ever out of the office or busy, i am there for them too. this makes them feel good to know that i care, but also that the doc is still in the picture and that we have a working relationship.

i have found that if i spend the time talking with them about normal things, i.e. why they take imdur, they realize i am knowledgeable and truly interested in their care. now i have folks only wanting to see me. so, it goes both ways... in the beginning, it did kinda ruffle my feathers, just because i was so new and wanted everyone to know i could help them! i just have learned to deal with it... and everybody else is right. it is absolutely their decision to make. :)

another reason some people have hesitations in seeing mlps is because they know someone who knew someone that encountered a "bad seed mlp." granted, there are bad seed mds as well... but they associated any mlp as that bad seed sometimes.

Jo Dirt · Jul 17, 2008

May I ask what an MLP is?

Maybe I need to get around more, but I don't have a clue.

Editorial Team / Admin · Jul 17, 2008

MLP=mid level provider. APNs/PAs are referred to as mid-levels.

ANPFNPGNP · Jul 20, 2008

actually,
with me being the new np to a group that has never had mlps, you can imagine many of our patients being unfamiliar with mlps as well, so i do encounter this from time to time. generally speaking, people will say something along the lines of "i really need to talk to dr. cardiology about my xyz." and they don't realize that i review their charts and health histories... they think they will have to repeat everything a thousand times and that i won't know what to do for them. it's a huge learning curve... 99% of the time they simply just do not understand what i can do nor that i work very closely with the doc.
i usually tell them that dr. soandso asked me to see them, but that he may pop his head in to say hello before they leave. i reassure them that i will update him after we have visited and want them to know that i can help them with many of their needs, if not all of them in the clinic setting. basically, i try to make friends... today, this lady was hesitant to see me, but then when i asked her if she would rather see the doc, she said... "well no, you are already here. thats okay... i'll see if you can answer my questions." needless to say, i answered her questions and she left before he even had a chance to say "hello" to her. *lol* i also make it a point to give them my card personally and remind them that if the doc is ever out of the office or busy, i am there for them too. this makes them feel good to know that i care, but also that the doc is still in the picture and that we have a working relationship.
i have found that if i spend the time talking with them about normal things, i.e. why they take imdur, they realize i am knowledgeable and truly interested in their care. now i have folks only wanting to see me. so, it goes both ways... in the beginning, it did kinda ruffle my feathers, just because i was so new and wanted everyone to know i could help them! i just have learned to deal with it... and everybody else is right. it is absolutely their decision to make. :)
another reason some people have hesitations in seeing mlps is because they know someone who knew someone that encountered a "bad seed mlp." granted, there are bad seed mds as well... but they associated any mlp as that bad seed sometimes.

i had never encountered this problem before in urgent care, since they could either see me or no one at all, until i went to work for a group of docs who had been practicing for over 30 years. several of those elderly patients wanted to see the "big guy," because he had been treating them for years. i've been there for almost a year now and it's very rare that a patient refuses to see me. however, there are times when i definitely have to get the doctor, because i recognize when i'm over my head. this usually only happens when i have a patient who needs to be admitted.

something else, bedside manner is very important! there are docs out there who probably shouldn't be practicing, yet they have very busy practices simply because their patients adore them. there are other docs who are at the top of their game, but they're going under because of their lack of personality. personally, i would rather see that doctor who knows what the heck they're doing!

scribblerpnp · Jul 24, 2008

No, to me it is their loss. I know I spend more time on education, well child checkups and health promotion and illness prevention than any of the docs I work with. The docs have 10-15 min visits, I have 20 min visits slots. So if the MD means that much to some parent, go ahead and see the doc. Usually the parents who refuse to see me are ones that I have never seen for a visit. Once they do see me, often they don't care so much anymore. And living in an area where I am the only PNP in a 30 mile radius doesn't help much. Most new pts don't really understand my role, unless they see me so I can explain it.

The other staff in our office (RN's, MA's, secretaries, etc) will bring their kids to me over the docs anytime, so that is all the validation I need.

If a parents seems dubious about my ability, I have no problem bring the doc in to "double check" things.

Even when I answer the phone, I do not ID myself as the NP because if I offer the pt a time slot with the NP (I'm the only one), I don't want them to fee obligated to say yes.

No big deal, if they aren't willing to fill my time slot, there is always someone who is (and they will get seen sooner).

TX_ICU_RN · Jul 27, 2008

I went to the gynecologist the other day and before I went in I noticed a new name under the doctor's name, with the initials NP.
When I was in the waiting room the nurse came in and asked if it was okay if I saw the nurse practitioner. Sure, didn't bother me. It never occurred to me that someone would refuse to see a nurse practitioner.
I just wonder if any NP's become a little offended or hurt if a pt. does refuse to see them?

I did when I first started practicing, but the first time I had to see a patient that REALLY did not want to see a NP changed my mind. The doc had to leave to go to the hospital for an emergency and the mom decided she would "settle". The tension was very high in the room and I had a horrible thought pop into my mind:

UNHAPPY PATIENTS/PARENTS ARE MUCH MORE LIKELY TO SUE YOU! THE PEOPLE WHO DON'T WANT TO SEE A NP AND ACTUALLY EXPRESS THERE OPINION ARE DOING ME A GREAT FAVOR!!