Let me start off by saying I avoid this "nurse practitioner" like the bubonic plague. This "individual" constantly insults all nurses, myself included. This nurse practitioner is rude, unprofessional, and let's be honest, not very good at her job. Any who, enough ranting and raving, let me get to the point here.
I have a patient that is elderly and has a terrible, incessant, wet, nonproductive cough; upon listening to lung sounds, I note crackles in lower bilateral lung fields and immediately suspect pneumonia. The patient does not have a fever and his oxygen saturation is 98% on RA. I fill out an SBAR and proceed to place a call to the MD.
About 45 minutes later this "nurse practitioner" calls back and responds to my findings as "Well there isn't much I can do about this. I guess you can give him duoneb treatments QID and get a cxr, even though they never show anything." I do as the "nurse practitioner" asks and call our local mobile x-ray service to get the ball rolling.
Upon receiving results, I note it says, probable for pneumonia or atelectasis of LL lung. I then place an follow-up call to the "nurse practitioner" and read the results... here is the unbelievable response: "Do you see why I hate chest x-rays?! They NEVER show anything... just as useless as every nurse I've worked with. I guess you should get a CBC and CMP to see if the WBC's are elevated. DO NOT call me if they are slightly above normal. He is have dead anyway, there is nothing we can do." At this point in time I am completely speechless and dumbfounded by the response of someone who is supposed to be an advocate for those who cannot speak for themselves (The patient is AAO to self).
The results of the CBC/CMP came back and the values are all out of sorts, so I decide to fax the results because it was during normal business hours. There was no response. I place a call to the office, and still no response. Later that evening, the beloved (note my sarcasm here) "nurse practitioner" comes into the facility and is reviewing all nurses notes and recent labs.
While in the building, I note, with the help of our amazing CNA, that the patient may have a UTI. I proceed to dipstick the urine and note it is positive for leukocytes, nitrates, blood, and excessive amounts of bilirubin and the specific gravity of off. I walk up to the "nurse practitioner" and tell her my findings hoping "this person" would order a UA+C&S but, instead the response was: "Are you SERIOUS? Push oral fluids!!!" Rolls eyes and turns the back towards me.
I had to walk away... I can not believe how ridiculous this person is! I do not know how to handle the situation other than calling the medical director to get this patient taken care of. How do you guys handle or tolerate this type of person? I am at the end of my patience rope with this person. Please advise and be kind. Thanks!!!
