Overlook?

[Maria1308]

Working at a clinic as a nurse. There is an older lady (I think 64 yo) that would comes in complaining of high blood pressure readings at home (especially early mornings upon awaking), lower back pain, and occasionally upper abdominal pain. and we recently discovered that she had a positive test (*3) result of occult blood (stool). I feel so bad for this lady because she has no family and have a hard time hearing or understanding our doc. Our doc increased her dosage of beta-blocker and losartan and ordered a EGD but not a colonoscopy and sent her home to follow up in four weeks. Well she came back for her scheduled office visit and our doctor found out she went to see an allergist three days ago who gave her antibiotics and sinus spray for a sinus infection. Well our doc basically scolded her (like literally made her feel like a child) for seeing another doctor. Long story short she came out teary eyed and basically asked to cancel all future appts as she no longer wished to see our doctor. Well I left out the fact that this woman lives about two houses down from me. I’m wondering what can be going on with her as to why her blood pressures are still high. I feel that she definitely needs a colonoscopy and a egd. Any idea. I honestly don’t think she’s going to go to any doctor from the sound of it and I’ve been trying to convince her to at least see someone else. I also wonder if the losartan she has is one that have been recalled.

[amoLucia]

It is admirable that you are a caring person, but be careful that you don't become overly involved in her care more as a neighbor than a nurse. You are a clinician and your job is to be an advocate not a significant other who wants to direct her care.

She needs to follow with a case manager or clinical social worker; make the referrals. They can safely intervene and there may also be other resources that she can utilize.

It is hard to step back from being too close - I know the feeling. So on her behalf, THANK YOU for your help. And kudos to you for your concern for someone so vulnerable.