NervousNP

I truly appreciate your response! You are so correct. I have told many patients about their terminal illness. I've actually had to tell a coworker i worked with daily and was also my patient about her metastatic multiple myeloma. That's why I'm so upset with myself. It was my selfishness because seen I began treating her I had nothing but bad news from day one. However, lost of trust is much worse. And it was unfortunate that an ED doc had to break the news to her and her family. I completely understand where you are coming from and much prefer the truth and honest feedback. Thanks again!

Thank you for your input. She actually had all the specialist appointments already scheduled which i did verify to include oncology. This was a hard lesson for me but it has caused me to never make decisions based on my personal emotions. Thank you again, your response is greatly appreciated

Thank you for your response. I completely agree. I did speak with the patient's sister. She was upset as rightfully so. I have had nothing but bad news after obtaining imaging/lab results for this patient since I became her PCP. I felt so bad for her, not at all excusing my poor decision not to reveal her diagnosis which of course did more harm. Thanks again for your input.

I had a pt that came to me very ill in May. She was admitted for a hgb of 4 after having a syncopal episode going to her neurologist. She was having bloody stools but never informed me. She was in the hospital for 12 days. During that time she was consulted by general surgeon, hem onc, & GI. She had a kidney & liver bx after mass identified on CT scan. She was discharged prior to bx results & had scheduled follow ups with myself as well as all the specialists. My appointment was first & the others 1 1/2 weeks later. Her liver bx was positive for hepatic carcinoma. After discussing with a colleague I decided not to tell her because I felt the specialist should. I scheduled her sooner with GI because she was jaundice at her f/u appt to the following Wednesday. She missed the appt & subsequently ended up in the ED for progressive weakness. Unfortunately the ED doc informed her of her terminal dx. As expected the family was in shock, disappointed & I'm quite sure angry with me for not telling them during her follow up appointment. I feel so horrible & truly regret my decision to wait on the specialist. I feel like a failure as a provider. I just wanted other options of what you as a primary provider would do. Thank you for taking the time to read my post.

I thought I was the only one that felt this way! I work in family practice but I also still question somethings even almost 2years out. I do worry about when I have to send someone out to the ED I'm going to feel like they think I'm stupid but you are correct if you have the proper advanced diagnostic equipment in house & they deteriorate it's on the provider. So good for you for being extra cautious!

I have done some CME, no conferences as of yet. I don't network with my local ANP organization, just haven't made time. I'm a mother of 3 small children although I have plenty of help with my husband so I may become more involved her soon. I didn't get an orientation although my pt load was slowly increased over this time frame. I don't have a mentor as an NP I had plenty as an RN in the ED though but it's not the same. My specialty was colorectal & I left because I worked with surgeons only no other NP to orient me & I felt I just didn't know what I was doing & I was able to transfer or primary care

Hello! I've been in family practice for 18months after being in a specialty for 6months after school. I've noticed in my practice I get nervous only at times when diagnosing & have not done the most basic things that I know better such not getting an EKG for someone with palpations although the CV exam was normal! I have wonderful colleagues but I also have be independent & I feel like I'm not where I should be...any feed back would be greatly appreciated, please be completely honest!