"I'm a Nurse Practitioner!"

[Anna Flaxis]

Patient comes in by ambulance for Unspecified. On the way in, EMS throws in an 18g and draws blood for labs. Patient looks good, is completely with it, condition seems pretty benign, but need to check a few things. Order CBC, Comp, EKG, do orthostatics, send blood to lab, hang 2nd liter of NS. New ED Doc That I've Never Worked With Before picks up the chart. Orders something that makes sense (but I couldn't order it myself), and something else that seems unnecessary. But whatever. I don't have "M.D." after my name, so I don't question, I just do, and order the test that seems unnecessary.

A while later, Family Member comes out of room, interrupting report I'm giving to Esteemed Colleague so I can go to my federally mandated meal break 6 hours into my 8 hour shift (and I'm starving).

Family Member: "Um, yeah, I was wondering if anyone is ever going to come in and take some blood?"

Me: "They took blood in the ambulance on the way in. It's already in the lab."

Family Member: "Oh, okay, well I was just wondering because the doctor said he was going to order XYZ test, and I'm a Nurse Practitioner, and nobody ever came in and got blood."

Me: "Yeah, they got it in the ambulance. It's in the lab. XYZ test is being done right now."

Family Member: "Okay, well I just thought I'd check, because I'm a Nurse Practitioner...."

Me: Blank stare.

Family Member: Goes back into room.

I finish report and go for a latte since nothing's open at this hour, and I didn't bring a meal.

While I'm on my federally mandated meal break drinking my Latte Dinner, New ED Doc That I've Never Worked With Before apparently tells patient and Family Member that he's going to keep the patient for overnight observation, and Family Member goes home. NEDDTINWWB then asks me to do orthostatics and order another unnecessary test.

Me: "I did orthostatics already (pointing at the chart where I had clearly documented orthostatics on arrival, which were negative), his pressure was rock solid, but I guess I can do them again if you want..."

NEDDTINWWB: (Seeing my documented orthostatics for the first time and barely glancing at them) "Yeah, I think we should repeat them, and get ABC test."

Me: "Okay, but he's not on any blah blah blah medication for his blahbitty blah blah, because yadda yadda, so are you sure we really need this test?"

NEDDTINWWB: (Looking irritated) "Yes, the admitting doctor wants it."

Me, to myself: "Yeah, but if the admitting doctor knew what I just told you, he would think this test was just as unnecessary as I do."

Me, in reality: "Sure, no problem."

Sigh. So, I repeat orthostatics and order ABC test, a bit surprised that this A&O, reasonably healthy, middle aged, walkie talkie patient is going to be admitted for observation of his Benign Condition. This should be a slam dunk treat and street. There is nothing to observe.

Admitting Doctor Genius (really, no sarcasm here; he is brilliant and I'd let him take care of me and mine any day) comes and sees the patient, and says the patient does not need to be admitted (surprise). He does a great job of explaining the Benign Condition to the patient, and the patient is satisfied with the explanation and his disposition.

Next thing I know, my phone is ringing.

Me: "Hi, this is Stargazer."

Voice on Phone: "Yeah, this is the Family Member for Patient X. I want to know what's going on, because I thought he was going to be admitted and he just called me to say he's being discharged, and I'm a Nurse Practitioner, so..."

Me: "I'm sorry, but I can't give out personal medical information over the phone. I can tell you that we've run some tests, everything looks fine, and he's being discharged."

Voice: "Well, I'm not satisfied with that. Did they do Test X? I'm a Nurse Practitioner, so I know they should do Test X."

Me: "I'm sorry, I can't give out specific medical information over the phone. All I can tell you is that we ran some tests and everything looks fine, and he's being discharged."

Voice: "That's not good enough. Did they do Test X or didn't they? I'm a Nurse Practitioner and..."

Me: "Ma'am, I can't give out confidential medical information over the phone. I can let you talk to your family member if you like."

Voice: "I already talked to him. I want to know why he's not going to be admitted. I'm a Nurse Practitioner and I know he's "At Risk", plus I just had surgery."

Me: "Two Medical Doctors have examined him and have determined that it's not medically necessary to admit him. All of his test results are normal. He is being discharged. That's all I can tell you."

Voice: "Blahbitty blah blah Nurse Practioner yakkity schmakkity blah blah blip blip."

Me, to myself: "I don't care if you're the Queen of England, I'm not divulging PHI. You can go jump in a lake."

Me, in reality: "Well, maybe when you come pick him up, the doctor will still be here and you can ask him your questions."

I then very efficiently discharged the patient to the lobby.

[Anna Flaxis, BSN, RN]

Thanks, but I try to save my options to thinking for my time off, haha!

Next time I have a doctor or a nurse or a doctor or nurse's relative for a patient, I'll try to do something other than think! I'm sure they'll appreciate it, LOL.

But seriously, I'm just messing with you, Whispera. Clearly you are trying to be helpful.

[hecallsmeDuchess]

There I was going to say congrats to you on becoming a NP! Hmm, I also don't like when people drop names or titles as if they want me to be impressed or something. So thankful I've perfected my blank stare for situations like that.

Oh by the way, wondered for a second what NEDMDTINWWB meant, then I got it. LOL.

[Ruby Vee, BSN]

these kind of people are annoying. a few months ago i had a patient who has an md for a sister. when she came to visit the patient, instead of introducing herself as "hi, i'm so and so, the patient's sister." i got "hi, i'm dr. so and so, how is he doing?" never mentioned their relation, lol. at least she wasn't annoying and actually asked appropriate questions.

i've had that happen . . . i always ask "what service?" if i don't actually recognize them. if they cannot immediately tell me "cardiology" or "dermatology" or whatever, i'm suspicious. in all my years i've, i've gotten flack from two doctors who really were caring for the patient and outed several dozen who either weren't actually doctors or weren't caring for the patient. or both. i don't care if you're a world famous physician, if you aren't caring for the patient, you don't get information unless the patient says you get information! (and yes, i've refused to give information to world famous physicians.)

[PixieButtercup]

I work on a post-surgical unit....usually very busy. A few months ago I had a fresh post-op come up from PACU with about 5 family members. The daughter asked me how many patients I had that night. I answered 7. She then turns to the patient and says "Oh Mom! You're in luck! Your nurse hardly has any patients tonight so she won't be too busy. She can come in here and visit with you whenever you want!" She then told me "I know what I'm talking about. I'm a physician's assistant." After a little bit longer of a conversation, it's revealed she's not a physician's assistant, but a medical assistant.

[sugarmagnoliaRN]

I work on a post-surgical unit....usually very busy. A few months ago I had a fresh post-op come up from PACU with about 5 family members. The daughter asked me how many patients I had that night. I answered 7. She then turns to the patient and says "Oh Mom! You're in luck! Your nurse hardly has any patients tonight so she won't be too busy. She can come in here and visit with you whenever you want!" She then told me "I know what I'm talking about. I'm a physician's assistant." After a little bit longer of a conversation, it's revealed she's not a physician's assistant, but a medical assistant.

Holy crap!

[DizzyLizzyNurse]

Anyone ever have a family member volunteer that they are a nurse? I was a little embarrassed when my mom was in the hospital and my grandma started telling the nurse, "You'd better take good care of my daughter! Her daughter is a nurse!" I just kinda mouthed "Sorry!" to the nurse.

[Forever Sunshine, ASN, RN]

Anyone ever have a family member volunteer that they are a nurse? I was a little embarrassed when my mom was in the hospital and my grandma started telling the nurse, "You'd better take good care of my daughter! Her daughter is a nurse!" I just kinda mouthed "Sorry!" to the nurse.

My mother tells every healthcare worker she comes into contact with, "My daughter is a nurse!" lol

[Forever Sunshine, ASN, RN]

I work on a post-surgical unit....usually very busy. A few months ago I had a fresh post-op come up from PACU with about 5 family members. The daughter asked me how many patients I had that night. I answered 7. She then turns to the patient and says "Oh Mom! You're in luck! Your nurse hardly has any patients tonight so she won't be too busy. She can come in here and visit with you whenever you want!" She then told me "I know what I'm talking about. I'm a physician's assistant." After a little bit longer of a conversation, it's revealed she's not a physician's assistant, but a medical assistant.

I'd correct her and tell her "No excuse me I said 7 patients.. "

[TrafalgarRN]

Haha...i like that..its happened once where this veterinarian was mad because i didn't flush her Saline Lock with Heparin and instead used Normal Saline. To make matters worse this was one of the ER's in those so called country club neighborhoods. I tried to explain that we don't do use Heparin for Saline Locks but she thought she knew it all and kept telling me she was a doctor. I just got mad and told her " What you do with animals is not what you do to humans and we have policies here that are to be followed". I think she got shocked that in a country club setting someone who have guts to talk to her like that. I then had a 'real doctor' explain the same thing to her. And just for kicks i went back to ask her whether they used Heparin to prevent saline locks in animals from clotting...i just had to show her what an idiot she was.

I don't care whether you are a doctor, nurse, EMT blah...blah...i explain what i have to do to every patient or family and if you have any medical knowledge well and good but please sit down and be polite. You are not treating yourself or your family and are under someone else care. Yes your a dermatologist but please don't keep telling me you are a doctor...why do you want the EKG when i know you can't understand it?

I keep it cool and don't let people know what i do when that times comes for a hospital visit. I listen and ask questions when in doubt. Next person who keeps bugging me they are a doctor or NP and aren't helping will earn themselves a "16":D

PS: If you call to ask for your family and i don't have any of your contact information in their demographics then i don't have such patient in my department:). What...you came in earlier to see your mom in room 4? Sorry i can't give any confidential information over the phone....I can't even admit they are patients in the department. Good day.

[Ruby Vee, BSN]

my mother tells every healthcare worker she comes into contact with, "my daughter is a nurse!" lol

my mother used to tell everyone in sight that both her daughters were nurses and her son-in-law, too.

[Ruby Vee, BSN]

haha...i like that..its happened once where this veterinarian was mad because i didn't flush her saline lock with heparin and instead used normal saline. to make matters worse this was one of the er's in those so called country club neighborhoods. i tried to explain that we don't do use heparin for saline locks but she thought she knew it all and kept telling me she was a doctor. i just got mad and told her " what you do with animals is not what you do to humans and we have policies here that are to be followed". i think she got shocked that in a country club setting someone who have guts to talk to her like that. i then had a 'real doctor' explain the same thing to her. and just for kicks i went back to ask her whether they used heparin to prevent saline locks in animals from clotting...i just had to show her what an idiot she was.

while there is an idiot in your story, i'm not sure it was the vet. up until recently, they were called "heparin locks," not saline locks, and we flushed them with heparin. some places still do.

[FSPW-ICU]

That NP probably has a BS in Forestry and had never worked in a real ED.