Where did you get your license, KMart

[litebrightgirl]

:angryfire Ok. I'm a LPN working on my BSN. I've been sick for little over a month with a cold. This past week I have been progressively worse. I work in a doctor's office and the PA said I need to get a script for a z-pack. This morning I went to one of those quick care places in the drug store. There was a FNP on duty. I told her my symptoms: headache, non productive cough, achy, runny and stuffy nose, low grade fever, and chest congestion. Without even seeing me she said take some OTC meds. I told her I needed antibiotics. She said who told you that. I told her a PA that I work with. She proceeded to tell me that I was not sick and that if the PA wants me to have meds then he could give them to me. But I can see you if you want, but I'm not giving you anything for it. I said ok thanks and walked out. I was never so outraged as I was today. It was just a disgrace to our profession. For a split second I thougt I don't want to become a NP anymore if I have to work with NP's like her. She just totally disregarded me. I ended up going to another clinic and saw a MD who gave me a z-pack, tessalan pills and advair( I have asthma) without me having to tell him what I needed. What are your thoughts about this?

[BmoreCRNP]

Ok. I did not go to my PCP because I couldn't get in for another 3 weeks. That is why I went to urgent care. Second, I have a hx of asthma and was only on a preventil inhaler and my asthma has been getting increasingly worse so the MD put me on Advair. The urgent care clinic is downstairs from my PCP, so he had access to my records and was able to prescribe it. Third, I went to work today and the MD in the office sent me home after 4 hours because my symptoms were getting worse. I was never given a neb tx in the urgent care. Don't know why b/c he listened to my lungs and said they were tight. Today, the MD in the office gave me a neb tx and agreed with the MD in urgent care's dx, not the NP who wouldn't see me. I didn't want to start a war with all of this. BTW, I agree that MD, PA, and NP prescribe meds too much but for her not to even look at me and say I'm not sick was unacceptable. Oh and prarienp, I didn't feel like my chest was tightening so I didn't know that I had a problem with my lungs. I was coughing too much to pay attention to that. And I didn't tell the MD in urgent care I needed abx b/c he at least took the time to examine me. Not trying to be smartmouthed, just answering your question

It's possible you started with a virus that caused an exacerbation of your asthma. This is very common. If you went to minute clinic I can tell you that they have a philosophy about over-prescribing antibiotics. Also, there is no way to really know if you have a bacterial infection unless someone does a bronchoscopy and cultures the fluid/mucous. Viral and bacterial illnesses are treated empirically, which means we kind of take an "educated guess" based on the assessment/symptoms/history of illness, etc. It's possible the NP was right about you not needing abx, however she did a poor job of assessing you and then explaining her rationale for not giving you antibiotics.