Wednesday, April 22, 2009

Human Responses From A Family Nurse Practitioner

Nurses and Nurse Practitioners are human beings and it's our responses that make us that way. Often, as a nurse practitioner, I have to catch myself and avoid making snap judgments about the patients that I see at the office on first sight.

We've all done it.

The patient who walks in covered in tattoos and scraggly clothes reporting a bad back is a drug seeker. You know the type. Probably smokes weed and hasn't worked a day in forever and is just mooching the crap out of the system. What a loser! Right?

The patient who presents time after time with screaming high blood pressure is non compliant with their meds. I'm mean really! How hard is it to take a pill every morning for God's sake!

The patient who asks for Xanax for nerve problems is a psycho bipolar chick. She's antsy and must be on her manic stage and says she can't sleep. Wonder how much she was taking of the stuff before. Don't providers screen these people. Come on!

The mom who brings in her dirty, smelly barefooted kids crawling in head lice is a bad parent. I'm mean this one for sure is a loser and needs to have HRS called in and have those kids carted off to Foster parent land. Who does she think she is anyway? There are people who would love to have her kids and she doesn't deserve to have them if she can't take care of them.

Wait a minute: Here's the real story:

The man with the tats is a very nice, polite patient who's MRI shows multiple degenerative discs and has spinal cord compression issues. He gets pain meds and shows up to any appt that I make for him. Yes, he's a biker but he can't ride for those charity events like he used to and has a full time job that just about kills him to go to every day.

The screaming high blood pressure is stress related. His wife of 56 years is dying of cancer and he is having to drive her back and for to the next big city for chemo. He sometimes forgets to take his meds but once put on an anti anxiety med, his blood pressure responds. I have to remind him to take care of himself so that he can continue to help her.

The patient with the nerve problem survived physical and sexual child abuse for years and has extreme PTSD. She trialed several meds and I had to finally give her Xanax in a small dose and she is able to hold a job and be functional. She is getting counseling as well and is able to open up to me because I have been there myself. (That's another post)

The mom with kids that are dirty, smelly and have head lice are homeless and have just moved to the area to get away from an abusive boyfriend who was hurting her and the children. She doesn't do drugs, loves her kids and just needs someone to steer her in the right direction. She came in because she heard that I was a compassionate provider who really loves the kids in my practice and takes time to listen. She's been given the numbers for local shelters and is working on job training to better herself.

We all need to be careful not to judge a patient by their cover and take the time to get to know them before making snap decisions. There are true drug seekers who appear very put together and know exactly what to say to get what they want. Some are actually lovely little old ladies that you would find in any church social. Clean cut businessmen who you would take home to Mama are out there selling on the streets and making a killing.

You may even find health care providers wearing jeans and a tee shirt shopping at Walmart who aren't "all done up and representing". (I'm just a regular Mom type person, sorry!) I've been made comments to from other nurses that have seen me shopping and cattily mentioned that I didn't "look like a nurse practitioner that day." Too bad for you!

What types of snap judgements have you made?