Tuesday, June 21, 2011

How Can Your Nurse Practitioner Help You Today?

That's the question of the day most of the time. I see many types of patients in the rural health office that I work in. For the most part, my patients actually have problems that I can do something about. Some are not so lucky.

I cannot help the patient who comes from another office with no records and has been receiving narcotics and Xanax indiscriminately. I understand that you are in pain and it seems to be the most important thing about you. I am sorry that the doctor wrote you meds that you became addicted to. I can't do that. Not even if I could, would I do that. I am thinking of your future and your families future. No, I doubt any pain management clinic will take Medicaid because they don't pay well. In fact, forget about seeing any kind of specialty for the problem that is causing your pain because as much as you would like them to fix the problem and get back to work, it's NOT going to happen. This contributes to the whole problem in general. The cycle goes on.

Don't get me wrong. I am not some person who doesn't understand your pain. I have lived with pain for the last 25 years of various kinds. Some fibromyalgia and some from different surgeries. Car accidents are no fun and neither are knee injuries on the job nursing for years at the hospital. I also have allergies to codeine and morphine and Tramadol makes me feel like I am dying. I know that when other nurses and Docs take my med history they look at me like I look at you, usually disbelieving that I will not be asking for the heavy meds. I take Ibuprofen and suffer. Maybe one day, I will need something stronger. I hope to God not. I have to work to diagnose and treat patients. I cannot be impaired in any way.

I also cannot fix the cancers that other providers has missed. Unfortunately, most of them are cancers that you contributed to by smoking two packs of cigarettes daily for the last 20 years. I'm sorry that they never got an X-ray or asked how long you have been losing weight. I'm really sorry that you had a bad Pap smear but you never went back for a follow up according to your records. Sometimes, providers miss things but mostly cancers are found in early stages if you do the basic check ups.

The excuses are usually related to not having insurance or any money. Find where your local Federally Qualified Rural Health office is located and get seen on their sliding fee system. Most have x-ray available at least.

I hope that you come to see me and ask me to help you today. I really do. Just make sure that you aren't seeking drugs because if you do, you can keep on walking.


  1. This is an excellent post. It really hit home for me as a NP student. Answered a lot of frusterating questions that I had which were lingering for awhile.

  2. Glad I could help Tina. Sometimes it's really hard not to become jaded and a little bitter out here. I really do love my job. Some days are outstanding but some are unbelievably frustrating. Hope you do well in your studies!

  3. It's unfortunate, but sometimes people do actually need to be told these things. Pity we can't be upfront for liability reasons.
    I wish we had the ability to help people help themselves more often.

  4. Nice and well written post! i really like the way you expressed your thoughts! Keep it up!
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