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Old 01-10-2013, 11:24 AM
 
Location: Minnesota
400 posts, read 1,912,093 times
Reputation: 420

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This is a bit of a rant - let me know if you can relate - about nurses who prescribe you antibiotics without actually diagnosing you; which they can't do anyway as they aren't doctors. Is this a new trend? Are doctors so lazy as to let their nursing staff hand out medication without giving the patient a reason?

For example, I went to see a gyno nurse for pelvic pain the other day, some cramping and chills. Without even examining me or doing a urine test, she prescribed me a week's worth of antibiotics. When I told her I'd just finished a round of antibiotics a week ago for a sinus infection, she seemed surprised which irritated me because she had my electronic chart up on her computer screen but never even bothered to look at it. Then when I asked her why she prescribed me antibiotics again without a diagnosis, she tried to reason that it's because my symptoms, and I quote, "seem like a good reason to." Seem like a good reason to? What the heck?!?!

So I scheduled an appointment with a gynecologist whose first request was for me to do a urine test. Turns out I have a urinary tract infection. NOW I will take the antibiotics. Sheesh. I feel like asking the doctor's office for a refund on my first co-pay with my nurse visit, and report her actions as irresponsible. She was Googling stuff on the Internet during my visit with her which seems really unprofessional for someone who claims to have 25 years of nursing experience. What a nightmare. If I hadn't see the gynecologist and blindly taken the antibiotics the nurse prescribed, who knows if they would have even worked on my urinary tract infection.
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Old 01-10-2013, 12:55 PM
 
Location: Durham UK
2,028 posts, read 5,409,709 times
Reputation: 1150
Quote:
Originally Posted by Midwest Maven View Post
This is a bit of a rant - let me know if you can relate - about nurses who prescribe you antibiotics without actually diagnosing you; which they can't do anyway as they aren't doctors. Is this a new trend? Are doctors so lazy as to let their nursing staff hand out medication without giving the patient a reason?

For example, I went to see a gyno nurse for pelvic pain the other day, some cramping and chills. Without even examining me or doing a urine test, she prescribed me a week's worth of antibiotics. When I told her I'd just finished a round of antibiotics a week ago for a sinus infection, she seemed surprised which irritated me because she had my electronic chart up on her computer screen but never even bothered to look at it. Then when I asked her why she prescribed me antibiotics again without a diagnosis, she tried to reason that it's because my symptoms, and I quote, "seem like a good reason to." Seem like a good reason to? What the heck?!?!

So I scheduled an appointment with a gynecologist whose first request was for me to do a urine test. Turns out I have a urinary tract infection. NOW I will take the antibiotics. Sheesh. I feel like asking the doctor's office for a refund on my first co-pay with my nurse visit, and report her actions as irresponsible. She was Googling stuff on the Internet during my visit with her which seems really unprofessional for someone who claims to have 25 years of nursing experience. What a nightmare. If I hadn't see the gynecologist and blindly taken the antibiotics the nurse prescribed, who knows if they would have even worked on my urinary tract infection.
Well NPs can "diagnose" otherwise how would they know what to prescribe?
You don't need to be a DR to diagnose-in fact many NPs do a better job than Doctors.
However sounds like this NP made no attempt to examine you , but she did correctly diagnose you with a UTI-which was why she gave you the antibiotics. You had classic symptoms and I would have done a urine dipstick-however it could have been negative but my diagnosis would still have been UTI in the absence of anything else. All you did was delay taking the antibiotics until you saw the gyn doc, which potentially could have made you worse.
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Old 01-10-2013, 02:13 PM
 
Location: Minnesota
400 posts, read 1,912,093 times
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Quote:
Originally Posted by Whatsthenews View Post
Well NPs can "diagnose" otherwise how would they know what to prescribe?
You don't need to be a DR to diagnose-in fact many NPs do a better job than Doctors.
However sounds like this NP made no attempt to examine you , but she did correctly diagnose you with a UTI-which was why she gave you the antibiotics. You had classic symptoms and I would have done a urine dipstick-however it could have been negative but my diagnosis would still have been UTI in the absence of anything else. All you did was delay taking the antibiotics until you saw the gyn doc, which potentially could have made you worse.
Well there is a huge difference between "you have a UTI" vs what the nurse said which was "seems like a good idea." Sorry, but I pay a co-pay for a reason and expect a medical professional to give me a diagnosis as a reason for a prescription.
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Old 01-10-2013, 03:34 PM
 
1,458 posts, read 2,647,781 times
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You keep saying nurse. You need to be more specific.

An advanced practice nurse?
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Old 01-10-2013, 08:33 PM
 
Location: Minnesota
400 posts, read 1,912,093 times
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Quote:
Originally Posted by rohirette View Post
You keep saying nurse. You need to be more specific.

An advanced practice nurse?
Yes, she is an advanced practice nurse. But that still doesn't excuse her flaky reasoning to prescribe me antibiotics without properly diagnosing me. If she knew I had a UTI then she is required by law to say so. But she didn't. She gave me the vague "just in case" excuse, which left me in a panic thinking, "in case of what exactly!?" Hence my rant here. I don't want to take antibiotics if I don't know what the reason is for. Plus if she doesn't tell me it's a UTI, how does she know which antibiotics to prescribe since she's not a doctor. Does that make sense at all?
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Old 01-11-2013, 09:47 AM
 
Location: Durham UK
2,028 posts, read 5,409,709 times
Reputation: 1150
Plus if she doesn't tell me it's a UTI, how does she know which antibiotics to prescribe since she's not a doctor. Does that make sense at all?

No because she will prescribe in exactly the sameway as a Dr -ie with an antibiotic that is usually prescribed for a UTI.

You could have asked her what the diagnosis was.
I agree that she she should have examined you and done a dipstick and for her not to was bad practice and could have left her open to a malpractice case.
Would be interested to see what she documented in your records.
You should express your concerns in writing to the practice manager and you can also report a nurse to the state board of nursing.
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Old 01-11-2013, 11:24 AM
 
Location: Minnesota
400 posts, read 1,912,093 times
Reputation: 420
Quote:
Originally Posted by Whatsthenews View Post
Plus if she doesn't tell me it's a UTI, how does she know which antibiotics to prescribe since she's not a doctor. Does that make sense at all?

No because she will prescribe in exactly the sameway as a Dr -ie with an antibiotic that is usually prescribed for a UTI.

You could have asked her what the diagnosis was.
I agree that she she should have examined you and done a dipstick and for her not to was bad practice and could have left her open to a malpractice case.
Would be interested to see what she documented in your records.
You should express your concerns in writing to the practice manager and you can also report a nurse to the state board of nursing.
I have to disagree with you on this nurse's knowledge of antibiotics. The pharmacist I spoke with told me she prescribed the WRONG antibiotics for the UTI. I'm relieved that I called too. I think she is the exception as I have to hope that advanced practice nurses know what drugs beat what bacteria.

I also agree with you that it is bad practice for the nurse not to do a dipstick test. She opened herself up to a legal problem by 1) not performing all the required tests 2) not verbally giving me a diagnosis 3) prescribing drugs without giving the patient a diagnosis.

When I met with the gynecologist - her boss, in essence - he covered for her (smart of him?) by agreeing with me that the nurse was wrong to prescribe me drugs without properly testing and then diagnosing me. He actually switched the prescription and cancelled the nurse's prescription. So he essentially covered for the nurse, who I clearly believe should lose her nursing license for her choices.

This reminds me of a psychologist I once saw after my father's death (not the one I went to therapy with for 5 years) whose medical license had been revoked for 2 reasons; he had sex with some of his patients and he also was abusing drugs. I can't believe I got referred to this man by my medical clinic. And I can't believe my medical clinic didn't know that this psychologist was practicing without his license for a period of time.

I can go to my state's board of medical licensing website and file a complaint against this nurse if I wanted to. I can also look her up by name to see if she has any complaints against her or problems with her license.

But I think at this point, I'm going to stick with seeing the doctor instead. Just goes to show not everyone who has a medical license SHOULD have one. Better screening needs to be done in my opinion, or this nurse at least should be disciplined by my doctor, her boss.

I'm just of the mindset that the U.S. is an over-prescribed country and that if I'm going to take a medication, I better da*n well have a proper diagnosis first. I'm not going to trust someone just because they tell me to trust them.
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Old 01-11-2013, 03:32 PM
 
Location: Durham UK
2,028 posts, read 5,409,709 times
Reputation: 1150
Quote:
Originally Posted by Midwest Maven View Post
I have to disagree with you on this nurse's knowledge of antibiotics. The pharmacist I spoke with told me she prescribed the WRONG antibiotics for the UTI. I'm relieved that I called too. I think she is the exception as I have to hope that advanced practice nurses know what drugs beat what bacteria.

I also agree with you that it is bad practice for the nurse not to do a dipstick test. She opened herself up to a legal problem by 1) not performing all the required tests 2) not verbally giving me a diagnosis 3) prescribing drugs without giving the patient a diagnosis.

When I met with the gynecologist - her boss, in essence - he covered for her (smart of him?) by agreeing with me that the nurse was wrong to prescribe me drugs without properly testing and then diagnosing me. He actually switched the prescription and cancelled the nurse's prescription. So he essentially covered for the nurse, who I clearly believe should lose her nursing license for her choices.

This reminds me of a psychologist I once saw after my father's death (not the one I went to therapy with for 5 years) whose medical license had been revoked for 2 reasons; he had sex with some of his patients and he also was abusing drugs. I can't believe I got referred to this man by my medical clinic. And I can't believe my medical clinic didn't know that this psychologist was practicing without his license for a period of time.

I can go to my state's board of medical licensing website and file a complaint against this nurse if I wanted to. I can also look her up by name to see if she has any complaints against her or problems with her license.

But I think at this point, I'm going to stick with seeing the doctor instead. Just goes to show not everyone who has a medical license SHOULD have one. Better screening needs to be done in my opinion, or this nurse at least should be disciplined by my doctor, her boss.

I'm just of the mindset that the U.S. is an over-prescribed country and that if I'm going to take a medication, I better da*n well have a proper diagnosis first. I'm not going to trust someone just because they tell me to trust them.

By not reporting her or making a formal complaint you are in essence allowing things like this to continue.
It's these types of incidents are what often perpetuates the poor opinions some people have of nurses or NPs.
You're happy to come on here and bad mouth nurses, but not going to do anything to prevent others from having a similar experience.
I would have thought she should at least lose her prescribing priveleges until she's gone through further training and assessment.
By the way- nurses don't have medical licenses- they have nursing licenses.
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Old 01-11-2013, 04:54 PM
 
Location: in a house
3,574 posts, read 14,308,959 times
Reputation: 2400
If what the OP said is, in fact, true the issue is that for whatever reason, she was not examined. Lots of things cause pelvic pain, the original complaint.
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Old 01-11-2013, 07:50 PM
 
Location: Minnesota
400 posts, read 1,912,093 times
Reputation: 420
Quote:
Originally Posted by Whatsthenews View Post
By not reporting her or making a formal complaint you are in essence allowing things like this to continue.
It's these types of incidents are what often perpetuates the poor opinions some people have of nurses or NPs.
You're happy to come on here and bad mouth nurses, but not going to do anything to prevent others from having a similar experience.
I would have thought she should at least lose her prescribing priveleges until she's gone through further training and assessment.
By the way- nurses don't have medical licenses- they have nursing licenses.
It takes me 5 minutes to log in to my state's medical board's website to file a complaint, as well as file a complaint at my clinic. I find it ironic that you accuse me of "bad mouthing nurses" as though the nurse should not be criticized for her clear lack of following proper medical and legal procedures. Then you disparage me for saying I may not file a complaint.

So I should praise the nurse for trying to prescribe me the wrong antibiotics without properly examining me or performing the necessary tests? I shouldn't hold her accountable for her actions? Of course I will. But it's my choice. Until you walk in my shoes, hold off on the disparaging remarks okay? And if you read the title of my post, it says "mini rant" not "praise for good nurses."

Quote:
Originally Posted by mm_mary73 View Post
If what the OP said is, in fact, true the issue is that for whatever reason, she was not examined. Lots of things cause pelvic pain, the original complaint.
No, the issue isn't my physical symptoms. It's how a nurse with an advanced nursing degree didn't do her job properly and avoided trouble because I went to see her boss, the doctor, instead who finished the examination of my symptoms, properly diagnosed me, and prescribed me the correct medication.
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