I am a nurse practitioner. I have 18 years’ experience as a nurse. I have a Master’s Degree in nursing. I have saved lives and I have advocated for patients to be allowed to die with dignity. I have caught doctors’ mistakes and I have made my own mistakes. I have taught new nurses and I have taught medical residents. I have a great deal of knowledge and a great deal to learn. That being said, there are few things I am not: I am not doctor wanna-be. I am not a doctor in training. Nursing has its own body of knowledge and its own approach to patient care. I could have going to medical school but I chose to go to nursing school then to “nurse practitioner school”. I am not a mid-level practitioner. I do not provide “mid-level” care. I see the same patients as the physician for whom I work. I see them when they’re sick. I try to figure out if their symptoms are related to the multitude of medications they take (extra dose? omitted dose?) or if those symptoms are part of a new problem. I see them when they come out of the hospital with multiple medication changes (was there a reason for the change or did the hospital just not stock their usual medication?). I see them for their physicals and try to explain why we “drew ten tubes of blood” and what it all means. Does the physician I work for know more than I do? Absolutely. Certainly. Kinda. Maybe. He is one of the smartest people I have ever met. He knows everything about every patient – without looking at a chart. He is patient and understanding when I have questions. But we have different knowledge. He’s been a physician for a long time. I’ve been a nurse for a long time. He thinks like a doctor; I think like a nurse. I think about the whole person. How he is going to pay for his medication. How she can do a wound dressing change with no help. I worry about how my patients comprehend complicated directions for their medications. I worry about how they will manage their medications: once a day; twice a day’ this pill used to be green; do I take this in the morning or at night; I thought I was supposed to take nine pills but there were only eight. I wonder if they have enough to eat or if they can get in/out of the bathtub safely. I teach. I don’t ever pretend to be something I’m not, but I’ve quit correcting my patients who call me Dr. Tina. I does concern me, however, to get a prescription refill request from a pharmacy that says “Dr. Saiani” because the pharmacy should know better. I’m never afraid to say that I don’t know what’s wrong with a patient, but that I will find someone who does (either “my” physician or a specialist). I don’t have to have a physician in the building in order to practice, but it’s sure nice knowing he’s there if I need him. This is not a rant against physicians or patients. It’s just a random thought on a Monday evening. It’s just who I am!
Posted on: Tue, 03 Sep 2013 01:26:21 +0000
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