My father is a physician, so I was used to family and friends constantly calling our home asking a health question or two. As a kid, I enjoyed the benefits of having a parent in healthcare. I rarely went to my pediatrician, and rather was diagnosed with a viral illness here and there from the comfort of our living room sofa. Over the counter medications along with a prescription or two, were stockpiled in our cabinets. I was even taken in the back entrance of the hospital for an off-the-record X-ray or two after sports related injuries.
As a nurse practitioner, chances are you have a similar setup in your own home. I know I do. Health knowledge always comes in handy, and saves my husband and I a number of what would be trips to an urgent care clinic every year. I know which lacerations need sutured, and which I can bandage and call it a day. I understand when an illness warrants antibiotics, and when it does not. Providing medical advice to friends and family, however, can land you in a sticky situation as a nurse practitioner. Despite the convenience, it’s not always the most advisable move.
On a family vacation a few years ago, I found myself in one such situation. On a boat trip in Alaska with family and close friends, one of our friends fell ill with vomiting and abdominal pain. Located in a remote area of Glacier National Park, sailing back to an port with adequate medical facilities was a day or two away. Extrication by helicopter was an option, but obviously quite expensive.
After talking with our friend and looking him over, I knew he was sick. Had he showed up in the emergency department where I work, I would have ordered labs and a CT scan to make a more definitive diagnosis. I was concerned he could have an appendicitis. I would have felt terrible, however, if I had suggested helicopter evacuation for a simple case of gastroenteritis. I was stuck. I didn’t know what to suggest.
In this instance, I opted to give our friend all of the information I could, and let him make the call. Ultimately, we headed the boat towards land, and he went to the emergency department the next day. He was diagnosed with an appendicitis.
Making medical recommendations for family and friends as a nurse practitioner must be carefully considered. When you are in a close relationship with someone, it can be difficult to look at situations objectively, preventing you from making the right call. An incorrect diagnosis or suggestion could damage your relationship, placing additional weight on the decision.
Early in my nurse practitioner career, I felt awkward saying “no” when friends or coworkers asked for my medical expertise. Now, however, I have created boundaries for myself to make this easier. When it comes to coworkers, for example, I say something along the lines of “I’m sorry, as a rule I don’t offer medical advice or write prescriptions for people I work with as I have seen this turn out poorly in the past. Would you like me to suggest someone you can make an appointment with about your problem?”. Typically, this reply is well received. People understand. I protect my professional relationships, not to mention my license to practice. It’s still difficult, but I think it’s the right thing to do.
How do you respond when friends, family, and coworkers ask you for health advice? Where do you draw the line?
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