I got my hair done yesterday- a quick trim and dye job with my usual hair stylist. My salon experience, per usual, was unbelievably stereotypical. I plopped down in the black swivel chair and my stylist immediately began dishing about her latest personal woes. Why is it that hair stylists always seem to have some sort of dramatic situation at hand? From boyfriends and step-sons to too many margaritas and home improvement mishaps, she’s an endless supply of stories.
Yesterday, as my hair stylist was slapping dark dye into my roots and I was wiggling my right arm further under the cape to avoid staining my shirt, she divulged about her latest encounter with the healthcare system. Always interested in others’ experiences with medicine, I tuned in.
My stylist visited the emergency department a few weeks ago and a CT scan and dilauded were ordered. She didn’t want the CT scan thinking it was unnecessary and she is uninsured, but the nurse practitioner advised her otherwise. She declined the dilauded– what she really thought she needed were nausea meds and IV fluids, but was met with attitude from the nurse when she deviated from the prescribed plan. Ultimately, she was discharged with a nonspecific diagnosis based on her CT results and referred to a specialist within the hospital system.
Visiting the specialist a few days later, she was faced with a condescending physician preceded by an hour long waiting room stint where she observed receptionists painting their nails and chatting on cell phones. Frustrated, she vowed never to return to that particular specialist. She sought out another on her own. Fortunately, she was impressed by this physician’s office.
She waited less than ten minutes in the waiting room, was worked in for a procedure she needed that same week, prescribed effective, non-narcotic pain relief, and given timely follow-up. The specialist wasn’t overtly friendly, but gave honest, straightforward advice. He told her she needed to change her diet and provided her with the information to do so. “I don’t need a friend” she told me. “I’m paying for advice, for someone to tell me what to do” my stylist said.
Besides my shinier, split-end-free hair, I left the salon yesterday with a few takeaways in regards to my medical practice. First, while in most cases our patients aren’t paying us as nurse practitioners directly, office appearance and professionalism matter. Receptionists texting and filing their nails affect your impact when imparting medical care and advice. If as NPs we want to be credible healthcare resources, we need our practices to demonstrate professionalism at every level from the moment the patient walks in the door.
Second, work with patients on a plan of care. Over-ordering tests, or even ordering those that my be necessary, isn’t always the patient’s preference. Some patients may wish to forgo an expensive test like a CT scan even if they will walk away without a definitive diagnosis. Taking the time to explain the risks, benefits, and costs of tests we order is essential- even though this requires time and energy on our part at NPs. Our patients are real people who are going into real debt to pay their medical bills. Paying off a CT scan requires a lot of hair cuts and dye jobs!
Lastly, don’t give up on offering lifestyle advice to patients. As a new nurse practitioner I practiced in an idealistic manner. I encouraged healthy eating and exercise only to become quickly disillusioned. Very few of my patients took my advice. So, I quit giving it so often. But, even though it may seem our efforts to encourage lifestyle changes seem to be falling on deaf ears, at some point our words may sink in. When our patients reach a time of health crisis they just may be willing to listen. This is when you have the opportunity to make a difference in someone’s life. It’s why you went to school. Don’t miss the opportunity.
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