I wish I were more of an “it is what it is” kinda guy, I really do. Perhaps then when patients really try my patience, and upset me, I could tell myself, “self, it is what it is”, and just let it go. But I don’t.
This week has really been trying my patience, because of my patients.
See, I am the nurse practitioner, and they are the patients. When they come to me with problems, I listen to their symptoms (self-reported), assess the situation (make my own observation of symptoms if they are present), and based on my education, guidelines, and any other information that I need to access in order to come up with a plan of care, I make a diagnosis, and come up with said plan of care. At that time, it is the time where the patient either likes what I have to say, and agrees to do it, or it can go another way entirely.
Lately, it’s been a little more of the latter, and it’s wearing me down.
See, I am invested in this job. I actually care what happens to the patients, and I want to make sure that I am always operating under the healthcare tenets of beneficence and non-maleficence; which simply means that you do no harm, and you always seek to do the best for the patient that you can. Hence, again, why I use my education, knowledge, and guidelines to guide my practice; whether the patient agrees or not.
Now I get it, you can google anything. ANYTHING. And you can find a ton of information out about just about anything as well. BUT, I challenge anyone that questions why I decided to go one way versus another in my decision to treat (or not); where did you find that info? How did you know how to sift between accurate and often times, mostly wild conjecture? How did you know and when did you learn how to interpret labs, symptoms, multiple medical conditions (not to mention how they interact with all of the other intricacies of other bodily systems), and how to pick and choose between hundreds of different solutions, medications, and remedies to come up with the best solution for yourself? Unless you’ve gone through school for it, you are probably operating under the assumption of what someone else has said, and there is no factual evidence behind it; that is, unless you know where to find the correct remedies and solutions.
This is where the frustrating part starts.
I say, based on what you have told me, and my assessment, we are going to do X.
They say, “well I read online that you need to do X”.
I disagree, because this is not the truth. I assure them that I am using factual, evidence-based practice to guide my decisions, which I even offer to get a second of, by asking my colleagues.
Still, I am often met with eye rolling, and being told that they “know their body”, and demanding certain treatments, which can actually do more harm than good. Worse still are those that have series health conditions and don’t seem to heed my warnings about medication compliance, and put themselves at risk for further harm daily.
It really wears you out when you are not an “it is what it is” kinda guy like me; and because of that, I need to rant sometimes, and that is what this is. Maybe I’ll get better at letting it roll off with years of practice; I certainly hope that I do. I wish I could be a little less stressed about the minutiae of it all, and realize that, yes, when it comes to many patients, it truly is what it is, and I have to just let go, and realize that all I can do is attempt to lead them in the right direction; despite the fact that they have the car in reverse and are slamming on the gas at the same time. I just need to focus on the realization that I am not in the car, and whatever happens really is, ultimately up to them.