Nurse practitioners

[Sir_Dispensalot]

After having had a recent unpleasant episode with my GP surgery's nurse practitioner (the one who gets to write on the green Rx), i decided to have a surf around the net. seems Dr Crippen seems to think along similar lines as I do...

NHS Blog Doctor

To cut a long story short, my (step)daughter had to see the NP for a mild chest infection. Due to her being asthmatic, she often needs antibiotic prophylaxis in order to prevent a trip to hospital.

When talking about her inhalers, the NP flippantly told my young 'un that if she didn't use her steriod inhaler every single day (regardless of time of day, season of the year or the state of her asthma) her lungs would rot away.

I nearly hit the roof. I told the NP "since when does asthma, a REVERSIBLE obstructive airways disease cause chronic progressive lung damage? If it did rot your lungs then we'd see a good 10% of the uk population in iron lungs by now!"
I also told her how much she had scared my (step)daughter, and how bloody lucky she was that i wasn't going to involve the pct and the fitness-to-practice body.

After a second appointment (this time with the GP), the prophylactic antibiotics were obtained, and little miss wheezy managed to avoid a trip to the local infirmary.

What scares me is that if I can run into a dingbat like that in one of my local surgeries, should i be going over a lot more NP scripts for more 'unusual' items?


/rant over

naturally i realise that all NPs aren't dingbats!

[Jeff]

So how often should his step-daughter use her steroid inhaler?

Jeff

[johnep]

I always understood that should be used daily. It should be 50mcg strength and not QVAR. If problem only during hay fever season. Then that is when should be used.
johnep

[Sir_Dispensalot]

for clarification, her asthma is generally well controlled and she only needs to introduce steroid therapy during hayfever season and when she has a chest infection.

[Tony Schofield]

Nurse practitioners are the same as everyone else.

Some are fantastic leading those that come into contact with them to the conclusion that more use of them should be made. Some are arrogant, haughty, ignorant fools who put the public at risk.

A bit like doctors, pharmacists, lawyers..............................

[jaymags]

Like the one who prescribed Plavix 300mg. Unfortunately the 'script came in on a Saturday,with a locum. When I got in on the Monday and checked the guys record a warning came up, how the others missed it was beyond me, "dose considered high contact prescriber". Having done this the nurse in question soon phoned back in a state of panic, "you haven't given it have you, it was meant to be for 150mg?" I think she just clicked on the first line that said Plavix without looking at the strength.

[Tony Schofield]

So who are you holding to account? The prescriber or the pharmacist and staff?

It looks as though all are culpable as per the Migril case.

We can't beat a nurse practitioner over the head in such a situation as there seems to have been a "negligence fest" on that Saturday

[jaymags]

Everyone I guess Tony.
1. The fact that the nurse prescriber got it wrong in the first place.
2. The fact that the staff missed the warning.
3. The fact that the locum also missed it.
I would have loked to beat every one over the head for that one.

[Tony Schofield]

Quite, so to highlight this as an example of a nurse practitioner falling below the mark is perhaps unwise as it has highlighted deficiencies we would rather weren't aired concerning the pharmacy performance?

[johnep]

Yes, we should not be washing each others dirty linen in public. Leave that to the politicians.
johnep