Nervous about talking to docs

Pancreatitis
#1

I was wondering if anyone else out there is nervous about talking to your doctors? You would think that me being a nurse that I would have a thicker skin and talking to docs would not bother me. But as any nurse can tell you I have been screamed at by so many physicians in my 14 years that I can’t remember them all. I know that nurses can be the proverbial dog that gets kicked but it has given me a phobia of sorts.

I have an appointment with my PCP 6/20 at 3pm and want to talk to her about getting a focus directive put in my electronic chart. I heard about these from a few of the members and I think they are essential for CP patients who must frequent hospitals and ER’s.

Four days before I was admitted to the hospital this last time I called my PCP’s office to let her know that I was going downhill fast. Usually the office calls her and she and I talk (or her assistant talks to her and then me) about whether I should be a full admit or a 23 hour to get hydrated. She is the only doctor in her office and has a nurse practitioner who sees a lot of her patients so she can round at the hospital. She also has another local PCP cover for her some days/evenings and weekends (she covers for him also). When I called the office the assistant never called back and I had to call the office again. Then the assistant (not the one I normally deal with) told me that they had left a note on 'her" desk and were waiting for a response. I thought she meant my PCP’s desk but I guess she was out that day or unreachable. The nurse practitioner had the assistant call me back and tell me to go to the ER because she (the nurse practitioner) couldn’t admit me. Needless to say, that was a complete waste of time, money and effort and I ended up in the hospital 4 days later.

I want the focus directive on my chart so if my PCP isn’t able to see me for whatever reason, they will admit me if I think I need to be admitted, treat my pain, nausea etc. and I won’t get the ER doc with the blank stare when I recount my history for the 100th time. I will also not have to hear another ER doc say, “I don’t think it’s your pancreas because you Amylase and Lipase are normal”. UGH!!!

My PCP is pretty cool but she can be prickly at times and is not one to patiently hear me present my case, so to speak. So I am afraid that I will approach her about this, she will flatly say “No” and I will leave sad and depressed…again.

I also have to possibly find another GI b/c mine is “shifting his focus” and getting out of the pancreas biz. I am not crazy about my GI but he is the ONLY doctor in the state who will see me. So if he goes and there is no one else left in the state and I will have to go out of state and start all over again. I HATE having to see docs all the time!

Sorry to ramble on so much. I just have a lot of anxiety about dealing with these issues with my docs. Any tips on how to deal with them without having my blood pressure go through the roof? I remember someone writing about the docs having the “keys” to our health. They control whether or not we will get treated, when we will get treated and how well we will get treated. Like all of you, I to have had everything from overwhelming compassion to outright disrespect.

Love and Hugs to all and I hope this reaches you at home, in peace and without pain,

Angela

#2

Angela,

I’m sorry this won’t reach you until after your appointment, but I wanted to let you know that while I’ve been through a lot medically in my life and had never been afraid in any way of seeing docs, I’ve found in the last few years since the first gallbladder and then CP pain started, I’ve been doubted, accused, and felt frequently blamed in some way. My CP is idiopathic and there’s really nothing else I could have been doing differently. I’ve been so afraid of being judged/misjudged based on my “complex” history or long allergy list that I found myself cutting down my lists when I’d go to a new doc-- and that’s not a good thing to do-- since any of the info on those lists could be key info for the right doc. I hate being called “complicated” and docs basically giving up-- or even worse-- insinuating if not directly stating that I must be part of the problem (the latest was the PCP who still maintains that because off all this, I must be getting some sort of “secondary gain.” That really has been upsetting, since I’ve repeatedly tried to get back to my work, coaching, athletics, etc.-- but my ducts kept closing up and requiring ERCPs/sphincterotomies, stents, etc.-- like that was MY fault?? Argh!! So, while I don’t ‘fear’ the doctors and know they’re just humans with specialized training, most have been far from a source of comfort lately.

I’d love to find out more about the focus directives-- I’m not sure they do that around here, but I should look into it-- it’s likely a good thing for most of us to have.

I also had 7-1/2 years in the medical field in aeromedical evac-- and I don’t know if you run into this as an RN, but I find that my medical knowledge can be both a blessing and a curse-- that sometimes I know just enough to be a pain to the docs at times, but also to be a great advocate for myself when I’m in a bind and something’s wrong.

Hope your appointment went well! Take care–
Hugs,

Lisa

#3

Angela,

I am not a trained medical professional, but I do try to keep up on things and usually know more than most patients that go into the doc.

I think doctors can be intimidated and/or pull the smarter-than-thou attitude with patients that have a good knowledge of their disease. My doctor has admitted to me that he has made some mistakes and calls me a challenge.

If a doctor gets mad and doesn’t believe you you can do two things. Change doctors or call him on the carpet (which can be done in a kind fashion).

I used to be intimidated by doctors, but am no longer. A good friend of mine told me once that YOU are the doctors employer!! YOU are paying HIM! You do not have to put up wih any attitude or poor service. YOU can fire HIM/HER!! He works for you, not the other way around. Sometimes they forget that or just don’t care or maybe they do care and don’t know what else to do and get frustrated themselves.

I have also run into the doctor that got mad because his assisstant spent more than the allotted 10-15 minutes in his office. I actually heard the doctor say something to the assisstant. Needless to say I never went back.

The bottom line is, this is not a perfect world, most doctors are over worked, even if it is by their own hand. I wrote this the day after your question so hope that all went well.

Just remember, that you are the employer, and it is your body. You have a right to the truth and to some respect.

Keep the faith and God Bless,

Vonnie

#4

Dear Friends,

Was at the pool with my girls all day and we are all exhausted. I will get on to write some more. Take care everyone and i will write more later.

Love,

Angela

#5

Thanks so much for all the words of encouragement. The visit went a little better than I had hoped. My PCP told me that there was no such thing as a "focus" directive (standing doctors orders that are placed on a patients electronic chart that states when to admit and what needs to be done so the ER docs aren't making the decisions) in KY. She may be right, I don't know. She told me that the doc on call for her knows about me and my case so hopefully there won't be any problems. I told her about calling the office that Monday (4 days before my last admit) and the nurse practitioner telling me to go to the ER. She seemed uninterested. So I guess if that happens again then I will confront the NP and tell her "no", I refuse to go to the ER and that my PCP usually admits me. Or if she insists I go to the ER, I will tell the doc to admit me and see how that goes.

 

The problem with being confrontational or demanding is that when you start making demands or refusing to do what they (nurse practitioner/docs)tell you to do then you get labeled "noncompliant" or a "problem patient". Someone wrote me who was also in the healtcare field like myself and said that it can be a curse at times when you are the patient. That is so true!! I know what the nurses are saying at the desk because I used to sit at that same nurses station/desk. Most docs/nurses don't like patients who know "too much", that is they don't like patients who are informed or "know the lingo". There is suspicion cast upon patients who know a lot about their health problems and use the correct terminology. I am ashamed to say that nurses/docs think that these patients are hypochondriacs who sit at home on their computers looking up signs and symptoms so they know exactly what to say to the staff when they come to the hospital/ER.

 

During my last trip to the ER I told the doc I was having steathorrea and he started to make smart#ss comments like,"how do you know that word" and "I have never had a patient come in and tell me they have steathorrea before". He got called out of the room after that last comment before I could explain. I then overheard the doc say to the nurse, who must have ran in to him in the hallway say "we've got a real nut job in 8". I was in room 8. When he returned to the room I was so upset about what he had said, I was speechless. I wanted to walk out immediately. Thankfully my mother had come with me and said to the doc "She is not a nut job. She knows what steathorrea is because she has had it for 29 years and she is a nurse so she knows how to speak the language." After he stammered out some sort of apology "I never said she was a nut job, blah, blah, blah" he dropped the attitude and started to listen.

 

Why must we constantly fight to get any kind of respect or to just be taken seriously? Do these nurses/dosc think that we have nothing better to do with our time than to sit in an ER for hours at a time? I know that there are legitimate drug seekers out there, but that is not who we are. We are human beings with lives, loves, family, friends and hobbies that reach out only when we can take no more of the excruciating pain that accompanies CP. I don't know about you but I certainly DO NOT consider a week long hospital stay a good time. I have many other places and things I would rather be at or doing......sorry, I let my bitterness take over for a minute.

 

I am still unsure if I have a GI or not. Because I got the info of him "shifting his focus" towards colon cancer and away from pancreas from my mother's best friend (he and my GI graduated from high school together and talked at Churcill Downs on Derby day) my PCP refuses to talk about alternatives. She wants me to make an appointment with him and get the answer from him. Needless to say, I would be betraying a confidence if I were to confront my GI. Talk about being between a rock and a hard place. I guess I will just assume he is still my doc until he tells me otherwise. OY!!!! Well, I have rambled enough. Brevity is not my strong suit. Thanks again to all who responded to my situation and I will take all of these great suggestions and carry them with me for the next time I have to see a doc. My hope is that it will not be soon and only to have a routine check-up. A girl has to dream!!!!

Much love and hugs,

Angela