[NP-Clinical] Need help

[Dena]

Julie--

First of all, due to HIPPA (etc, etc, etc), you shouldn't be telling your
husband about ANY of your patients, but certainly NOT about a friend.
Personally, I would set him up to see your boss and be there for the
appointment as his friend for emotional support. I would then have your boss
see him for any follow-ups and stay in the supportive role-or perhaps ask
HIM what role HE would like you to serve in-friend or provider. It's way too
emotionally taxing for you to be in both roles. and I'm not sure how ethical
it is anyway.

Dena Galler

 

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From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Julie Orfirer
Sent: Thursday, May 10, 2007 7:14 AM
To: np-clinical at nurse.net
Subject: [NP-Clinical] Need help

 

So, this is why you aren't supposed to see your friends as patients.

 

My husband's best friend, our best man at our wedding, was over a few weeks
ago and said he was diagnosed with osteoporosis but had to wait several
months to get an appointment with the endo that his doc suggested he see.  I
said, well, you can come to our office and figured he'd see someone else in
the office and not me (due to being a friend and some recent personal issues
that were sort of between the two of us - way too complicated to discuss).
But, there he was on my schedule.  I figured, what could go wrong?  So I did
all the routine stuff and included a monoclonal protein study  which I do
for just about anyone in their 60's and he had had prostate cancer 2 years
ago.

 

Just got the report back.  Bad news.  He has an "M-spike in gamma region",
"monclonal IgG kappa C/W MGUS, early myeloma, amyloidosis, etc".  I admit
that I don't really have a clue whtat all that means chemically but I know
what it means clinically.  In fact, just had my first case of multiple
myeloma yesterday - got the report from the heme/onc of another man who had
the same results - his x-rays look terrible.  So that's why I'm so running
to that conclusion.

 

He has an appointment for next week - I don't know what to do.  I don't know
if I can tell him about this or if I should or if I should switch him to my
boss's schedule or see him together with her or what.  I don't know how to
keep this a secret from my husband until then.  I was just telling him last
night about my other patient whose x-rays were filled with lytic metastatic
lesions.   I'm really torn up.  (Just drying my eyes now from reading the
report.)  His 70th birthday is in a month.  I know that people live well for
a long time with MM. But....

 

Would appreciate anyone's opinions, advice.

 

Julie



"To affect the quality of the day, that is the highest of the arts." - Henry
David Thoreau
http://sculpturefest.org/pages/artists2006/markey.html

  

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