Sunday, 26 October 2008

All in a days work

My last patient before the weekend was a 40 year old mother of 4. She split up with her husband six months ago and has been struggling emotionally, socially and financially since then.
She had a night out with friends 4 weeks ago 'to cheeer her up'. She had a few drinks, a dance in the local club a kebab, a snog and then in time honoured tradition a one night stand with a young erect penis without a conscience.
She came to see me because she thought she might be pregnant again, as she has more experience than me, I took her word ( and 2 positive HCGs) for it.
We had a chat about her situation. Her husband ( soon to be ex) is already fixed up with a 25 year old chlamydia bandit - no support there then.
The donor, well she never even found out his name.
So having established a gravid state, her absolute inability to cope with another child in these cicumstances, and giving lots of words of advice and encouragement. FLMN makes the referral to the early pregnancy unit, for a termination, gives the lass as much moral support as I can and reassures her that all will be well in the end.
I had a card this week from the patient, nothing flash or extravagant, just a few words saying 'thanks for being a friend when I needed one'.
I earn a good wage in my job, have a degreee of respect from my colleagues and patients, but this, this knocks all that into a cocked hat.
I have a privileged job and I love it!

Saturday, 25 October 2008


In the interests of improving my prescribing practice I recently bought a new book. A very 'useful, concise and practical introduction to the vast and complex subject of medical treatment', is how it is described in the blurb. I like the book, it is all that it says above, and I will keep it close at hand in my clinical practice. It goes on further to say that the book is 'useful for nurse practitioners' so that's me sorted then.
One of the authors, Hugh McGavock rang a bell in my dusty brain. Could it be this Hugh McGavock?. Mmmm. Probably is I think.
So, it's OK to have a pop at nurses who prescribe, and make totally outrageous and baseless statements about their practice. But on the other hand it's OK to make a few quid by pushing a book at them.
The balanced side of me says ' good old Hughie, he's realised that nurse prescribing is here to stay so he might as well further the cause with a helpful publication'. The cynic in me smells the faint whiff of hypocrisy and the tang of greed.
What do you think?
That notwithstanding, I recommend the book to all nurse prescribers.