Without a doubt, the nursing profession is rooted in scientific knowledge. We diagnose and treat patients based on presenting symptoms, resulting labs, and diagnostic procedures. As nurses and nursing students, we are taught to remain unbiased while caring for patients. However, some nurses and healthcare professionals do not practice this vital quality. Nonetheless, it is crucial to relinquish our personal opinions or preconceived notions about “certain” patients like drug users/seekers because it may prove to be the difference between a misdiagnosis or an epic save. As health care professionals, we see patients at their worst. These individuals are relinquishing a hidden past that may be unknown to their spouse or dearest friend. They may be sharing their darkest secret in hopes of us diagnosing and treating their complaint. So, we must do our due diligence by setting aside our pride and opinions to provide care that is based solely on the case at hand and not by public opinion.
As a nurse practitioner student, I was fortunate to learn from excellent clinicians like Deborah Mitchell, MSN, FNP-BC, and Edgar Brown Jr., MD. They taught me to listen keenly and elicit the patient’s “backstory” (or social history), which can be helpful in formulating potential differential diagnoses. However, they also stressed to me that I must never allow my personal judgment about the patient’s actions sway how I treat him or her. For instance, an African-American gentleman with a history of drug and alcohol abuse presented to the clinic with left upper abdominal pain and chest pain. He reported that he had been experiencing excruciating pain for two weeks. Moreover, he stated that he went to the local emergency department two days earlier because his pain became unbearable. Unfortunately, the clinician on duty was aware of the patient’s social history and diagnosed a muscle spasm and discharged the patient home. The clinician did not order labs, diagnostic exams, or perform any test to support their diagnosis. So, the gentleman sought treatment from Deborah Mitchell, MSN, FNP-BC. As a nurse practitioner student, watching her work was mesmerizing and inspiring. She actively listened to the patient’s story and concern. She shared with the patient that she was sorry about his experience at the ED and that he was not experiencing a muscle spasm, but something much more concerning.
So, she ran a battery of tests and labs. Unfortunately, the EKG results had shown a possible cardiac infarction, which warranted immediate medical intervention. As a result, Edgar Brown Jr., MD, was consulted. Dr. Brown sent the patient to the closest ED for serial troponin labs to rule out a possible cardiac infarction or cardiac ischemia. Moreover, Deborah Mitchell and Dr. Brown agreed that the patient required a stat CT scan of the chest and abdomen. Unfortunately, the CT scan had shown large masses in the patient’s lungs that needed immediate attention. All in all, if Deborah Mitchell and Dr. Brown’s personal judgment influenced their patient’s medical treatment, he may have fallen victim to an unfortunate outcome. As health care professionals, it is not our role to pass judgment upon those who seek our care. Our job is to do no harm. Sadly, sometimes, personal opinions hinder how we provide care to “certain” patients. It is imperative that we provide equal care to all individuals. As a new nurse practitioner, I utilize their teachings and practice methods when providing care to my patients. Health care professionals are not the judge and the jury. Rather, we are the detectives that collect the evidence and build the case.