Question about medication

[Deleted]

I don't know how many doctors or psychiatrists we've got here, but what the hell.

Say you have a patient, and you're prescribing them medication for depression. This patient complains of chronic insomnia, and is unable to sleep for any substantial amount of time without taking something. Would you prescribe that person an antidepressant that has insomnia as the most common side effect?

Also, would you be on your cell phone for half the appointment, and ask the patient what he/she thinks they should take? "You wanna try an MAOI inhibitor?" "Um...I don't know..."

I'm starting to think I saw the dumbest nurse practitioner on the planet.

[Brood Lone Wolf Funker]

No offense but your Nurse Practitioner sounds like a goober. I have a similar issue and my psychiatrist gave me Clonidine which was very helpful. I would suggest trying to find a better suited one

[Deleted]

Jan 9, 2016 15:48:15 GMT -5 Brood Lone Wolf Funker said:

No offense but your Nurse Practitioner sounds like a goober. I have a similar issue and my psychiatrist gave me Clonidine which was very helpful. I would suggest trying to find a better suited one

Yeah that's the feeling I get too. But I'm always so skeptical of doctors/meds, I really just wanted to try and be positive and go along. And she's the person who prescribes meds at the eating disorder clinic where I go to therapy, so I felt like I'd keep it in house and give it the old try. But now I haven't slept in 3 days.

[MC Blowfish]

You are you're best health advocate. I have two great doctors and I've met plenty of great nurses, but I've also heard plenty of horror stories. If you feel like you're not getting the care that you need, you should seek out a second opinion.

[Red Impact]

As someone in the medical profession, asking someone if they want to try a certain class of drugs sounds like ahorrible idea. The main people who might know that much about medicaitons are other doctors or those trying to get pills for other reasons.

What you need to keep in mind is that it's really easy to specialize and get out of practice in certain areas in medicine. If this is a nurse at a weight loss clinic, it's possible that she's out of practice in prescribing anti-depression meds. That said, though, the way you make it sound shows very bad bedside manner. Your best bet is to go see a general practitioner/family med doctor and start there.

[Deleted]

Jan 9, 2016 22:23:49 GMT -5 Red Impact said:

As someone in the medical profession, asking someone if they want to try a certain class of drugs sounds like ahorrible idea. The main people who might know that much about medicaitons are other doctors or those trying to get pills for other reasons.

What you need to keep in mind is that it's really easy to specialize and get out of practice in certain areas in medicine. If this is a nurse at a weight loss clinic, it's possible that she's out of practice in prescribing anti-depression meds. That said, though, the way you make it sound shows very bad bedside manner. Your best bet is to go see a general practitioner/family med doctor and start there.

It's not a weight-loss clinic, it's for eating disorders like bulimia, anorexia, binging, etc. They have group and individual therapy of different kinds. The individual therapists determine if their patient needs a psychiatric evaluation. I'm pretty sure prescribing SSRIs etc. isn't out of the ordinary for someone in her position.

Since you're in the profession, what do you think would be a good way of reporting her behavior? I don't want anyone else to have to go through that situation. I thought about telling my therapist but I don't want to put her in a bad spot where I'm badmouthing a colleague.

[Red Impact]

Jan 9, 2016 22:50:10 GMT -5 @lovehater said:

Jan 9, 2016 22:23:49 GMT -5 Red Impact said:

As someone in the medical profession, asking someone if they want to try a certain class of drugs sounds like ahorrible idea. The main people who might know that much about medicaitons are other doctors or those trying to get pills for other reasons.

What you need to keep in mind is that it's really easy to specialize and get out of practice in certain areas in medicine. If this is a nurse at a weight loss clinic, it's possible that she's out of practice in prescribing anti-depression meds. That said, though, the way you make it sound shows very bad bedside manner. Your best bet is to go see a general practitioner/family med doctor and start there.

It's not a weight-loss clinic, it's for eating disorders like bulimia, anorexia, binging, etc. They have group and individual therapy of different kinds. The individual therapists determine if their patient needs a psychiatric evaluation. I'm pretty sure prescribing SSRIs etc. isn't out of the ordinary for someone in her position.

Since you're in the profession, what do you think would be a good way of reporting her behavior? I don't want anyone else to have to go through that situation. I thought about telling my therapist but I don't want to put her in a bad spot where I'm badmouthing a colleague.

I'm sorry, I read that correctly, but my brain couldn't catch up to my fingers.

Where I work, if someone has a problem they usually either discuss it with the provider (I'm in rehab, so we tend to see our patients for lengthy periods of time) or their supervisor, and not with a colleague who may not be in any position to do something about it. Not having been there, I couldn't speak about her exact behavior, but if there is a problem, it can't be fixed if she doesn't know about it.

Ultimately, the best policy, I think, is to just be honest. Depending on the sie of the clinic, ask to speak to someone in management or to whoever you'd log a complaint with, and go from there. Recount your conversation as best as you can or write out the complaint, and just line out how you think it could have been handled. As for the phone ,if you know it wasn't work related (f.ex. she wasn't checking up on possible drugs) then that's definitely something to bring up with her supervisor.

[Deleted]

Jan 9, 2016 23:14:24 GMT -5 Red Impact said:

Jan 9, 2016 22:50:10 GMT -5 @lovehater said:

It's not a weight-loss clinic, it's for eating disorders like bulimia, anorexia, binging, etc. They have group and individual therapy of different kinds. The individual therapists determine if their patient needs a psychiatric evaluation. I'm pretty sure prescribing SSRIs etc. isn't out of the ordinary for someone in her position.

Since you're in the profession, what do you think would be a good way of reporting her behavior? I don't want anyone else to have to go through that situation. I thought about telling my therapist but I don't want to put her in a bad spot where I'm badmouthing a colleague.

I'm sorry, I read that correctly, but my brain couldn't catch up to my fingers.

Where I work, if someone has a problem they usually either discuss it with the provider (I'm in rehab, so we tend to see our patients for lengthy periods of time) or their supervisor, and not with a colleague who may not be in any position to do something about it. Not having been there, I couldn't speak about her exact behavior, but if there is a problem, it can't be fixed if she doesn't know about it.

Ultimately, the best policy, I think, is to just be honest. Depending on the sie of the clinic, ask to speak to someone in management or to whoever you'd log a complaint with, and go from there. Recount your conversation as best as you can or write out the complaint, and just line out how you think it could have been handled. As for the phone ,if you know it wasn't work related (f.ex. she wasn't checking up on possible drugs) then that's definitely something to bring up with her supervisor.

It definitely wasn't work-related in terms of my appointment time. She said she teaches somewhere and it was about a student. She asked me questions and as I answered she was on her phone texting, and it made me feel like she wasn't even listening. Put me in a pretty bad spot as someone who earnestly wants to get well but was sketched out about taking anti-depressants because they hadn't worked out well in the past. She asked if I sleep well and I was very clear that I've had trouble sleeping as long as I can remember and as of lateI can barely sleep at all, then she goes and prescribes Lexapro which, I come to find out, has insomnia as its most common side effect according to drugs.com (not sure about how accurate it is, but it's a very thorough, massive database which makes me think it's legit).

I'm a skeptical person and I get offended easily at times, so I bit my tongue and thought "oh well, I got the meds, maybe they'll work". But I'm seeing now that my skepticism was for good reason.

[Red Impact]

Jan 9, 2016 23:29:10 GMT -5 @lovehater said:

Jan 9, 2016 23:14:24 GMT -5 Red Impact said:

I'm sorry, I read that correctly, but my brain couldn't catch up to my fingers.

Where I work, if someone has a problem they usually either discuss it with the provider (I'm in rehab, so we tend to see our patients for lengthy periods of time) or their supervisor, and not with a colleague who may not be in any position to do something about it. Not having been there, I couldn't speak about her exact behavior, but if there is a problem, it can't be fixed if she doesn't know about it.

Ultimately, the best policy, I think, is to just be honest. Depending on the sie of the clinic, ask to speak to someone in management or to whoever you'd log a complaint with, and go from there. Recount your conversation as best as you can or write out the complaint, and just line out how you think it could have been handled. As for the phone ,if you know it wasn't work related (f.ex. she wasn't checking up on possible drugs) then that's definitely something to bring up with her supervisor.

It definitely wasn't work-related in terms of my appointment time. She said she teaches somewhere and it was about a student. She asked me questions and as I answered she was on her phone texting, and it made me feel like she wasn't even listening. Put me in a pretty bad spot as someone who earnestly wants to get well but was sketched out about taking anti-depressants because they hadn't worked out well in the past. She asked if I sleep well and I was very clear that I've had trouble sleeping as long as I can remember and as of lateI can barely sleep at all, then she goes and prescribes Lexapro which, I come to find out, has insomnia as its most common side effect according to drugs.com (not sure about how accurate it is, but it's a very thorough, massive database which makes me think it's legit).

I'm a skeptical person and I get offended easily at times, so I bit my tongue and thought "oh well, I got the meds, maybe they'll work". But I'm seeing now that my skepticism was for good reason.

Then I would definitely bring it up with a supervisor, because a provider should't be messing around on their phone well, ever, unles it's work related. Then I'd get another opinion on what medication might be appropriate. Another provider might suggest the same one, I coudln't say one way or the other since, thankfully, my profession doesn't prescribe drugs.