Rude Nurse Practitioner & Tetanus Vaccine

I would not only complain to the office manager, but I would send a copy of the letter to each of the physicians in the practice. Before I became a SAHM, I was a nurse practioner for about 8 years, and I worked in an OB?GYN practice. Anyways, any nurse practitioner, is practicing her medicine under another physicians lisence in the group, and whatever she does (or he) will reflect poorly or negatively on the doctor. The doctor has to sign off on all of the nurse practitioner's notes, and orders and such at the end of the day. I think that she was completely unproffesional, and in all honesty, from what I remember, I think that the TD can be given anywhere between the 4 and 5 year mark. But definitely, they should know how you were treated, esp. if you have a good relationship with the doctor, and like the rest of the practice, but these things need to come to light.

As mothers, our protective instincts regarding our children make us unique. Reading your post, I didn't have the same instinct as you regarding the Nurse Practitioner, but it is likely the difference between reading it and living the experience with your own child.

Her bedside manner may have been lacking, but ultimately, her concern is for your son, and there may have been a small window of opportunity to vaccinate before tetanus is a real threat. Unfortunately, ER physicians are required to know a lot about many different things. If it wasn't a pediatric ER, they may not have been as aware of pediatric guidelines as the NP working in the field and may not have felt comfortable not knowing his immunization status.

All the way around, it sounds like communication was an issue from the Pediatric Urgent Care (which should have been able to suture and administer the tetanus vaccination) to the NP who clearly didn't take into consideration the hoops you'd already jumped through.

The office/practice manager is there to address such concerns. I might give it a few days to let emotions settle before filing an official complaint. The US is in a critical shortage of Primary Care providers. They're way overworked and making on average 25% less than they were 5 years ago. It doesn't excuse her bedside manner, it may just explain why she was lacking in the graces you needed at that point in time.

Most of my career has been spent in and out of doctor's offices. There are great doctors and mediocre doctors. Great NPs and those that don't really impress me. My OB/GYN missed a suspiciously swollen lymph node on my collar bone dismissing it as "not that exciting" whereas my FP (who I have been very critical about in the past) order the tests that led to my cancer diagnosis after my daughter's birth 2 years ago. Sometimes, we just catch them on the right days, and sometimes we don't. Medicine is stil as much an art as it is a science, and the ability to communicate with patients is a big part of that art. I truly wish you'd had a different experience.

Here's what the American Academy of Pediatrics says about tetanus vaccinations:
http://www.healthychildren.org/english/search/pages/resul...

Good luck. I hope your son is well and this experience is a distant memory soon.

The NP was out of line. First off if your child were in danger of tetanus, the ER would have suggested an injection of Tetanus Immunoglobulin (different from the vaccine), because vaccines work to PREVENT the disease and will not have the desired effect when administered after the infection (although they may help prevent future infection). However, from what you describe, the wound bled and was pretty "clean", so the chances of tetanus infection are low.

Secondly, she should not have given your son any vaccines other than the "necessary" tetanus vaccine at that time. You already had an appointment scheduled with the doctor for the other vaccines and overloading an already stressed immune system is contraindicated. (Although Doctors do it, children who are ill, running fevers, recovering from illness or with stressed immune systems are not supposed to be vaccinated until they are fully recovered, because the body will have a harder time recovering from the vaccine introduced immune stressors. Healing wounds that require stitches do have an effect on the immune system.)

If you are pleased with the pediatrician as a whole, discuss the NPs attitude with your doctor before considering changing practices. Explain that you are very dissatisfied and concerned that you were "bullied" into treatment you did not request and did not want at that time--remind him you went in with an injured child and had already scheduled the *non-tetanus* vaccinations for a separate time. Follow up with a written letter to the office regarding how unprofessional the NP was during your appointment. Also, if possible refuse any future treatment from this particular NP (have the doctor or office staff make a note in your kid's charts that you do want any future appointments or treatment with said NP.)

I encountered a nurse like this one time - actually she was much worse and it was in a working situation, I reported her to my superior and she was disciplined and given a course on how to handle people, so ulitimately if you report he it may make her a better practitioner.

All four of my boys (ages 12 years to 20 months) were born with a hereditary blood disorder, so I have had more than the average experience and interaction with all different types of doctors and nurses for the past 12 years. Let me assure you that the way you were treated WAS rude and condescending and that you SHOULD make a complaint. If the office manager is not made aware of this NP, there is nothing they can do to remedy the situation. There's a good chance your complaint will not be the first one, and steps will be taken to assure that she either changes her attitude or be reprimanded. I know this from experience. NEVER hesitate to complain if you feel belittled or even annoyed by the way you were treated. You are paying them for their services, and if they are sub-par, you have every right to complain. Generally office managers will do anything they can to assure they don't lose you as a patient because they don't want to lose your business. You can also keep track of the name of this NP and make sure the office knows that you have no interest in ever being "treated" by her again, and when you call to make appointments, remind them that you will be happy to see anyone BUT her. I have had to do this and I can assure you, the office personel are usually more than understanding and will accomodate you. Please never hesitate to stand up for yourself OR your son. The worst that could happen is you end up leaving a medical office in search of a new doctor. It's unfortunate that there are professionals out there who care so little about professionalism, but you have no obligation to tolerate it. You don't have to be nasty about it, just state matter-of-factly that you don't appreciate what was said or how it was said and that you will not allow it to happen any more. Trust me...they will listen! :-) Good luck! And I hope your little guy feels better soon from his big shots! Don't forget to give him motrin or advil for that pain and swelling! Hopefully it won't slow him down too much on your trip.

Hi, V. -
It does sound as though the NP was a little abrupt and unprofessional. No excuses, but perhaps she was just having a bad day, or does deal all day with neglectful parents and is accustomed to having to push a bit. You don't need to justify your parenting to anyone, including the pediatrician's office. You are doing a great job, so try not to feel defensive because of this one negative encounter. We always think of everything we should have said/done after the fact. It's just that when something catches us by surprise, you just sort of shut down. On the positive side, your son is OK, he's 4 year vaccinations are now behind him, and you're going on vacation. Try to look at the good side. Yes, if you feel you have a complaint about how you were treated, I would certainly make a complaint with the office manager. If you were treated unpleasantly, they need to know. As far as changing pediatrician's, I've had this same thought myself several times. My pediatrician's office is ALWAYS running behind, and the front office staff is often unpleasant. The doctor, however, is amazing, and I ask myself who would I want by my child's side in case of a serious problem. Because I know the answer, I just deal with the other annoying situations and move on.
Glad your son is OK. Take care.

Absolutely speak up to the doctor's office manager or the pediatrician you most often see . You are the parent and deserve to be spoken to with a degree of respect. What ever her reason the NP was disrespectful to you and your child. I am not a medical professional but I am a mom and under no circumstances was this acceptable. When my daughter was an infant, a nurse delivered a shot to my child that caused her to bleed and I felt was rather rough. I immediately went right out of that exam room to my childs doctor and said that I did not want that nurse to deliver shots to my child in the future. If you love the doctor, speak up or going to the office will cause you stress in the future.

My kids are grown, so going to the pediatrician days are over. Thank the Lord!! My personal opinion, after being in the same situation with an NP visit for myself, was to go to the Office Manager, let them know you were not happy in regards to the NP's bedside manner, and request a meeting with the Medical Director.
The reason I suggest this, is that often times the Office Manager in a Medical practice, is just there to supervise the office staff, i.e; receptionists, front desk staff, medical records, etc. It's the Medical Director that oversees the actual Medical staff.
I have been a patient of this particular practice for more than 14 years, almost since they opened, and have given my share of 'atta boy/girl' compliments, and took me very seriously when I asked for the meeting with the Medical Director. They took a report of the 'incident', and offered me several solutions. They could have had her apologize, either verbal or written, make a note in the scheduling computer so I would not be scheduled with her again, or I could take it further, and report her to the State Board.
I only wanted her to be made aware of how her words and actions affected others, most of us only go to the Dr. if something is wrong, right? I also requested not to be scheduled with her again.
I don't feel that what I asked for was vindictive in any way, and DO understand that EVERYONE has bad days, I did not ask for any reprimand for her, just that her attention be brought to this.
I still use this Medical practice, and still see 'my' NP, and I think that if I had not said something, I would feel uncomfortable going there.
I truly hope that everyone's suggestions help you in deciding what to do.
Good Luck!
E.

It sounds like the NP you interacted with was rude and unprofessional. Her attitude is definitely worth complaining about. It's hard enough to have a child who is sick or has had an injury that landed them in the ER without someone treating you like you are a bad parent. Since you like the main doctor, I understand not wanting to switch office, but since you may have to see this NP again if you stay, it's well worth making a formal complaint. Hopefully, she will be able to learn from the experience and become more skilled at patient care.

Just went through the same thing a few days ago when my hubby accidentally sliced the entire length of his thumb with a box cutter. We went to the urgent care as well hoping to get quicker treatment and were also referred to the ER (and no, you had NO way of knowing they would do that).

Because he cut himself with a foreign object (metal, especially) we were asked multiple times at the urgent care and the ER if he'd had his tetanus shot so you're very right in your assumption that if it was a concern, it would have been addressed.

Sounds like you just experienced an extremely rude/pushy medical "professional" that pretty much lied to you about the immediate need for a tetanus vaccine....and you can bet she's done it to others. She should absolutely be reported. In fact, you should consider yourself obligated to do so on behalf of the other parents that take their kids to that practice.

I realize you felt on the spot and bullied, but if it ever happens again, leave. I would have refused and left, and then discussed it with someone in charge, perhaps also talking to the pediatrician. Heck, write it down so it's a formal complaint.

I have not had that interaction, but I have had to push back when a nurse came whirling in with five syringes for my daughter and I said, "No, she's on an extended schedule. We are not getting all of those today."

I would certainly complain, especially since it was so bad that you might consider swapping doctors. Where we are, there are a couple of doctors available at the office. We have our primary and then the kids might see whoever is there in a pinch. We outright refuse any appointment with one of them after both my stepdaughter and stepson had a bad visit with her.

Bottom line was she was out of line and she should not have 1) made decisions for you or 2) pushed those decisions on you at a visit not related to his 4 yr checkup.

Hello V.,

I would without a doubt complain to the office manager about how you were treated. No parent that goes in to take care of a certain thing should ever be bullied into doing something they are not ready to do. You clearly had an appointment to get sutures removed and not the appointment to get the vaccinations. If he needed a tetanus, the hospital would have done it when they put the sutures in. That NP was rude and disrespectful and if you don't complain she is going to keep doing this every time you see her. That is totally uncalled for.

D. P.

Without questions, I would call the office manager and complain about the way you were treated. Like you said, you had a specific reason for scheduling his appointment for his 4 y/o check up when you did. You could not predict the future and know that he would have an injury. If the NP felt it was necessary to give the booster at his suture removal appointment, she should have said some nicely and with respect, to you , the child's mother!
I love my pediatrician(s), but have found their office staff to be rude and difficult to deal with at times. And I have called the office manager. One time I mentioned a problem that I had to one of the NP and she told me to make sure and tell the office manager whenever I had a problem. I got the impression that I wasn't the first to complain...
It sounds to me like you are a good mom, don't let this women bully you just because she has a license.

You most definitely need to talk to the office manager and I would ask to speak with the lead doctor directly! If the one nurse was supposed to get a doctor and she brought back a NP, that is NOT the same! No excuses for that one. I also agree that there was NO reason for his shots today! You had an appointment scheduled and if the ER thought he needed a tetanus shot (which are normally only important if you cut yourself with something metal), they would have given him one! (I know, my hubby cut himself in the hand and hadn't had one in awhile...he got one that day!) I would tell them that you are thoroughly dissatisfied, and I would be looking for a new doctor. There is no reason for the rude behavior, and this NP obviously has no clue about these things (which is extremely scary if you ask me)! Talk to the doctor and his office and see what they say, but this would have me looking!

This nurse practitioner disobeyed the first rule for people in medical professions: don't make patients feel stupid! There is a whole host of problems with people in health professions doing it and the number one problem is that it turns people off from coming to the doctor unless they reallt need it. It does not even matter if she was right or wrong, she could have explained this to you in a friendly and professional manner. It's just unprofessional.
I would absolutely call the office and complain. If this is a large practice you can ask whether they can put a note in your file that you do not wish to work with this particular NP again and keep your pedi. If not then I would switch doctors and let the old one know why you left.
Good luck!

I think your thought process here is right on. I work in healthcare (dietitian) and have been to lots of peds apts (3 boys), I absolutely think this should be brought to the physicians attention, in fact you could use this post with minor changes. How they address this will tell you if you should find another office or if this is feedback they will value and address appropriately. I was once spoken to similarly after being up with my son all night. I did not address it the way I wanted to. Parents usually have good intuition in these matters, its when we ignore it that we are sorry! A. D

Hello!
If you have otherwise never been unhappy with the Doctor and office, I would not change Doctors, but fill him/her in at your appointment. Also advise the office manager personally and in writing. Should the NP actually respond to your feedback, then maybe not all is lost, but otherwise I would arrange not to see that NP again, but stay with the office.
Hope this helps!

Report it. I used to work in the medical field and I have found those people need to be reported. We learned in school it doesn't matter how unpleasent a patient, or how silly a question, and everything in between, you are there for them 100%. That includes a good "bed-side" manner.
Once a physicians assistant questioned my dad on his decision of not having a "do not resuscitate." My dad was very ill, but wanted to try to live, and he kept asking him..."Are you sure?" "Do you really understand your conditions?" Finially, I walked up to him and asked him to kindly get the BLEEP out in a low voice. He then tried to raise authority to me, which I had to knock him back down in place and sent him out. The ER supervisor came over to talk to me about preventing care for my father and asked me to leave....I told her the incident, and that PA never step foot in my father's room again.
If you never voice your concerns people like that will continue to treat other patients in the same horrible manner you were treated. Good Luck! =)

If you have had a great relationship with your ped until this point, by all means do not stop going. My son is almost 3.5 and he hasn't had his 3 year shots! Ahhh! And I went in there when he had an ear infection and she just said bring him in soon then...so rudeness or "if you don't etc etc....".

I would tell an office manager about the situation. She might be new, she might have been filling in, she might have had a dozen crazy patients before you....but it doesn't matter. Just be very clear, don't get emotional, and write it down before you call her.

.

I agree with most of the other post-ers here - report her. Clearly if you have your child at the doctor's office you are already under stress and there is no need to put you under more strain! Hopefully if you report her she will be repremanded and never treat anyone this way again.