Interestingly this is a huge part of my job, but something that I don’t think I have written about before. I am a drug dealer (or an Independent Nurse Prescriber, if you want to make it sound slightly more legal!)
Like any good drug dealer, I don’t handle the drugs myself, I simple make sure the right people are getting the fixes they need. Unlike a good drug dealer I don’t get a huge wage for this, nor do I drive a BMW or own a gun…(I’ve got a stapler, but that only shoots about…hold on a second…<clunk-chung!!!>…yeah about 2 foot).
Another difference between me and the gun slinging BMW driving type of drug dealer is that actually I don’t want to give my clientelle any drugs, and I will not issue them just because they ask for them. My clientelle don’t seem to realise this all the time.
This week I have had to clarify that I won’t give sleeping tablets out just because you’ve become reliant on getting to sleep only when you use cannabis. You need to learn how to sleep without drugs, not just exchange illegal drugs for legal ones. Maybe I am a bit harsh. I was going to give her 7 days worth of Zopiclone in conjunction with some self help on insomnia to help her establish a sleep pattern, but she started demanding them and saying she’d make an appointment every day to see me until she got some…so alas she went without…She’ll get bored with it before I do!
Every single day of my working life I have to remind patients that antibiotics do not kill viruses. Antibiotics only kill bacteria. That sniffle that you’ve had for one day, isn’t chronic sinusitis and doesn’t need antibiotics, and just because your Dr prescribed you some last time (just to get you out his room quicker (he said cynically)) doesn’t mean it is clinically indicated this time…
The clinical relevance of it being Friday, Christmas soon, your birthday or the fact your going on holiday doesn’t influence my prescribing (well very occasionally it will – alright you can have some Norethisterone so you can bonk your new husband on your honeymoon and wear a swim suit without sanitary towels hanging out and your tampon absorbing half the swimming pool).
I quite like…this for something other than the sound of me whinging voice…
I also like this for something nice (but it isn’t relevant to the topic)…
In summary I will prescribe drugs, but when I feel it is clinically indicated and not just because the patient thinks it might help…It might help to dive into a vat of goose grease…but I wouldn’t tell you to do it without clinical indication…or a particularly vindictive mood!