Wound care 101: the moron NP and her snatch-biscuit receptionist

Originally posted on Reddit by u/TheCrankyRunner

Alright, ladies and gentlemen. Gather around because it's story time. It's a tale of unbelievable incompetence, and not only incompetence, but supreme, nauseating arrogance on top of it.

I'm a clinical manager and wound care nurse for a home health company in a rural area of the country. In my area, we have a particular nurse practitioner who, I've come to discover, is despised by pretty much every other healthcare provider in this community. I had never had any dealings with her personally or professionally. Sure, I'd heard some stories, but nothing could have prepared me for the outlandish, unbelievable shit show that unfolded over the past ten days or so.

We received a referral from our local hospital for a certain patient, who happened to have this nurse practitioner as a PCP. Upon admission to our services, it was discovered by the admitting nurse that this diabetic patient had an unstageable pressure injury to one of her heels. It was covered by stable eschar, which, as everyone should know, should not be removed. This is wound care 101.

So this unfortunate patient follows up with her PCP, and everything promptly turned into a disastrous, steaming, fly-infested pile of shit. She referred the patient to a local orthopedic surgeon for assessment of the wound, which wasn't a problem at all. But she also referred her to outpatient wound care, which Medicare won't pay for because she's on home health services. We only discovered this because the wound care clinic called to let me know. We had a pleasant discussion about the wound and were doing the exact same fucking treatment.

Things went further south when I called this moron's office to politely let her know that Medicare won't pay for both services, and her complete snatch biscuit of a fucking receptionist snapped, "Well, are you qualified to take care of that wound?" I asserted that I am wound care certified and am indeed qualified to care for that wound. I pointed out it's the same certification that the wound care clinic staff have and that she and I had even spoken about our ideas for a treatment plan. She curtly replied she would notify Queen Cunt Cake and hung up. Fine. Whatever, bitch.

Immediately afterwards, Boss Snatch herself called the fucking wound care clinic and DEMANDED the patient be seen by them. Baffled, the director of that clinic called my boss to find out what the fucking hell is going on. We decided to simply discharge the patient and let her do outpatient therapy to save ourselves the headache.

We call this miserable, broom-riding shrew to let her know that's what we were doing. She threw a giant fucking tantrum like a spoiled, piece of shit brat and demanded a meeting with me, my boss, my nurse, and our physical therapist.

So we go and waste an hour of our lives that we'll never get back by meeting with this old bag, and everything promptly turned into an even bigger flaming dumpster fire. She INSISTED that we soak the fucking wound. I told her this was not best practice and it is not advised to remove stable eschar at this point. We went back and forth. She demanded we keep the patient and that we "have better communication," even though she and her snot-nosed receptionist were insufferable cuntsicles every time we called them. FINE. WHATEVER.

We leave and attempt to do what's best for the patient. But she refuses to sign our orders. She sent our POC back with portions scribbled out and wrote her own inappropriate orders over them. I called her in an attempt to clarify this obscenely ridiculous balderdash. I told her I noticed that she had crossed out our interventions involving providing diabetic education to the fucking diabetic patient, who, by this time, had to call EMS more than once because her sugars dropped into the 40's at night. "You're not qualified to teach that," she snipped. I told her we needed it in order to even discuss diabetes with the patient, which fell upon deaf ears.

So I wrote out her bullshit in the form of a physician's order, which she also refused to sign, because I had included the wound care orders from the surgeon in there. The very fucking surgeon she herself had fucking referred the patient to. She didn't like those orders.

By this time, I'm fucking livid. My boss and I decide we absolutely HAVE to discharge this patient to outpatient services because this fiasco is going to jeopardize the licenses of all of us involved. My nurse has a talk with the patient, who agreed to go to outpatient therapy, even though she was disappointed. I call this nasty, passive-aggressive twatwaffle to let her know we are discharging this patient and it isn't up for discussion this time. She doesn't answer, so I leave a voicemail.

Not ten minutes later, I see her dreadful name come up on my caller ID, and I promptly answer. She didn't listen to my voicemail, so I reiterate, "This is not a good working relationship. The patient is being discharged and will go to outpatient therapy like you originally wanted." And then... this bitch, guys. This FUCKING MISERABLE CUNT decides to play dumb and innocent. "I don't understand. What's not good about this working relationship?" I can feel my temper flaring. "Because you won't sign our orders. You won't sign our plan of care. You won't even let us talk about diabetes with her." And she had the fucking audacity to say, "You don't have the education to talk to her about it. And, she doesn't need it. She manages it fine."

And I abso-fucking-lutely LOST IT at this point. I told her that was the stupidest thing I've heard. I said she obviously doesn't know how to control her diabetes since she's constantly calling 911 over it. I said that if she considers that "control" then she obviously doesn't know how to manage the patient's diabetes, either. I don't exactly remember everything that came spewing out of my mouth at that point. I vaguely remember calling her incompetent, unsafe, and unprofessional. I said we are not working with her anymore under any circumstances. She threatened to turn us in for abandonment. I said, "Oh, you go right on ahead and do that," before hanging up on her.

There is no time in my recent memory in which I went off on someone like that. It felt fucking fantastic. Everyone in the office heard me. My boss returned shortly after. She congratulated me on sticking up for myself but told me not to lose my shit on people like that in the future. As for that old battle axe's threat, we're not worried. We didn't do anything wrong, and any sort of investigation would only get turned around on her.

She called my boss yesterday to tattle on me, and my boss simply said, "Oh, well, I'll talk to her about it." The bitch then said, "My opinion of your clinical manager is damaged, but in time I'll be able to forgive her and work with her again." Joke's on her, though. We're never accepting a patient of hers ever again.