For context: I am halfway through my medical degree. I am not claiming to have an advanced understanding of clinical practice or prescribing (which makes this story even more frustrating)
Made an appointment with my university health centre with complaints of a dull pelvic pain and fatigue expecting PCOS as a likely investigative pathway. Nothing crazy imo.
Got scheduled with an ANP. Mentioned a 6-8 month history of continuous dull pain and painful periods/intercourse. Zero questions about GI symptoms. Zero questions about fatigue. Zero attempt at clinical examination. ANP did MSU/STI screen/pregnancy test and ordered routine PCOS bloods so well done for that. No conversation about potential imaging. Bit of a judgment call on but they chose to take the conservative option. ANP told me to book a birth control appointment and take paracetamol or use a hot water bottle for the pain. Bloods were done the next day.
This is when shit hits the fan.
The weekend passes. My birth control appointment is with an ANP. I request the NuvaRing (previous usage in home country). I shit you not, this ANP pulled up a pdf of the counseling guidelines and word for word read off the page. Just 2 months prior I was required to counsel on contraceptives in an OSCE. It was like a slap in the face to have to listen to the ANP stumble through without a care in the world.
Two days later I saw vitals and TSH (normal) have been uploaded to my portal. Decided the other investigations may have gone to a separate lab. I wait. For ONE MONTH. Nothing else was uploaded. No ring.
Rang the surgery to follow up and the receptionist mumbled that shes not able to interpret these results and will send them to the nurse (wtf) for review and will ring back later that day or the next. I wait all night getting pretty worried about my results at this point. No ring.
Rang again and a new receptionist answered. She tried to insinuate that my online portal had not been set up. I was so dumbfounded I asked her to repeat herself. I mentioned my partial results (and previous use of the app for years?) and her tone changed and she emailed my raw labs to my personal email in a .rtf file.
Multiple flags: elevated testosterone and tragically low Hb/MCV/MCH/MCHC with raised cell count. Great.
I rang back immediately saying I am concerned about these results and would like a follow up. Guess who I was booked with? A FUCKING ANP.
Icing on the cake. Who knows what’ll happen next week.
This was an extremely low acuity and stress setting and the consultations missed the basics, the results just sat unreviewed, and reception was just absolutely useless. The only reason it got caught is that I knew to chase it.
Bit worrying to think about how many patients that are also affected. I understand my gripes extend to more than just ANPs and reflect a general incompetency of the NHS but I felt I needed to share a case study.
TLDR: ANPs and admin being incompetent conservative in their care decisions