So I'm sure you tards notice trends in prescribing on your CRAPPEs and pick up on other trends during the daily grind at the drug store on the corner. Most recently, I've noticed the following: ARNPs are basically the doctor that no one ever cheated off of at the Clown College of Medicine. They suck. They aren't just absent-minded doctor kind of suck either, they're good at sucking. Its like they go home at night only to rub one out to the crappy doctor on Scrubs.
The ARNP greatest hits:
Today an ARNP called me to tell me that a patient had been calling them all day to request that they call in their "topical drug." The ARNP asked me to run through the patient's med profile and lo and behold: no topicals. I believe we'd forced some sort of drug through every orifice of this patient, yet no topicals. So what does the ARNP do? I assume you're all screaming "not write a damn thing, because this ARNP has no clue what they're treating!" That'll do tards, that'll do. But no, the ARNP let on that she's not really sure what the problem she's treating is, and then said "Just give'em Triamcinolone, Apply to AABID, that'll probably be okay." Uh yeah, unless there's a fungus-amongus. Then you're just depressing the body's ability to fight it. In fact, I ripped this straight from an info packet on Triamcinolone that it took me 15 seconds to find: "You should not use this medication...if you have a fungal infection anywhere in your body." Woopsy! If you don't know what the problem is, don't prescribe some random medicine, mmkay?
Today another ARNP wrote a script for Prozac 20 mg 4QD. Firstly, this comes in a 40 mg capsule and you could take that 2QD -- it just looks neater and a little less obscene. Secondly, you don't treat patients by just progressively giving them more and more drug until they're better -- fucking try something else! There's how many drugs for depression? Hell, how many SSRIs are there alone? They aren't a one trick pony, I'm pretty sure I can name five generic ones off the top of my head and at least one tradename-only SSRI. But no, if you fail Prozac therapy it can only be because there just wasn't enough Prozac.
This is the crown jewel of ARNP fudgings. This didn't happen to me, but its too classic to leave out of such a blog entry. Vitamin D 50,000 U caps, 1 cap every day. Of course, thats supposed to be dosed one *weekly*, not *daily*. I don't care who you are -- if you're alive and taking that strength of Vitamin D, you take it weekly. The only reason you'd need seven times the amount of Vitamin D that a normal deficient person needs is if your bones are literally dust and your caregiver has swept you into the pharmacy with a broom. The Rph (pronounced 'arf!' in my mind) called the ARNP and went through the "You fudged it, here's how we do it in medicine, k?" routine. Nuh-uh. The ARNP wouldn't change it. Okay, now you're beyond stupid -- now you're too stupid for me to save you. I forget how this ended, but I like to think that it ended with the patented "Jesus take the wheel" approach to healthcare -- guess who is playing Jesus. Hint: arf arf!
Awesome:
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