"No treatment plan,no interest"

I took my partner to Joondalup ED with leg /calf pain unable to weight bear with knee giving way.

On arrival the initial processing was efficient ,they were triaged to the ED Ambulatory Unit and we were fast tracked through.

We were advised my partner would be assessed by the Nurse Practitioner (NP).The NP decided to organise an ultrasound to exclude a deep thrombosis (DVT). I was surprised why an ultrasound was required as I believe my partner didn’t have symptoms associated to a DVT.

My partner was cleared of a DVT. The NP then said you can go  but I’ll get you a pair of crutches .Being an experienced nurse I asked what was the NP's assessment  and diagnoses of my partner's condition. They advised they only prioritised  whether the patient had a DVT or not otherwise go to your GP. They asked why were  we not satisfied with their service.

I explained when  a patient cannot weight bear and a knee gives way it’s usually a sign of a mechanical injury. In my opinion, their knowledge base was limited and lacking as they believed a mechanical injury had to be as a result of direct trauma. I believe the NP had not made any clinical assessment of the knee and had no idea what they were dealing with and weren't interested to provide an opinion.

In my experience, in such cases they should have communicated potentially the diagnoses or referred onto a medic to confirm. They could also have suggested treatment of Rest, Ice, Compression (this they could have done to add support to the knee) and Elevation. I felt their communication was poor and they only focussed on one symptom without doing an appropriate  physical assessment. 

All the NP could keep saying is my priority is to check for DVT otherwise follow up with GP. We left the ED with my partner on crutches but knee giving way. After GP and MRI my partner had a full  medial menisci tear with fluid in the joint.

I am very supportive of advanced nurse roles however I was very disappointed with this practitioners knowledge ,assessment, communication and seeming lack of interest in the patients treatment plan. I addressed my concerns with this NP but believe they have little insight in their lack of knowledge base or therapeutic care.