To not want to see a Nurse Practitioner.

[Selks]

Have just rung the GP for a Drs appointment today after being ill for a fortnight and having a suspected kidney infection. The collective advice of MN and NHS direct said I should see a Dr ASAP.
The only appt offered to me was with a nurse practitioner. I spoke to the duty Dr and that is all they will offer me. No disrespect intended to nurse practitioners but after being misdiagnosed by the nurse practitioner before for an unrelated issue I am not keen to see them again for a condition that if misdiagnosed could potentially end me up in hospital. Dr was unwavering when I voiced my concerns.
AIBU to want to see an actual Dr?

[whatever5]

If you have a kidney infection you should have been given a longer course of antibiotics. A GP would know that, I'm sure.

[hiddenhome]

When I had pyelonephritis I had to go and see one of the GPs to tell her that I'd been given the wrong antibiotics by another GP she consulted her computer then gave me new ones.

[HicDraconis]

And given the pain, you probably need to have a renal tract calculus excluded as well (kidney stone). Don't assume pain = infection, may be mechanical.

[Selks]

Duty Doc has just rung back and I'm pretty annoyed....after the lengthy exam and her TELLING me it is a kidney infection she has logged it on the computer as a UTI! I said to the Dr I know it is not a UTI as have had them before and this is very different. Anyway the Dr was quite sheepish and has made the prescription up to a week now (which is good but means I have to go down again and pay for another prescription, grrrr).

Humph. Not impressed.

[Selks]

AND....hopefully I will be ok for work on monday (this is the plan) but if I am not I will not now be able to get a sick note that says kidney infection if it is wrongly listed as a UTI....

[whatever5]

OP- did the NP send off a urine sample for testing?

[Want2bSupermum]

I wouldn't be impressed either. It upsets me to see the standards within the NHS fall year after year. A nurse should not be diagnosing someone with a suspected kidney infection. A UTI yes but not a kidney infection.

Im not a doctor but living here in the US I have had a very positive experience with a nurse who is able to write scripts. At the paediatrican office the nurse writes the scripts up when they are really busy and they are double checked before being send to the pharmacist. It is very efficient and our pharmacist delivers to our house. Sometimes the medicine is at home by the time we get back.

[Selks]

whatever, yes, the sample has been sent off, which is a good thing I expect.

[Mignonette]

Renal colic = calculus

Lower flank pain upon palpitation or continual = UTI/Pyelonephritis.

Some UTI's cause pain in the flank (renal pain). Mine always do but the kidneys are clear. Don't assume that kidney pain always means kidney infection. Pain can and often is referred.

I don't assume all MW's are bad because both of my births went wrong because of their incompetence.

I don't assume all Doctors are incompetent because of the ones I have worked with who i wouldn't want near a pet fish let alone a human.

If you want to see a GP then upon calling reception, tell them it is a condition that needs to be seen by a GP and tell the receptionist you do not wish to discuss with her, the precise nature of your condition. This is what I do and everybody I know does. It works.

[Selks]

Well the pain is all on my side and back all the way from top of buttock to mid back ribs, so nowhere near my bladder. I can't imagine that pain this strong is referred pain. I don't understand why she would say 'kidney infection' then write on notes UTI?

[hiddenhome]

When I had pyelonephritis, I could actually feel that my kidneys had swollen up. They were painful and I could feel the pressure inside. I could hardly walk.

[Mylovelyboy]

Ok, I had terrible ear infection and could not get docs appt for nearly two weeks . After your doctors surgery has closed, dial 111, tell them your symptoms. Lay it on a bit if you have to, and you will get an out of hours appointment at your local hospital. Dont bash me. I had no choice but to do this as my surgery had no appts or emergency appts and I needed anti-bios. It might be your only option to see a doctor quick. All the best and hope you feel ok and get it sorted soon

[Mignonette]

Many UTI's have no bladder pain. UTI's in the elderly and in pregnant women are frequently asymptomatic w/ regards to pain. That is why they can be insidiously dangerous in those patient groups.

She clearly made a documentation error. It happens and it is not right but I have met so man great NP's (my sister was one of the first) and some not so good. They are however, not a second best option. We have been conditioned to equate GP=best option when in fact they often are not. I would choose drug/Px advice from a pharmacist, a GP nurse for jabs and a smear for example. I would never want a jab from a GP- they don't do enough of them! i'd rather do it myself.

There are a lot of nerve endings in the urinary tract. It may or may not be partially referred pain but it would be inappropriate for me to say. However I would encourage you to contact out of hours if the pain worsens, becomes colicky (wave like), you develop rigours, frank blood in the urine or retention of urine.

Until the cultures come back, broad spectrum is all they can offer. this is because of the irresponsible patients who do not take their antibiotics properly or who take them inappropriately. It has caused local HA's to need PX protocols to rotate what drug is PX and when to try to mitigate resistance.

I hope you begin to feel better soon. Fill a hot water bottle up and hold against your flank. Keep well hydrated and Pass urine frequently. Keep a close eye on its colour and specific gravity- is it getting cloudy or clearing?

[MrsWedgeAntilles]

Its not whether you were seen by a GP or an NP that makes the difference, its whether either one of them is any good at their job.

[Mylovelyboy]

OP please contact out of hours. Myself and everyone on here have all good intentions for your well being but enough is enough, Its gone on too long. Leaving these things only makes matters worse. Out of hours is actually easier and quicker than some (especially mine) doctors surgeries can be.

[Mylovelyboy]

MrsWedge I second you on that one

[candycoatedwaterdrops]

I've noticed that a lot of people seem to confuse UTI and kidney infection.

[Selks]

Mylovely, thanks but I have antibiotics to take, so I'm going to see how it goes. I can contact the surgery again tomorrow if I'm concerned.

[Arohaitis]

MrsWedge for lots of people it does make a difference, in my case if I know I have a problem that needs a nurse I see a nurse, if I have something that needs a Dr I want to see a Dr, it is a waste of time and the taxpayers money to make me see a nurse first (hers and mine!)

Mignonette that's great advice but perhaps you could tell us how to keep an eye on urines specific gravity

[Featherbag]

Did she check your heart rate/temp? For a true pyelonephritis to be diagnosed you'd be pyrexial and tachycardic. The UTI/kidney infection terminology debate strikes me as a bit tomayto/tomahto tbh, as technically speaking the urinary tract starts at the kidneys, with the ureters forming the top of the urinary tract. So, the infection could've climbed as high as the ureters - some would (incorrectly but understandably) refer to this as a kidney infection, but UTI is the correct term. If your temp and pulse are within normal range, 3 days of abx is the correct initial treatment. If they're not, or they become abnormal, you need to be seen by OOH ASAP for different treatment.

I do hope it doesn't become pyelonephritis OP, I had this and was in hospital on IV abx for 3 days, I remember the pain (6 years ago) better than I remember the pain of analgesia-free childbirth (2 years ago)! Drink lots and lots of water, and if it's nitrofurantoin you've been prescribed make sure you don't take them on an empty stomach, they're evil!

[Selks]

Thanks Featherbag.

[Theodorous]

I wouldn't see a nurse, it's a two tier service and nurse training is not academic at all. I did the np training 10 years ago and some of the people on the course were severely thick

[Shonajoy]

YABU. Take the appointment and if you're unsatisfied then see a doctor. It was an NP that saved my life, literally. She referred me immediately after looking at my cervix during a smear test.

[OhYouBadBadKitten]

I am not very confident with NP - fine for a narrow range of conditions but my experience has been that they tend to under diagnose. Both dd and I have ended up pretty poorly after being told that we had something minor and not being treated (or given the wrong treatment).

and there is this thread which is frankly astonishing - how could the symptoms not have concerned the NP that the mner saw?

Can anyone clarify the training as http://www.brighton.ac.uk/courses/study/nurse-practitioner-bsc-hons this course seems to be a year long, I presume on top of a nursing degree. It doesnt seem very equivalent to a gps training. Happy to be educated on this!

[OhYouBadBadKitten]

this course