First Impressions

Originally written 7/2/18


Kyle and I both took Hadley to her first appoint with Nurse Practitioner L. In general, I like making any kind of appointment first thing in the day. People are just fresher and, in my opinion, nicer before the day has had a chance to turn sour. We had the first appointment of the day and got there 20 minutes early. Actually the lights were still off and the door was locked. We waited out in the hallway and I imagined the entire front office staff rolling their eyes. Oh well.

We did the usual check-in, weight, length, confirm meds and health history with the medical assistant. Then we met Hadley's new provider, Nurse Practitioner L. She politely introduced herself and sat down across from the three of us. We had taken Hadley for her usual blood draw a few days earlier so she reviewed her results with us. Hadley's TSH was up to 20.979 which is too high.

Then the let down.

She started asking us about Hadley's thyroid history and looking at her computer clicking through her record while we talked. I was so disappointed. Why hadn't she familiarized herself with Hadley's history? I mean, she's barely 1. It couldn't take that long to go back through her past visits right? She had no clue! Hadley was her first patient of the day, there's no way she had already gotten behind. Why couldn't she take the time to review the chart before she walked in the room?

I probably don't need to say this but Hadley was not paraded around the office that day as she was with Dr. K. We left feeling disappointed and a little cheated. I prayed for Hadley and her new provider.

Fast forward 3 months. Kyle and I both took Hadley in again to see Nurse Practitioner L, this time for her 15 month check-up. Again we went first thing in the morning and again we went through the same intake process. Then Nurse Practitioner L came in. She was fully engaged. She spoke about Hadley's most recent labs (this time her TSH was up to 44.608), and her labs values and trends from the past 15 months. She brought up signs, symptoms and concerns that were previously discussed with Dr. K and concerns that she had. She told us that we would be increasing Hadley's medicine and rechecking her TSH in 6 weeks. She asked us what questions we had. We asked what we should look for or be concerned about at this point and she was quick to comfort us. Since Hadley's mood, disposition and appetite had not changed we really had nothing to be worried about at this point. Managing Synthroid while an infant is growing rapidly is a challenge. After she answered all of our questions, she talked to Hadley and held her hand while she walked about the room. She played with her and let Hadley play with her stethoscope. When she sat back down she again asked if we had any questions. Her kindness and compassion as a person and as a provider were exactly what we were looking for.

I feel like I've always taken a common sense approach to my family's health care. I don't panic when the boys get hurt. I don't get frustrated when we wait forever in an exam room. I don't need someone to hold my hand while Tuck gets stitches or when Colton gets an X-ray. I am even able to have a "strictly-business" attitude when Hadley gets her blood drawn. But this is different. This is a life-long disease that requires frequent and diligent maintenance. I'm not interested in a passive relationship with the person providing long-term care for my daughter.

I admit that I went to our first appointment with Nurse Practitioner L with hesitation and with my guard up. First impressions are so important, but I've learned through this that they're not everything. Who hasn't had a bad morning, not enough coffee, a rough start to your day? Who hasn't ever made a bad first impression? I'm grateful for forgiveness when I'm not perfect, and I think second chances are just as important as first impressions.



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