My Worst Day as a Nurse Practitioner | She Had Me in TEARS

The Day a Patient's Mother Had Me in Tears: My Worst Experience Ever as a Nurse Practitioner

Tears streaming down my face. Blood red, flushed, hot. Sitting at the computer in front of a 15-year-old patient, trying desperately to finish her visit summary while her mother stood outside the exam room—because I had just asked her to leave.

This was my worst experience ever as a nurse practitioner.

Watch the Full Story Here ⤵️  

How It All Started: The Perfect Storm of Sick Season 

I wish I could say it ended well. I wish I could say I handled it perfectly. But the truth is, I said something I never thought I would say in a patient encounter: "You need to leave now."

If you've ever had a hostile patient interaction, felt emotionally drained after telling someone they don't need an antibiotic, or found yourself dreading certain appointments on your schedule—this story is for you.

It was between Thanksgiving and Christmas—peak sick season. You know how it goes: school starts, kids share germs, strep season kicks off, respiratory viruses spread like wildfire. Then everyone gathers for Thanksgiving dinner, and it's like pouring gasoline on a fire.

I was working in retail health at the time, and the clinic was severely short-staffed. Patients who couldn't get into primary care were desperate for help. So I signed up to work extra hours throughout the week.

Toward the end of that grueling stretch, management begged me to pick up a Saturday shift—just four hours. You can do anything in four hours, I thought. After all, as nurses, we're used to 12- and 13-hour shifts.

But I regret agreeing to that shift. It was during those four hours that I had my worst patient encounter ever—and the experience that would ultimately change how I approach the "no antibiotic" conversation forever.

The Patient: A Sweet 15-Year-Old With a Viral URI

The patient that day was a 15-year-old girl I had never met before. No established relationship. No built trust. Just a young woman with a sore throat, runny nose, and feeling run down. No fever. No headache. No nausea or vomiting. No systemic symptoms.

I examined her and quickly realized: Good news—it's just a simple respiratory virus. Bad news—there's nothing I can do to cure it.

She was sweet. Accepting. Easy to talk to. I sat down at the computer and started explaining our game plan while documenting her visit summary.

"If an antibiotic would help you, I'd absolutely prescribe one today," I told her. "But it won't help. And I don't want to put you at risk of side effects like nausea, vomiting, diarrhea, or yeast infections when it's not going to make you better."

She nodded. She understood. I was giving her symptom management recommendations when suddenly—someone else joined us in the room.

Enter: The Impatient Mother

Mom walked in—not because she had been parking the car or picking up a prescription. No, she came in hot. Impatient. Frustrated.

"Hey, what's taking so long?" she demanded.

I tried to stay friendly and empathetic. "So sorry, we're almost done. I've checked your daughter out. I was just letting her know she doesn't need an antibiotic—she's got a respiratory virus."

I started to explain our plan, but she immediately cut me off.

"What? I know she needs an antibiotic. That's why we're here—to get an antibiotic."

I took a breath and tried again. "I understand, but she doesn't have evidence of strep infection or any other bacterial infection that needs an antibiotic. It's clearly a respiratory virus, and an antibiotic won't help her at all."

She wasn't listening. She cut me off again. She wasn't happy.

And at that point, I have no idea what else she said. I went deer-in-headlights. My mind was spinning: Is this real life? Is this really happening? Do we really have to go here?

The Breaking Point

I was sitting at the computer. I stood up. And suddenly, I felt tears welling up in my face.

I pointed to the door.

"You need to leave now."

She stopped. Shocked. "You can't make me leave."

"You need to leave now."

She paused. "You can't make me do this. I'm going to call management."

In that moment, I didn't care. I didn't deserve to be treated this way. I needed this moment to end before something worse was said.

She left.

I closed the door calmly. The daughter was still sitting on the exam table, utterly mortified.

The Aftermath: Apologizing Through Tears

I sat back down at the computer to finish her visit summary. Tears started streaming down my face. My face was blood red, flushed, and hot.

The daughter dropped her head and slumped her shoulders. "I'm so sorry."

"Oh my goodness, sweetheart—you do not owe me an apology," I said. "I need to apologize to you. I am so sorry this visit went this way. I should be able to handle this better."

As I typed through tears, I continued: "I do want you to know I am taking the best care of you. I promise I'm being honest about what's going on. If you needed the antibiotic, you would be getting it—but I can actually do more harm by giving you one."

She was so sweet. "I understand."

I apologized again. She left the room.

After the visit, I called management and explained what happened. It was a whole ordeal. But it was also the turning point that forced me to decide: This will never happen to me again.

What I Learned: Why This Conversation Went So Wrong

Looking back, several factors set me up to fail:

1. Peak of Sick Season

Patients were tired, overwhelmed, and stressed. Christmas is one of the leading times for heart failure admissions and heart attacks—because of the ridiculous stress we put ourselves under during the holidays. It wasn't a good season for anyone.

2. No Established Relationship

I had never met this patient or her mother before. There was no trust, no rapport, no history of me caring for them well.

3. I Hadn't Crafted the Conversation

I didn't have a clear framework for navigating this interaction. I didn't know what my responses would be when faced with pushback, confrontation, or outright hostility.

For my retail health and urgent care colleagues, this is exactly why you need clarity and confidence in delivering the "no antibiotic" conversation. I used to hear patients check in and say, "Yes, I just need an antibiotic," and I would drain from head to toe—because I knew what was likely coming.

The vast majority of patients who think they need an antibiotic actually don't. You have to navigate that conversation effectively. And it's a skill you can learn.

The Two Extremes (And Why You Shouldn't Be in Either Camp)

After that experience, I realized most nurse practitioners fall into one of two camps when it comes to antibiotic conversations—and neither is where you want to be.

Camp 1: The People Pleaser

This NP says, "I know they don't need it, but they're demanding it. I'll educate them about the risks, but I'll give them the antibiotic anyway."

If you're in this camp, you're still responsible if the patient suffers antibiotic-associated side effects. You're also contributing to the worldwide crisis of antibiotic resistance. I know why you're here—you can't afford the emotional drain. But I want you out of this camp.

Camp 2: The Hard-Nosed NP

This NP says, "I know the science. I have the license. This is viral. You don't need an antibiotic. Let it run its course. End of story."

Even though you're doing what's medically right, you're not building trust or relationship—two things that are absolutely necessary to impact patient outcomes and improve health for the long haul.

The Better Camp: Compassionate AND Confident

This is the NP who navigates the conversation skillfully—saying no to antibiotics while building trust, showing empathy, and maintaining relationship. This is where I want you to be. And it's where I had to learn to be after that terrible Saturday shift.

How to Start Mastering the "No Antibiotic" Conversation

You don't have to dread these patients. You don't have to feel drained after every URI visit. And you certainly don't have to sacrifice your integrity or your patients' safety just to avoid confrontation.

This is a skill—one you unfortunately didn't learn in school or clinicals. But you can learn it now.

Start here: Download my free guide, Top 10 Phrases Every Clinician Needs When Saying No to Antibiotics. It includes real-world scenarios and practitioner responses you can use today to craft your own confident, compassionate conversation.

👉 Download the Free Guide Here

You're Not Alone

If you've experienced a confrontational encounter like this, I'd love to hear your story. Drop a comment below and let me know: How did you respond? What did you learn? What do you do differently now?

One of my former partners and I used to say, "We can do more with effective patient education than any pill ever could." And that's the truth. If we're not building relationship, trust, and connection in the exam room, we're missing out on our most valuable tool to impact outcomes.

You're not unqualified. You're unsupported. Let's change that together.

I'm here to help!

📥 Download the Free Guide: Top 10 phrases to say no to antibiotics confidently
💬 1:1 Coaching: Work with me to craft YOUR no-antibiotic conversation

About the Author:
Melody Presley, APRN, FNP-C, is a board-certified family nurse practitioner with over 14 years of experience in primary care. Her mission is to empower nurse practitioners and NP students with the confidence, communication skills, and clinical tools they need to thrive in practice—without burning out.