Knee Rehabilitation

November 16, 2004

I thank the Lord for the progress I’m making here in the rehabilitation center after my knee replacement on November 8. I now only need Percocet for the pain every three hours which my stomach can tolerate right after I eat a snack. It was great to sleep 7 hours last night! I did better in Physical Therapy (PT) today as they walked me on a straight cane rather than the walker, but I am still a little wobbly. The Occupational Therapist (OT) taught me how to put on my support hose with a sock aide so now I can shower and dress myself totally independently. They even had me marching and raising my knees high! I met the recreational therapist and enjoyed doing an oil painting which distracted me from the pain for awhile. She said my church choir could come here to sing for the residents any time they like. I so appreciate the visitors from church and their sweet encouragement to me. I never realized before how much visitors help.

The oil painting I enjoyed doing in rehab which helped distract me from my knee pain.

November 21, 2004 – Sunday

I’m awake for now so I want to record snap shots from the past few days. I am now able to go 5-6 hours between percocet pills for the pain. At my request, they added magnesium and calcium to my medications. An hour after I took them, the deep burning pain went away and I could walk much more easily! I missed church so much this morning, so I turned on the TV and watched a couple church services. My nursing assistant, Angela, walked in and said she enjoyed hearing these men preach and that she had received Jesus Christ as her personal Savior.

I asked her if she knew of any other patient who would like to sing, pray, and read the Bible with me? She said she would think about it. Thirty minutes later she brought Teresa to my room and the three of us had such a precious time together. We sang “How Great Thou Art”, “Rejoice in the Lord” and then I read Romans 5 from the Bible. Teresa had some questions about eternal security, so I tried to help her with that. Then we sang “Turn Your Eyes Upon Jesus” and “It Is Well With My Soul” and Angela closed us in prayer. Teresa has cancer and will meet with her doctor and family tomorrow. She asked me to come to her room tomorrow and sing hymns again with her.

November 24, 2004 – Thanksgiving Eve

Home sweet home!! Mary brought me home yesterday afternoon. We enjoyed the most wonderful dinner together that she brought me. I slept fairly well last night, but it’s a little tough to get out of bed. Today PT comes. A friend will take me to the Thanksgiving service at church tonight and another friend has invited me to her house for Thanksgiving dinner. Thanksgiving is my favorite holiday of the year! Two other families invited me for Thanksgiving dinner, so I asked them to bring their left overs on Friday and Saturday nights so I have three Thanksgiving dinners in a row and fellowship with my friends. Dear Lord, You are so wonderful. Thank You so much for saving my soul, for Your loving kindness, and for all the help from my brothers and sisters in Christ. Amen.

December 8, 2004

I had a good post operative visit with Dr. R. He was pleased with my progress of being able to bend my knee to 100 degrees now, do straight leg raises, and climb steps with 50% of my weight on the hand rails.  He said I could go to aqua therapy since my incision is well healed. I can also drive again even though I’m still taking Percocet for the pain.  He wants me to take the entire 12 weeks off from work so I heal well. If I go back earlier, I’ll be stiff, sore and swollen and may have a setback. My home PT showed me how to do all the water exercises at the local indoor pool, so that will save me money. I only pay $33 per month at the pool compared to $20 each PT session three times a week.

When I got in the warm whirlpool, it felt so delightful that I almost cried tears of joy. I am exactly one month out today from my surgery. We had an ice storm yesterday, so I had to cancel my endocrinology appointment. I don’t dare walk on the ice or snow yet because I certainly don’t want to slip and fall.

December 18, 2004

It has been a rough week. I’m having so much pain at night that I can’t sleep. I decided to go to outpatient PT to see if she can help me with the pain. Kimberly, PT evaluated me and said I still have swelling, I’m doing too many exercises, and I need to rest more. She instructed me to only do 2 sets of 10 repetitions of each exercise just once daily in the pool or on land. She reminded me that a knee replacement is extremely painful and takes time to heal. I’m thankful that tomorrow I complete my twice daily Lovenox shots in my abdomen to prevent blood clots. My stomach is all bruised and tender from the shots. Dr. S. mailed me two fun books for Christmas. It was so kind of him to remember me.

Reflection

And so ended 2004. It was a year of stretching with two surgeries, an international trip to China, and adrenal collapse. But through it all, I could see how much God stretched me and caused me to know Him better through these trials. Truly He filters everything through His loving hands for His glory and our good.

“My brethren, count it all joy when you fall into various trials, knowing this, that the testing of your faith works patience. But let patience have her perfect work, that you may be perfect  (mature) and entire, lacking nothing.” James 1:2-4

 

 

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Total Knee Replacement

October 9, 2004

“For I reckon that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us.” Romans 8:18 “What man is he that fears the Lord? Him shall He teach in the way that He shall choose.” Psalm 26:12

If the Lord tarries, my total knee replacement surgery will be on Monday, November 8. I visited three rehabilitation (rehab) facilities and chose the nicest one with a private room and private bath. I have to pay $20 extra per day for a private room, but it is worth it since I am such a light sleeper. I don’t want to end up with a roommate who screams all night. This facility specializes in joint rehab and has an excellent reputation. My sister, Marsha, is flying here on November 6 and will be with me through the 15th. I am so thankful she can be with me during this time. My dad offered to give me money every month while I am out of work, so I thank God for my dad’s help also.

I thank God for all the valuable lessons He will teach me in this school of knee surgery that He has chosen for me. Here are the classes: Surgery 101, Inpatient Rehab 102, Home Rehab 103, Outpatient Rehab 104, Out of Work 3 months 105. I know He will throw in some surprise classes and pop quizzes. God encouraged me today with 2 Corinthians 1:5, For as the sufferings of Christ abound in us, so our consolation also abounds by Christ. God will not test me above what I can bear. Thank You, dear Lord, that You have it all perfectly planned out.

October 16, 2004

I went to an interesting class at the hospital to prepare me for surgery. They gave me a folder and had me watch a video by a TV actor who had both his knees replaced at the same time. He is now able to ride a horse, so maybe I can cross country ski a little next winter. Dr. S. told me not to give away my skis!

Yesterday I attended a conference for orthopedic nurses and many of the hospital nurses who will be taking care of me also attended. I learned much, but I’m not sure if it was good for me to hear about all the possible complications of knee replacement surgery. I am so thankful my two nurse friends from church will both be working the week of my surgery. It’s always nice to see familiar faces at the hospital.

October 30, 2004

I tried to donate blood to store for myself, but my veins collapsed. Two friends at church who have my blood type volunteered to donate on my behalf, so that was very generous of them. The Nurse Practitioner who was my first preceptor in graduate school now works for my primary care doctor, and she gave me my preoperative physical. It was great to see her again! I only have six days of work left. I am so ready to move onward and forward and have this surgery behind me.

November 4, 2004

“Thou hast enlarged me when I was in distress.” Psalm 4:1

I read this verse before I attended our monthly practice meeting yesterday at the hospital. Dr. E., my main boss, asked to meet with me privately after the meeting. He told me they were granting me the medical leave of absence for a maximum of 16 weeks even though they aren’t required to legally because they are such a small practice group. The hospital lost $2.5 million last year and has had to lay off a number of employees. He said he might need to decrease my hours when I return. He wants me to make rounds on all the hospital units to increase the visibility of the rehab unit and to promote the rehab unit as enthusiastically as possible. He said the workload will be difficult for Dr. S. while I am off. They are not paying me any salary while I’m off work, so at least they are saving money that way.

Many changes lie ahead at work in the next three months, but I refuse to worry about it because God isn’t worried! I praise Him for the wonderful peace He is giving me going into surgery.

November 15, 2004 – 2:40 a.m.

I had my surgery one week ago, and I’m now at the rehab facility in my pleasant private room. Marsha flew back to her home today. She was my advocate while I was in the hospital when I could not think straight from the pain and anesthesia. I am so thankful for help from her and the nurses from church. I thought I would lose my mind from the pain right after surgery. I fainted several times in the hospital from low blood pressure caused by the pain medicine, so the doctor changed to another one. They put my leg in the continuous passive motion (CPM) machine which made my leg spasm, so I refused it.

My titanium knee xray looks similar to this.

Marsha drove me from the hospital to rehab in my car, but it was agony to bend my swollen knee enough to get it in my car. I think I should have come by ambulance instead. The rehab facility couldn’t obtain my pain medicine from the pharmacy for 12 hours after I arrived, so again the pain was incredible. Mary, my friend from church, visited me and held my hand when my leg spasmed. We sang one hymn after another to try and distract me from the pain. I’m so glad I brought copies of the words of all my favorite hymns with me. Some of the brethren from church came to visit me on Sunday afternoon which was a blessing. They sang “Rejoice in the Lord” and “Isn’t He Wonderful?” I am finding singing to be very therapeutic.

Reflection

And so I began my 10 day stay in the rehab unit. The intensity of the pain after surgery surprised me. I really didn’t know a person could experience that much pain. The experts say that bone pain is the worst kind of pain, especially in the knee joint because the swelling has no where to escape. People who have had both their hip and knee replaced have told me that the knee replacement pain was significantly worse. However, everyone experiences surgical pain differently. A few people only need mild medicine, but I definitely think I was at the opposite end of the spectrum. One probable reason was my age of 49 years and having intact nerves.

More Knee Pain

August 2, 2004

“Beloved, think it not strange concerning the fiery trial which is to test you, as though some strange thing happened unto you.” I Peter 4:12

“In every trial, there are gleams of light and relief, but full deliverance is often delayed by our anxiety to obtain it. God Himself and not the deliverance is to be the satisfaction of His servant. Consequently, the deliverance is often postponed until we are without prospect or expectation of it. Then it may happen in a manner so far beyond our conception that we must see and understand the love and interest which surrounded us during the whole period of our trial.” -None But the Hungry Heart

As I begin my second week of recuperation here at home after my knee surgery (arthroscopy), I am so thankful for this encouragement from the Lord. Dr. E., my big boss, was so kind when I talked with him this week. He said to take all the time I need to recover. He knows I’m not hanging out in the Bahamas:) He asked if I have osteoarthritis, chondromalacia (rough knee cap), or torn meniscus (cartilage). I told him that I have all three which shocked him. He said he was at a loss for words to say something to make me feel better, but God is my comfort and strength.

I spoke with one of the nurses at church who had her knee replaced. She encouraged me to have it done as soon as possible so I don’t ruin the other one. She was able to drive ten days after surgery, but said the pain is intense the first few weeks.

August 9, 2004

I tried to return to work last Thursday for four hours, but it was really difficult because I became so weak. I’m afraid the stress of surgery has made my adrenal glands crash again. It took me three hours to do one admission and see nine patients. I can only stand about 30 seconds, so I went back to work too soon. I am going to write out surgical guidelines for myself for the next surgery to help me remember. I spoke with two nurse friends at church who both work in orthopedics at the community hospital. They both recommended Dr. R. who did my first two knee arthroscopies.

I tried to go to church yesterday, but became so weak after driving two blocks that I had to turn around and come home. So I laid on my couch and listened to a good Bible message on thinking right. I keep asking God to help me to see this exercise in my life from His point of view and to help me not to wrestle, but just nestle in His loving arms today.

August 14, 2004

I saw Dr. R. for a second opinion on my knee. He needs the operative report and and photos from Dr. M. He’s not too eager to do a total knee replacement on me because it only lasts 8-10 years on someone my age. If I can wait 11 more years until I turn 60, the knee replacement will last 15-20 years. He ordered water therapy in the pool which I did yesterday and today. I am still getting weak and dizzy once or twice a day, so I’m not sure when I will be strong enough to return to work. I’m off work without pay now since I used up all my sick and vacation time. I know the Lord will provide.

Dear Lord, Carry me this day. I give it to You in all my weakness. Thank You, that this path of affliction is for Your glory and my good. Help me to trust and rest in You. In Christ’s Name, Amen

August 26, 2004

“The Lord will give strength unto His people; the Lord will bless His people with peace.” Psalm 29:11

God is so gracious in carrying me along this week. The endocrinologist and naturopath both agreed that my adrenals are my main problem causing the weakness and dizziness and have restarted the cortisone and other supplements. I am getting custom inserts for my walking shoes to try and align my knees better since my knee caps point out instead of straight ahead.

Dr. E. called me again to say hello and see how I was doing. When he worked in internal medicine, he had a patient with adrenal insufficiency and said he knew what a difficult problem it is to have and treat. He assured me that they will not replace me and not to worry about my job or come back too early. If I need to come back just 3 or 4 hours daily, that can be arranged. It was so nice of him to call and reassure me.

I thank God so much for the compassion of Dr. E. and Dr. S. and allowing me to work with these two men. They are so refreshing compared to my two previous nurse managers at the LPN school and the insurance company. But I realize that none of this will matter 100 years from now, so I’m just trying to keep the big picture. I now qualify for disability since I have been out of work for over a month. I thank God so much for His encouragement today.

September 30, 2004

“And after you have suffered for a little while the God of all grace, who called you to His eternal glory in Christ, will Himself perfect, confirm, strengthen, and establish you. ” I Peter 5:10

After taking the cortisone for 9 days, I was finally able to return to work a couple weeks ago, but the knee pain is intense. Dr. S., my boss, ordered forearm crutches for me to walk with as these give the most relief from knee pain. My patients are so sympathetic as I make rounds on them and we joke about our mutual aches and pains. I’m connecting with my rehab patients on a new level.

My knee pain was so bad that I needed to walk with forearm crutches at work.

I saw Dr. R. yesterday about my continuing knee pain. He reviewed the surgical report and photos and said I need a total knee replacement if I don’t want to end up in a wheelchair. I don’t qualify for a partial knee replacement because my bones are soft and I have triple compartment arthritis. I will need about 10 days in a rehab facility after the hospital stay since I live alone. He recommended two facilities and said I should visit both before surgery to see which one I preferred. I will need to be off work for three months after surgery. He is very comfortable dealing with people with adrenal problems, so they will give me a huge steroid dose the day of surgery to prevent my adrenals from crashing again hopefully. He is going to order the newest and most expensive titanium knee for me that is supposed to last 30 years. It costs $30,000! I sure hope it lasts until the Lord takes me home.

Dear Lord, Help me to relax with the pain right now and rest in Your everlasting arms. I just want to line up with Your plan and not my own. You plan this surgery and use it for Your glory and honor. In Christ’s Name, Amen

Reflection

And so God prepared me one step at a time for a very difficult surgery. Many days it seemed like I would never be pain free again in my life. I realized even more what a blessing health is, but many times He teaches me the most when I am so very weak and can do nothing but lean on Him. This very difficult time in my life gave me much greater compassion for the health problems of my patients.

Pain, Pain – Go Away!

April 22, 2004

I had my painful left knee injected with cortisone yesterday because I could barely walk. I have been trying to climb more flights of stairs at work to get in shape for ascending the Great Wall in China, but it has only made my knee worse. I do wish I never would have tried to learn how to downhill ski nine years ago. A bad fall is what started all the arthritis in my knee. It’s difficult to make my walking rounds at work in the hospital because of the pain.

April 24, 2004

“He (God) gives power to the faint; and to those who have no might He increases strength. Even the youths shall faint and be weary, and the young men shall utterly fall. But they that wait upon the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run, and not be weary; and they shall walk, and not faint.” Isaiah 40:29-31

 I saw the Physical Therapist (PT) yesterday and he thinks I have floating pieces of cartilage in my knee again because of the catching and buckling when I walk. The orthopedic Physician’s Assistant (PA) read me the surgeon’s operative report from 1996 who said I have a major defect beneath my patella (knee cap) and exposed bone. My xrays this week showed arthritis behind the patella and a narrowing of the space, so I’m probably looking at a total knee replacement in the near future. The Lord knows. The PT gave me an electrical stimulation machine to use for the pain four times daily over the weekend. I apply electrodes on either side of my knee and then the small machine sends low dose electrical signals through my knee to block the pain.

May 3, 2004

“I will go before you and make the rough places smooth… and I will give you treasures of darkness, and hidden wealth of secret places in order that you may know that it is I, the Lord God of Israel, who calls you by your name.” Isaiah 45:2-3

So much has happened in the past week. SARS (severe acute respiratory syndrome) has reoccurred in Beijing leading to one person’s death, eight confirmed cases, and 1000 people exposed. I am scheduled to visit friends in Beijing on May 19. I have committed the situation to the Lord and have asked Him to open or close the door for me to go. It is so wonderful to be still and know that God is in control.

June 5, 2004

I had an interesting trip to China and enjoyed seeing the Forbidden City, Summer Palace, and climbing an unrestored part of the Great Wall with my friends. I thank the Lord for the health He gave me and for protecting me from SARS, but all the walking took a toll on my knee.

I just fit in the Circle Door at the Summer palace

I had fun dressing up as Empress Pam at the Summer Palace.

Staying cool Chinese style as I toured the massive Forbidden City.

July 2, 2004

My left knee started catching and buckling again last week, so my boss, Dr. S., was able to call the orthopedic surgeon and get me an appointment this week. Dr. M., the surgeon, is a friendly personable guy. He said, “I really like you, but I hate your knee.” He looked at my xrays and photos from my last arthroscopy two years ago and said I was already down to the bone in several places with severe arthritis. He informed me that a knee replacement lasts 17-20 years under the best conditions and doesn’t work well if I would need a second knee replacement on the same knee. I’m only 49 years old, so I sure hope the Lord comes soon! I also am very high risk for synovitis (painful inflammation of the joint). I will have my third arthroscopy on July 23 to clean out my knee.

August 1, 2004

I have had a rough recovery from my arthroscopy with weakness and dizziness. I saw Dr. M. for followup and he said my knee looks like one from a 90 year old woman and that it is not happy. He suggested that I need to think about getting a desk job, take another week off from work, and then return only four hours per day. The next step is a total knee replacement, but he can’t predict if or how long the arthroscopy will give me any pain relief. This news shocked me, but I’m thankful that my soul is happy in Jesus even though my knee isn’t.

“Although the fig tree shall not blossom, neither shall fruit be in the vines; the labor of the olive shall fail, and the fields shall yield no food; the flock shall be cut off from the fold, and there shall be no herd in the stalls; Yet will I rejoice in the Lord, I will joy in the God of my salvation. The Lord God is my strength, and He will make my feet like hinds’ feet, and He will make me walk upon mine high places. Habakkuk 3:17-19

God uses change so we can use our spiritual muscles that we have never used before.

Reflection

And so God gave me lessons once more in the school of pain. Little did I know that I would remain in this classroom for many more months. God is so kind to hide the future from us so that we may learn to abide in Him and trust Him just for today. Next post I will continue telling you about my painful journey.

 

Nurse Practitioner in Physical Medicine

July 18, 2003

Continue in prayer, and watch in the same with thanksgiving. Colossians 4:2

How I thank the Lord for the good interview with Dr. S. on the rehabilitation unit at the city hospital last week. I have been asking the Lord to open or close the door for this job according to His will. It is so wonderful to wait upon Him for His perfect timing. I had another good conversation with Dr. S. yesterday after I faxed him a thank you letter with a few more questions. He assured me that the hospital and rehabilitation unit are doing well financially, that my salary is in the budget, and that I definitely have the job.

July 25

I met yesterday with the Chief Executive Officer and the Chief Financial Officer of the rehabilitation network. They spoke highly of Dr. S. and the rehab unit which has a 97% patient satisfaction rate. I am impressed with this organization that began in 1995 and has now expanded to 70 outpatient sites in the state. They are interviewing one other NP for the position which surprised me. God knows which of us is right for this position. I have a third interview next week with Dr. E., the medical director of the entire network.

God blessed me today when I read 2 Thessalonians 3:5. The Lord direct your hearts into the love of God.” “May our hearts get such a lesson in the love of the Father that, instead of being depressed by trying circumstances, or elated by what are called providential circumstances, we may know that we are the objects of this wonderful love, and are being educated into it by the only One who knew it in all its power as He walked here below through this wilderness world.” JBS

Dear Father, Help me not to go up or down emotionally with my circumstances, but just enjoy Your love and be satisfied with today. In Jesus’ Name, Amen.

July 30

I had the interview with Dr. E. this morning and it seemed to go well. The Vice President called me at 4:30 p.m. and offered me the job! I spoke with Human Resources and I’m meeting with her tomorrow so I can start work on August 5. I reread my June 25 journal requests for my next job and realized that God fulfilled every one of them.

Dear Lord, Thank You, thank You, thank You! Please use me for Your glory and honor in this position. Amen

August 5

My first day at work was interesting. Dr. S. did not know I was coming and was upset with Human Resources for not telling him. I attended the weekly team meeting and listened as the therapists reported on each patient’s progress, recommended a plan of care for the week, and decided on a discharge date. I’m looking forward to learning from all the team members in physical, occupational, and speech therapy as well as the neuropsychologist, neurologist, social worker, and discharge nurse. Then I watched some videos about rehab, read manuals, received a key to my new office, and was given a tour of the hospital. The most difficult part of the day was maneuvering in the tight parking garage. Someone parked so close to my car door so that I couldn’t open it. I had to crawl in from the passenger’s side with my dress practically up to my waist! I’m glad no one saw me….

“Don’t worry about the future – worry quenches the work of grace within you. When God gives you comfort, enjoy it.” – Fenelon

September 22

I had a rough night. I awoke at 3:30 a.m. wondering how my patients were doing and if I ordered the right things for their treatment.

Dear Father, Help me through this day. You know how weary I am. Please do this job through me. Help me to rest in Thee and trust in Thee and remember that none of this will matter 100 years from now. I love You. Amen

October 8

I am so thankful that work is going better. Dr. F., the unit neurologist, has returned from vacation, and now Dr. S. is on vacation for a week. I am feeling more comfortable in doing the neurological exams on admission and daily rounds on the patients. Next week, the hospital is sending me to New Orleans for a conference for Rehabilitation nurses.

November 3

The conference in New Orleans was a great learning experience. About 1100 RN’s and 30 Nurse Practitioners invaded the huge convention center. I am thankful that a lady friend from church went with me. During our free time, we enjoyed eating in the French quarter, attending a Southern food cooking class, and taking a boat tour through the swamp. I walked a mile to get to the convention center from our hotel the first day, but didn’t feel very safe, so I took a taxi after that. It sure is different there compared to New England!

The French Quarter in New Orleans, Louisiana

 

A crocodile suns himself on the swamp tour.

 

Spanish moss drips from the trees in the swamp.

Reflection

And so began my first few months in physical medicine. In looking back over my 40 year career, I think this was my favorite job. It was very gratifying to watch the patients make slow steady progress until they were strong enough to return home. Of course, some of them had reverses and had to return to the hospital. The staff worked well together and formed a real team. The first six months in any new job are always the most difficult when the learning curve is so steep, but God carried me along once more one day at a time through all the ups and downs.

Little did I dream that Hurricane Katrina would strike New Orleans in 2005 and flood 80% of the city, causing catastrophic destruction.

 

 

Teaching Licensed Practical Nurses

May 1, 2003

I had crushing chest pain on Saturday, so I called the ambulance and went to the emergency room. They diagnosed me with pleurisy and pneumonia, put me on antibiotics, and sent me home. How I thank the Lord for the perfect peace He gave me during the hours I lay on the stretcher. “For me to live is Christ, and to die is gain.” Philippians 1:21

The job is going better, by God’s grace. I like teaching the students at the nursing home. The staff is very helpful, so that makes for a pleasant learning environment. I discovered that my new neighbor works as a nursing assistant there. Her first language is Portuguese and she only speaks minimal English. I think I’ll check some tapes out of the public library and try and learn a little Portuguese so I can talk more with her.

May 16

I am sick at home again with a fever of 101 degrees. This is the fourth time I have caught an infection since I started working at the school and the nursing home. I asked the Lord to make it clear if He wants me to work again as a Nurse Practitioner or keep teaching. I am required to work 2000 hours as a NP over a five year period to keep my certification, or I can take the board exam again which would be grueling.

June 7

“Teaching is not effective without a good example. You can easily discourage others by being impatient with them. The more forceful you are, the more you need to learn gentleness and kindness.” – Fenelon

The first clinical session has ended at the nursing home. At first, I hated working in the nursing home. But after I became better acquainted with the staff and the alert patients, I thoroughly enjoyed it. I watched in amazement as the students progressed from being frightened to touch a patient to being able to care for several patients confidently.

June 13

For I reckon that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us.” Romans 8:18

Yesterday morning I asked the Lord to help me depend on Him alone and not a paycheck or a job, which He answered very quickly. An hour later, Mrs. D. called me into her office and told me that my position was eliminated because over half of the first module class failed. I asked her why she chose me? She said my student evaluations were not good, and that I was not a team player. She also announced that C. would be the new director. C. has a very foul mouth, smokes, and cohabits with a man, so I know that it would have been difficult for me to work with her. I always felt like a fish out of water in the teachers’ communal office because I did not swear or tell off color jokes like all the others.

I can’t sleep from this head cold and can’t stop my tears of exhaustion. But on the brighter side, because I was laid off, I can collect unemployment while I look for another job. I thank the Lord that I don’t have to get up at 4:45 a.m. to go to the nursing home or prepare lectures at night after teaching all day. Perhaps God will improve my immune system so I don’t keep catching all these viruses.

“Don’t let your work either excite you or depress you too much.” – Fenelon “When we sit under Christ’s shadow with great delight, everything else becomes so small, and loses its hold upon our hearts.” CAC “Nearly all God’s jewels are crystallized tears.”

“Weeping may endure for the night, but joy comes in the morning.” Psalm 30:5

June 24

I had an interview at a children’s residential camp an hour from home today, but it wasn’t a good fit. The pay is too low and the camp is closed for three months in the winter. The atmosphere is so much different than Bible camp. God knows the way I should go.

Dear Lord, I ask You to give me a job where I can freely share the gospel, attend all the services at church, be within a 20 minute commute from home, and have a manager who is kind, fair, and supportive. I ask for a job that is not too stressful where I can use my Nurse Practitioner skills four days per week with good health and retirement benefits. Help me to wait quietly upon You. Thank You for this extra time to study Your Word and draw near to You. Thank You that You own everything and that nothing is too hard for You. Thank You for this measure of health. I love and adore You. Amen.

July 5

The Lord gave me a wonderful week of vacation with another lady from church at Yosemite National Park in California. The rock formations and water falls were breath taking. This is one of the most beautiful place on earth that I have ever seen, but I know heaven will be so much better!

God refreshed my heart at beautiful Yosemite National Park in California.

July 16

Yesterday I had the most difficult interview of my life at the college where I received my Master’s degree in nursing. The position is for Director of Health Services which includes treating the residential college students in the clinic. Four women conducted the interview in the board room with me seated at the head of a long table. Unfortunately, every time I looked up, I saw my reflection in a gigantic mirror on the wall. They took turns asking me about 20 challenging clinical questions from their typed list. My brain kept freezing from the stress, so it was a grueling 90 minute ordeal. After I left the room and closed the door, I heard them all burst into laughter. I walked down the long hallway feeling totally humiliated. This is definitely not the right job for me.

I had another interview today at a large inner city hospital 20 minutes from my home. Because my interview went so poorly yesterday, I spent several hours studying rehabilitation medicine last night to prepare for today’s meeting. I made a professional folder with my resume and business card to give Dr. S., the medical director of the ten bed unit. Dr. S. was delayed in a family meeting, so I quietly observed the unit while waiting. It seemed like a calm, well organized unit. The huge windows in the nurse’s station made it bright and cheerful.

Then Dr. S. took me on a tour of the unit while he explained how it functioned and what my role would be. He asked me a few easy questions about myself in the hallway. He seems like a genuine compassionate person who is board certified in physical medicine. Most of the patients have had strokes, joint replacements, or organ transplants. In acute rehabilitation each patient must be able to do a total three hours of physical, occupational, and speech therapy daily. Some advantages of having rehab in the hospital as opposed to a nursing home is that a patient can be quickly transferred back to the intensive care unit if needed and all their specialty doctors can assess them daily.

Dr. S. has been looking for a NP for eighteen months, so God has been keeping this position open for me! If I am hired, Dr. S. would like me to work from 11 am to 5 pm except on Tuesdays when I would start at 8:30 a.m. so I could participate in weekly team meetings. On Tuesdays, I would leave at 2:30 p.m. Initially, I will be paid for 30 hours weekly with full time benefits. If I want to increase to 40 hours per week, I can do research, inpatient consults, or see outpatients in his office, so there is room to grow professionally.

I will need to work every third weekend and come see all ten patients on either Saturday or Sunday and write a progress note, but it only takes a maximum of 90 minutes. I will also need to make rounds on two holidays, but Dr. S. said I can have first pick of which holidays I want to work. Next, I will need to meet the Chief Executive Officer, Chief Financial Officer, and Medical Director of the entire rehab network.

I spoke with my former classmate, Kim, who has been a NP on the transplant unit for the past year. She was excited for me and said the rehab unit has an excellent reputation. She makes rounds there after they transfer their post transplant patients to the unit. She told me about the hospital benefits and how she negotiated her salary, so I will see what the Lord does.

Reflection

Job changes are never easy, but I thank God that He went before me in every situation. As I reflect on this part of my career when nothing was stable and each month was rocky with constant change, I can now see how the Lord was teaching me to lean totally on Him one day at a time. He always provided my every need and still does! I pray that you will know the joy of leaning on Him also, the only One who is the solid Rock and never changes.

 

What Next, Lord?

January 1, 2003

My Pastor had a wonderful message last night at the New Year’s Eve service at church on Philippians 3:13-14, “This one thing I do, forgetting those things which are behind, and reaching forth unto those things which are before, I press toward the mark for the prize of the high calling of God in Christ Jesus.” I must forget the trials of the past year and press on, looking unto Jesus. He is the Captain of the ship and is smiling in the storm. He is in control and working out His sovereign will.

Dear Father, Thank You for saving my soul. Thank You that today is the first day of the rest of my life. Thank You that You are my joy, strength, and that You will supply my every need as You did last year. Thank You for a warm, safe place to live and a measure of health. Help me to grow to know You better and to study your Word more. Help me to eat right, exercise, and finish organizing my new home. Guide me to the right job and help me serve You in new ways. I look forward to seeing what You will do this New Year! In Christ’s Name, Amen

January 17

I had an interview last week for a substitute school nurse, but they only pay $12 per hour which is really low. I think that over time, I would become quite bored with school nursing. I sent out three resumes for a hospital research position, for a teaching position at an Associate Degree nursing program, and for a teaching position at a Technical School for Licensed Practical Nurses (LPN).

Mrs. D, the Director of the LPN program, called me today to discuss the teaching position. The school is located 15 minutes from my home. I would teach two to three days each week and supervise eight students for six hours the other two days per week at a local nursing home. The staff receives two weeks of vacation, eight floating days off, and every Monday off the last nine weeks of a thirteen week module. The students complete four modules in order to graduate and become a LPN. Most LPNs work as staff nurses in long term care facilities giving medications and treatments to the patients. It will be quite a change for me to teach students right out of high school compared to Registered Nurses or master’s degree students. Mrs. D. asked if I would rather teach Anatomy and Physiology, or Fundamentals of Nursing? I replied that I prefer to teach Fundamentals. We scheduled an interview for next week.

The hospital called me and said they are not interested in me for the research position, but would notify me of any Nurse Practitioner positions. I did not receive a reply from the AD program.

February 3

“Be strong (take courage)… and work; for I am with you, says the Lord of hosts.” Haggai 2:4

I had my interview at the LPN school. Mrs. D. asked me to teach the students for ten minutes on something in nursing, so I taught them how to do a computer ergonomic evaluation of a person’s desk to prevent repetitive use injuries. I learned how to do this when I worked in employee health at the insurance company. Apparently the students liked my presentation, because they all voted to hire me! I start work in one week on February 10.

February 20

I have now completed working two weeks of orientation at the LPN school and it has been rather rough between standing for five to six hours daily at the nursing home and dealing with bed bound comatose patients. My back pain is intense at the end of the day. I have been visiting the ten different nursing homes the school uses for sites for the students and shadowing the different instructors. One instructor, Donna, was particularly helpful. She is in her sixties and has terrible back pain, so she is not sure how much longer she can work for the school. She has been at the school for one year and works 40-50 hours weekly. They keep switching her to different modules, so she has to continually make new lesson plans.

“I will instruct thee and teach you in the way which you should go; I will guide thee with My eye upon you.” Psalm 32:8  

Dear Lord, Make your will clear to me and give me the strength to teach another day.

psalm 32 8

God encouraged me with Psalm 32:8

 March 7

I have been home sick for three days because I have a bad head cold, have lost my voice, and can’t enter the nursing home with my cold. So I am preparing lectures. I thank the Lord for this break to rest my back also. I’m still not sure this is the right job for me, but I am going to try and teach for six months or until I collapse.

March 22

I completed my orientation my first week of teaching the 31 new students. Some have had a previous career as a nursing assistant, beautician, engineer, accountant, or carpenter. Some were born in Ghana, Jamaica, and Poland, so it is a real mix of students. The school’s only requirement is that they have a high school diploma and pay the tuition of $17,000.

My first class was to teach the nursing process which took four hours. I thought I made it clear to the students, but the director said three students came to her and complained that they didn’t understand the class. She ordered me to review it all again with the students in the next two hours, so I did this in addition to reviewing their homework. Then I taught Environment and Safety in one hour which was supposed to take two hours. I am definitely having trouble gaging how long it takes to teach each topic. I was totally exhausted last night after teaching for three hours with my raw throat.

Reflection

And so began my rocky chapter of learning to teach LPN students. It was a continual exercise of leaning totally on God to give me the wisdom and strength to teach them while learning the expectations of the school. After being a competent Nurse Practitioner, it was a humbling experience to start over again in a new area of nursing. But on the other hand, the variety of positions one can have is one of the unique things about being a nurse.