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.

 

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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.