CODE BLUE – TOWER 5!

April, 1977 – Midwest, USA – Orientation

I had just completed my class on handling emergencies including cardiac arrest when I heard the overhead page, “Code Blue, Tower 502, Code Blue, Tower 502, Code Blue, Tower 502!” I was standing in the nurse’s station, so I grabbed the Code Cart and pushed it as fast as I could to Room 502.

Running with the Code Cart!

Running with the Code Cart!

Ann, another nurse on our unit had started to give respirations to Eleanor, a small gray skinned elderly lady I had just talked with the hour before. The doctor and nursing supervisor ran into the room behind me. Miss S., the supervisor, quickly told me to give the medications while she recorded everything the doctor ordered. We grabbed the board off the back of the cart, lifted the patient and put it under her back. Debbie, RN started compressions while Ann grabbed the Ambu bag, hooked it up to the wall oxygen, and placed it over the patient’s face.

Dr B barked at me, “Give 50 cc of Sodium Bicarbonate!” I grabbed the box with the large syringe, tore it open, screwed the plunger on to the syringe, pointed it toward the ceiling, and pushed hard on the plunger to clear the air bubble out of the syringe. Oh, No! I realized that I forgot to remove the needle cap as I saw it go sailing across the room! Dr. B glared at me. My hands started to shake as I grabbed the port of the patient’s intravenous line, pierced it with the needle of the syringe, and began to push the fluid with both thumbs on the plunger as hard as I could through her line. Her body quickly was becoming acidic, so the bicarbonate would counteract this. The Doctor continued to give orders and I pushed the medications through the IV while Ann and Debbie continued respirations and compressions. After 30 minutes, Dr. B. said, “Stop…we lost her.” He turned and left the room.

Everything became quiet. Miss S said, “I’ll call the family while you and the aide wash her body, put a clean gown on her, and clean up the room. Ann removed the code cart from the room and took it down the elevator to the supply department to exchange it for a new cart.

After the aide and I cleaned up Eleanor’s body, I stood alone beside her bed gazing at her. Her face looked relaxed. Her body was still warm. This was the first time I ever saw anyone die. I didn’t know her well, so I don’t know if she had a personal relationship with Christ or not. Silently I prayed, Dear Lord, Use me for your glory and honor. I don’t know how many days I have left here on earth, but You do. Help me to always be ready to meet You. Thank You for saving my soul by your precious blood. Amen

June, 1977 – Evening Charge Nurse

I have now completed orientation and feel like the biggest adjustment is over. It  came to the point where I was daily dreading when the time arrived for me to leave for work. The pressures and responsibilities almost overwhelmed me because all I could hear in my dreams at night was, “Code Blue, Tower 5, Code Blue, Tower 5…” I was so fearful of resuscitating anyone because of the havoc and chaos at my first Code Blue.

I poured out my heart to God and realized I must trust Him, because He is the one who controls life and death, not me! As it says in II Timothy 2:4-5, Who will have all men to be saved, and to come unto the knowledge of the the truth. For there is one God , and one mediator between God and men, the man, Christ Jesus. How God longs for each person to receive Him as their Savior, but He will not force Himself upon anyone.

Now I enjoy going to work every evening, and rest in the Lord to give me the wisdom and strength in every emergency, allowing Him handle it through me! I am just the glove on His hand. How delightful to rest in Him!

And now, the exciting part… the Lord has opened the door for me to teach a Bible class with one of my former patients! One day when I was teaching the class about diabetes, I was able to share the gospel with the patients. Mary listened attentively and asked me to come to her room after class. She shared with me that she also is a Christian and was longing to learn more about the Bible. She lives close to the hospital, so I offered to teach her, and she eagerly said, “Yes!” So every Tuesday morning I go to her home before I go to work and we have the most wonderful time together in the Word.

I was preparing for tomorrow and studying Genesis 22, where Abraham was willing to offer up his only son, Isaac, in obedience to God. He believed that God could resurrect Isaac and was willing to totally obey God in simple faith. I so desire to always obey God like that!

Reflection

Since those days, I have been involved in many Codes for cardiac arrest including infants in labor and delivery and adults when I worked in dialysis and the nursing home. Some nurses enjoy emergencies, but I never have. I am more comfortable having the difficult conversation with elderly terminal patients about their choice of whether or not they want to be resuscitated, and when to choose hospice care. It is a sobering thing to watch someone pass into eternity. But it is truly delightful when I know the person has received Christ as their Savior, and he is welcomed home into heaven above! What grace of our dear Savior to save sinners like us!

Precious in the sight of the Lord is the death of His saints.

Psalm 116:15

 

 

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Come Aside and Rest A While

Summer – 1976 – Midwest USA

I started out the summer working as a Nursing Assistant at Children’s Hospital where I had my clinicals last summer. They floated me one day to the burn unit and the nurse asked me to watch her do the dressings on a 2 year old so I could do them the next time with her watching. As a senior nursing student, they allowed me to do some procedures under close supervision. The little boy stood in his crib as she began to unwind his dressings. As the burned skin was exposed, his blood ran down his legs and arms and he began to scream. I felt myself begin to black out and turned and sank into a nearby chair and put my head on my knees. After the blackness cleared, I stood up and went out into the hallway. The nurse finished the dressings and came out into the hallway to speak with me. I said, “I’m so sorry, but I thought I was going to faint. I have never witnessed anything like that before.” She said she understood and told the supervisor not to assign me to the burn unit again. They sent me back to the orthopedic unit where I was last summer. I guess I deal better with the kids in traction than the burned ones.

After 4 weeks of arising at 5 a.m. in order to catch the 6:30 a.m. bus to work, the dizziness, nausea, and weariness was almost unbearable. I could not smile at anyone and my soul was crying in agony to God. I felt like Elijah under the juniper tree crying out to God to take him home. (I Kings 19:4-7) My Pastor was very concerned about me and asked me to take a walk with him before church Sunday night. “Pam, I think you are so rigid right now and have planned everything so much that God can’t work. Let go, and let God do whatever He wants! For one week, don’t plan anything. Take every day as it comes and do everything the opposite you usually do. Go out to a restaurant and eat a meal, listen to the birds, take long walks in the woods. Don’t study your Bible for one week except to read a few verses in the morning.  It will make you a better Bible student in the long run.”

His words were quite a shock to me, but I was willing to try anything since I had lost all joy in the Lord. The next weekend, I drove up to see Jane for one night and we went hiking at the state park. I had to stop every 30 feet to rest a little. When I awoke on Monday, I was still so dizzy and exhausted that I called in sick. After praying about it the rest of the day, I decided I needed to resign and return to my parents’ home to rest the remainder of the summer. I called the head nurse and told her the situation, and she said she understood. After 7 quarters straight of school, with the last one in psychiatry and the demanding classes, my body was beyond exhausted.

My parents were very concerned about me also and were extremely kind to me. After 2 weeks of total rest, I began to feel like myself again and could smile and laugh! I just finished reading a little book by M. R. DeHaan MD called Broken Things. He said, “The Lord only breaks those whom He is going to make.” “Sunshine all the time makes a desert.” I understand better now that I don’t need to strive and push doors open, but just relax and let the Lord open or close the doors. His tenderness in giving me 2 months just to meditate and enjoy Him brings tears to my eyes.

My Dad kindly drove our travel trailer to the state park a couple hours away and set it up so my Mom and I could stay for the week while he returned to work. God has given my Mom and me very precious times together. I so enjoy walking through the woods listening to the rustling leaves, watching the butterflies and dragonflies fly from flower to flower. At night, the chirping crickets lull me to sleep, and the singing birds awaken me every morning. How I thank God for these precious blessings and restoring my health!

Camping at the State Park was so relaxing!

Camping at the State Park was so relaxing!

Reflection

Since 1976, I have had several other times in my life of total exhaustion when I have simply burned the candle at both ends and pushed my body too far.  As I read the passage in I Kings again about Elijah, he had just run for his life 93 miles to flee wicked Queen Jezebel who was trying to kill him! No wonder he was exhausted. After he said to God, “It is enough! Now, O Lord, take away my life; for I am not better than my fathers.” And as he lay and slept under a juniper tree, behold, an angel touched him and said unto him, Arise and eat. And he ate and then slept some more and ate some more. He was able to go 40 days and nights after that. Now I realize I am certainly not Elijah, but the cure was the same for me. Sleep and eat, sleep and eat.

The disciples were deeply grieving after burying their beloved friend, John the Baptist, who was beheaded by wicked King Herod. I love the passage in Mark 6:30-31which says And the apostles gathered themselves together unto Jesus, and told Him all things, both what they had done, and what they had taught. And He said unto them, Come aside into a desert place, and rest a while; for there were many coming and going, and they had no leisure so much as to eat.” It’s so wonderful that our dear Savior sees when we need to rest and provides it for us!

trillium

3 petaled trillium wild flower reminds me of the Trinity!

A restful walk in the woods.

A restful walk in the woods with my sister, Marsha.

January, 2018

I am currently recovering from pneumonia and a horrific reaction to a medicine that put me in the hospital for 12 days. As I slowly regain my strength, I will repeat some of my most popular posts. Please pray for me to learn all the lessons God has for me during this time of recovery. I praise Him that He has made the Bible extremely precious to me as I lean hard on Him. The medicine caused some short term memory loss which was terrifying to me, but God quieted my heart when I remembered 2 Timothy 1:7, “For God has not given us the spirit of fear, but of power, and of love, and of a sound mind.” 

If you have any encouraging Bible verses that you want to share with me and other readers here, please post them in the Comments section. May you have a blessed week of “Looking unto Jesus, the author and finisher of our faith.” Hebrews 12:2.

Pamela, APRN

Babe of Bethlehem

“Now when Jesus was born in Bethlehem of Judea in the days of Herod, the king, behold, there came wise men from the east to Jerusalem, Saying, Where is He that is born King of the Jews? For we have seen His star in the east, and are come to worship Him.” Matthew:2:1-2

Bethlehem, Israel – March, 2013

25,000 people now reside in Bethlehem, Israel

25,000 people now reside in Bethlehem, Israel

Our tour group boarded our bus outside our hotel in Jerusalem and traveled 20 minutes to the city of Bethlehem which now has 25,000 residents. We drove past the huge cement wall built between Palestinian controlled Bethlehem and Jerusalem to prevent the Arab snipers from shooting them. At the checkpoint, the security guard waved us through after our driver told him we were American tourists. Our day to visit Bethlehem changed since President Obama was scheduled to visit here in three days. We parked in an underground garage and walked several blocks uphill to the Church of the Nativity, the traditional site where Jesus Christ was born in a cave. We passed Muslim women dressed head to toe in black, brown, or gray burkas.

Church of the Nativity

Church of the Nativity

Construction began in 326 A.D. on this oldest church in the Holy Land which is still in use. It is separated into three different sanctuaries of the Franciscan Catholics, Greek Orthodox, and Armenian Orthodox.

"Mouse hole" entrance to Church of the Nativity!

The tiny entrance to the Church of the Nativity prevented intruders!

We entered through a four foot high door with a foot high wall at the bottom. Our guide told us they built it this short purposely as a deterrent to any enemies! When an enemy entered all bent over, he couldn’t shoot anyone, but the person inside could knock him over or kill him easily.

Then we wandered from one sanctuary to the other. It was quite interesting to compare the different architectural styles, the Armenian one being the most ornate. We waited in line about 20 minutes to see the glass covered hole in the floor that is supposed to be the actual birthplace of Christ.

Traditional birthplace of Christ.

Traditional birthplace of Christ.

Our Hebrew Christian guide, told us that in 1948 when the State of Israel began, Bethlehem had all Christian residents, but now there are only about 40 families remaining. The Muslims won’t hire them, so all the Christian young people are leaving.

We went to a gift shop that an Arab Christian started to support these remaining families. The believers carve nativity scenes out of olive wood which are very intricate. I treasure the one I purchased that portrays Mary and Joseph gazing at the Christ child in the cave. I also learned the typical manger was made of stone, unlike the wooden mangers usually portrayed in America.

My olive wood nativity scene carved by Christians in Bethlehem.

My olive wood nativity scene carved by Christians in Bethlehem.

Reflection

As I recall my days in Labor and Delivery helping those babies into the world on Christmas morning in 1981, I couldn’t help but wonder if anyone assisted Mary during her labor other than Joseph? It simply states in Luke 2:7  And she brought forth her first-born Son, and wrapped Him in swaddling clothes, and laid Him in a manger. This is what the midwife or nurse would typically do who assisted the mother.  Midwives are mentioned in Exodus 1:15-22 who feared God and preserved the Hebrew male babies from Pharaoh’s wrath. “Therefore God dealt well with the midwives; and the people multiplied, and became very mighty.” I do not think God gave any details about Mary’s labor or delivery because He wanted all the emphasis upon Jesus Christ, the Savior of the world.

Shepherds of Bethlehem.

Shepherds of Bethlehem.

The common shepherds were the first ones who learned of the Savior’s birth and came to worship Him, their Creator, who “took upon Him the form of a servant, and was made in the likeness of men; And, being found in fashion as a man, He humbled Himself and became obedient unto death, even the death of the cross.” Philippians 2:7-8. Emmanuel, God with us, who left heaven above, and came to earth to be my Savior. Born to die. Thank You, Lord Jesus, that You love me so much!

Charles Wesley captured this thought beautifully in the fourth verse of “Hark, the Herald Angels Sing”.

Mild He lays His glory by, Born that man no more may die,

Born to raise the sons of earth, Born to give them second birth.

Hark, the herald angels sing, Glory to the newborn King!

I pray you all may have a Christ centered celebration of the birth of our dear Savior!

Christmas Babies!

December 25, 1981 – 2 a.m. Labor & Delivery Staff Nurse

I finished my night shift orientation in September and am feeling much more comfortable in my skills as I don’t need to think so hard about every little thing. Since it is my first Christmas in Labor & Delivery, I am required to work. Management designated me as charge nurse since the Assistant Nurse Manager is off tonight.

I glanced at the large white board in the nurse’s station which listed all the patients by name, stage of labor, and doctor. We still had six women in labor with four empty labor rooms. We had already done four deliveries since I was called in early at 9:30 p.m. to help the busy evening shift. I glanced at the fetal monitors which displayed each baby’s heart rate. All of a sudden, I saw one baby’s heart rate go dangerously low to 50 and stay there. A normal full-term baby’s heart rate is 120-160 beats per minute. Cathy, another nurse, stuck her head out the door of the woman’s room and yelled, “Call the doctor and nurse anesthetist, Pam! We have to do a stat C section (surgery). This baby is in trouble!”

The operating room technician, Teresa, ran to the prepared operating room (OR) while I called the two doctors. The nursing assistant helped Cathy wheel the huge bed down the hall to the O.R. Cathy had the mother lie on her left side to try and take the pressure of the baby’s body off her mother’s blood vessels so the baby could get more blood.

Newborn Baby!

Newborn Baby!

We worked quickly. As soon as the anesthesiologist nodded that the mother was asleep, the resident doctor cut her abdomen and lifted the baby out of her womb. He  cut the cord that was wrapped tightly around the baby girl’s neck, and carried her to the warmer. Her own cord had choked her as she came down the birth canal. The baby girl let out a weak whimper.  I suctioned out her mouth and placed the oxygen mask over her small face. I dried her off quickly and she took several gasps of air! I silently prayed, “Dear Lord, Please touch this baby girl’s body that she may live.”  She let out a louder cry and the delivery room staff exhaled a sigh of relief. Her tiny body began to turn pink. The Neonatal ICU nurse wheeled the baby girl down the hallway to keep a close eye on her until she stabilized.

I returned to my other patient, Marie, and checked her progress internally. She was ready to start pushing the baby out. She was totally exhausted after 16 hours of painful labor. After an hour of pushing, I saw a patch of the baby’s black hair peak out! We wheeled Marie in her bed down the hall to the delivery room, helped her transfer to the narrow delivery bed, placed her heels in the steel stirrups, and her hands on the steel handles. I had her husband, John, sit on a stool beside her.

She gave several more pushes, but wasn’t making much progress. Dr. D. instructed, “Pam, give fundal pressure during the next contraction to help her out.”  I looked at Marie over my mask and warned, ” I’m afraid this is going to hurt you.” As I felt her large abdomen harden, I reached across her, grabbed the steel handle with both my hands, and pressed my forearm into her belly with all my strength. She screamed and I felt like screaming as my back went into a muscle spasm. At last the baby’s head popped out and his slippery body slid into Dr. D’s hands.

“Congratulations, Marie and John! You have a nice big healthy boy!” announced Dr. D. I pulled the string on the Apgar clock and wrote down the time — 3:03 a.m. Christmas morning.  Dr. D.  quickly suctioned the mucus out of the baby’s mouth with the blue rubber bulb syringe, and the baby let out a loud strong cry. Dr D placed two clamps on the umbilical cord and laid him on Marie’s abdomen so she could see him. “John, would you like to cut your son’s cord?” “Sure!” grinned John as he took the sterile scissors in his hand and snipped the cord.

Dr. D. carried the baby to the warmer and the Apgar timer buzzed at one minute. I gave him a score of 8 out of 10 which was excellent! His trunk, hands, and feet were still tinged blue. I suctioned the mucus out of his mouth again, wiped off his body with the soft, warm, cotton blanket and put a little hat on his head to keep him warm. The 5 minute Apgar time buzzed and I scored him 9 out of 10. His body was now pink, but his hands and feet were still slightly blue. I wrapped him tightly in another clean warm blanket and greeted him, “Merry Christmas, Timothy! Welcome to the world!” John watched his new son with amazement.

A woman, when she is in travail, has sorrow, because her hour is come; but as soon as she is delivered of the child, she remembers no more the anguish, for joy that a man is born into the world. John 16:21

I carried Timothy over to Marie and placed him in her arms. All the fatigue vanished from her face as she gazed at him tenderly and kissed his forehead. After Dr. D. delivered her placenta and stitched her up, I put a warm blanket on her and wheeled mother and son to the recovery room.

The remaining hours flew by as we did two more Caesarian surgeries and two more normal deliveries. Eight babies were born that  Christmas night shift! I sat down twice for ten minutes during my ten hour shift. I was so happy to see the day shift staff walk into the nurse’s station at 7 a.m.! We gave them report, went to the locker room to change out of our blue scrubs into our street clothes, and walked wearily out the door into the bitterly cold Christmas morning sunshine.Christmas morning

Reflection

My severe back pain continued, and I was diagnosed with two injured back muscles. My doctor ordered me to take a month leave of absence while I went to physical therapy to heal and strengthen my muscles. He said I was in poor shape physically and needed to exercise regularly if I wanted to continue to work in labor and delivery. So I joined the local indoor pool and began swimming four times a week. I happily discovered that swimming was also a great stress reliever and helped me sleep better!

The babies that were born that early morning will celebrate their 36th birthday this Christmas and likely have children of their own by now. I wonder what kind of choices they have made in life? They share the same birth day when we annually celebrate the birth of Jesus Christ, King of Kings and Lord of Lords. I pray that each has chosen to receive Him as his/her personal Savior.

“For unto you is born this day in the city of David a Savior, who is Christ the Lord. And this shall be a sign unto you: You shall find the babe wrapped in swaddling clothes, lying in a manger.” Luke 2:11-12

Nurses’ Health Study Research Results

December, 2017

Nearly 30 years ago I decided to join the Nurses’ Health Study and complete a 30 minute questionnaire about my habits and life style every two years. In the beginning, I colored in the little circles in black pencil on a computerized answer sheet and mailed it back to them, but now I do it online. They have kept up with me through my many moves so I haven’t been lost in the shuffle. I am in the second cohort of thousands of nurses called NHS2. They now have a third group of younger nurses born on or after January 1, 1965. If you are a RN, LPN, or nursing student born then and would like to participate, please do your part to continue this wonderful ground breaking research and sign up at www.nhs3.org . They are especially recruiting male nurses. They have also recruited and followed the children of NHS2 nurses to see the maternal influence on their children as they age. They like to recruit nurses because we are reliable and honest in reporting our life style. All our years of charting about our patients is definitely a benefit to this research!

Physical Activity and Heart Disease in Women

Middle-aged and older women who are more physically active have significantly lower rates of coronary heart disease (CHD). Women who walked briskly for at least 2.5 hours per week saw a 35% lower risk of developing CHD.

Get your walking in!

NSAIDS and acetaminophen may increase risk of hearing loss in women

Two-thirds of women in their sixties suffer from hearing loss. Among 55,850 women in a subgroup, using NSAID (Ibuprofen, Motrin, Aleve are common over the counter names) for over 6 years was associated with a 10% increased risk of hearing loss. Use of acetaminophen (Tylenol is common brand name) for over 6 years showed a 9% increased risk of hearing loss. There was a 7% higher risk of hearing loss in women who used either of these more than two days per week. However, duration of use of aspirin was not associated with hearing loss. They are doing more research in this area.

Diet Quality and Physical Functioning

It is important to maintain physical function as we age. They compared those with the healthiest diets with less healthy diets and found the group with better diets were 13% less likely to develop physical impairment. Higher intake of fruits and vegetables, and lower intake of sugar-sweetened beverages, trans-fats, and sodium were associated significantly with less physical impairment as they aged. The strongest positive relations were found with increased intake of oranges, orange juice, apples, pears, romaine or leaf lettuce, and walnuts.

Gluten Free (GF) Diets

GF diets have increased in popularity due to concerns about celiac disease and gluten allergies. However, little research has been done to explore how GF diets impact people without celiac disease. NHS found that eating foods high in gluten from whole grains can be beneficial to health. Men and women with the highest levels of gluten intake had 20% lower risk of developing diabetes, and 15% less risk of developing coronary heart disease. Gluten intake did not lead to weight gain in people under age 65.

Maintaining a Healthy Weight

They examined which specific foods and eating patterns led to less weight gain and more weight gain as we age.

These foods were associated with less weight gain: tofu, soy, plain or artificially sweetened yogurt, seafood, fruit (especially blueberries, prunes, apples, pears strawberries, grapefruit, and avocados). Chicken without skin, replacing 1 serving daily of sugar sweetened beverage with coffee or water, vegetables (especially cauliflower, summer squash, string beans, broccoli, and green leafy vegetables), replacing 1 serving daily of fruit juice with coffee or water, eating nuts (especially peanut butter, peanuts, and walnuts).

Eat your fruits and veggies for your health!

These foods were associated with more weight gain: corn, processed meats, peas, chicken with skin, sugar-sweetened beverages, baked, boiled, or mashed potatoes, fruit juice, regular full-fat cheese.

The American Journal of Public Health published a special edition in September 2016 to celebrate the 40th anniversary of the Nurse’s Health Study which is still available.

I hope you will incorporate these findings into your own life style and instruct your patients so everyone can be healthier!

But even more important than physical health is spiritual health. I thank Jesus Christ that He has satisfied the deepest hunger of my heart. “And Jesus said unto them, I am the bread of life; he that comes to Me shall never hunger, and he that believes on Me shall never thirst.” John 6:35

Jesus is the spiritual bread of life.

 

 

Thanksgiving

Thanksgiving, 2017

“In everything give thanks, for this is the will of God in Christ Jesus concerning you.” I Thessalonians 5:18

Dear Readers,

It seems hard to believe that I began writing this blog four years ago after attending a Christian writer’s conference. My goals in recording what God has taught me during nearly 40 years of nursing is to glorify Him, encourage Christian nurses, and reveal to young people what nursing is all about.  I pray godly Christians will enter the field with realistic expectations.

As many baby boomers like myself retire, we need young men and women to fill the ranks who will give compassionate excellent care to their patients from a heart filled with Christ’s love. Nursing was often a challenging and difficult occupation, but the rewards were great whenever I had the opportunity to point one of my patients to my dear Savior, the Lord Jesus Christ.

I thank the Lord for each of you who come from over 130 countries around the world. When I began to write this blog, I didn’t know if anyone would ever read it, but nearly 7000 people have now discovered it. The main countries where you, my readers, reside are USA, Brazil, Canada, United Kingdom, Philippines, Germany, India, Australia, Italy, and France. Thank you for those of you who have told others about my blog. I’m hoping that I will have time to complete recording my nursing career journey over the next months.

I retired 18 months ago, but have been busy ever since with Spanish language school for seven months, relocating, and several travel trips thrown in there. People warned me that retirement could be busy, and I have found that to be the case! But it has been  enjoyable to make new friends in different corners of the world. I thank God for a good measure of health He has given me.

As we celebrate my favorite holiday here in the USA, Thanksgiving, I thank the Lord for each of you. I pray you will receive the Lord Jesus Christ as your personal Savior if you have not already done so. If I can answer any questions you may have about salvation or pray for you specifically, please email me at pamela.aprn@gmail.com.   For those of you who are fellow believers, may you continue to grow in His grace and keep ” looking unto Jesus, the author and finisher of our faith…” Hebrews 12:2. 

Happy Thanksgiving!

thanksgiving

Geriatric Nurse Practitioner

April 25, 2005

I thank God for carrying me through the first three weeks of working as a geriatric Nurse Practitioner at the 500 bed nursing home. The insurance company assigned me to provide medical care for 32 residents who have enrolled in their program as an alternative to Medicare. Judy has worked for the company for awhile and is my excellent preceptor. After she orients me, they will move her to another facility in the state. I need to do an complete physical examination on each of my patients, type it into the insurance computer in their format, and then call the family member to introduce myself. I only have nine more physicals to finish by the end of the month. In May, I will do a shorter assessment on each patient and call the family with a quick update. If the patient has a new problem, the nursing staff calls me to assess the resident that day and treat the problem as quickly as possible.

So far, the only downside is that there is no air conditioning because the home was built in 1935. I feel sorry for the patients in the heat, especially on the top floors which are the hottest. My office doesn’t have any windows or air conditioning, so the medical director said I could do my charting in the doctor’s night shift room which is empty during the day and has a window air conditioner. I have enjoyed working with Dr. R. who is a board certified geriatrician and likes to teach me about geriatrics. My biggest adjustment is assessing the patients with advanced dementia (memory loss) who are unable to communicate their needs. I have to depend on the nurse’s assessment and input from family in addition to my physical assessment. The staff is wonderful in giving the residents activities to stimulate their memory.

May 3, 2005

“I press on toward the goal for the prize of the upward call of God in Christ Jesus.” Philippians 3:14

I have a bad head cold after being at the nursing home for just one month and have already used up my sick time. We are not permitted to work with a respiratory infection because the elderly are susceptible to catch it resulting in serious complications. I’m just not sure I can work full-time anymore. God comforted me with I Peter 5:7, “Casting all your care upon Him, for He cares for you.”

Dear Lord, Thank You that this cold is a very little thing in light of eternity. Help me keep the big picture. If You want me to work today, put Your healing hand upon me. If not, I rest in You and trust in You. Thank You that You do all things well. Amen.

May 27, 2005

“For He shall deliver the needy when he cries; the poor also, and him that has no helper.” Psalm 72:12

God has so graciously been carrying me along at work and things are going more smoothly. I finished all 13 of the new patient’s physical examinations and 52 monthly visits plus all the sick visits for the month of May. I have now completed eight weeks of work at the nursing home.

My biggest concern right now is my vision which has become more blurry from all the long hours of charting on the computer. I saw an optometrist and she could not correct my left eye beyond 20/60 and said my left optic nerve doesn’t look right. I thank God that I don’t have a retinal detachment. My uncle went blind when he was about my age from retinal detachments.

June 1, 2005

After three hours of very uncomfortable eye tests with bright lights, the ophthalmologist said he couldn’t find any retinal or macular tears. He is referring me to a retinal specialist who can’t see me until August. Trudy, my dear friend who has battled glaucoma for many years, said that her eyes are in God’s hands. If she loses her sight, God will be her vision.

July 4, 2005

Two weeks ago a Nurse Practitioner (NP) at the insurance company resigned, so they assigned me to cover his patients in another nursing home as well as my own. So now I am responsible for 96 patients. When I interviewed for the position, they assured me that I would only have 70-80 patients. My new supervisor said this is their goal, but I’m the only one who is credentialed at the hospital which owns the second nursing home. I am so exhausted that I feel like I’m at the breaking point.

July 11, 2005

Mary, a NP at the main nursing home, told me there is a 32 hour position open that is not associated with the insurance company, and they want to recruit me for it! She also said the nursing home is losing money with the insurance company and will probably soon terminate their relationship. I like the administration at the nursing home, but have not had much support from the supervisors at the insurance company.

I interviewed with Dr R., and he offered me the position of 32 hours weekly with every Friday off, and full time benefits. He said they would bring me in at the top of the pay scale for Nurse Practitioners. This is such a gift from God!

Dear Lord, Thank You once again for Your wonderful deliverance and that You won’t test me above what I can bear.” Amen.

July 18, 2005

“Leaning on Jesus’ bosom.” John 13:23

God carried me through some grueling eye tests from the retinal specialist doctor. He strapped my head in a machine, put a magnifying glass straight on my eyeball, and then told me to look at a very bright light without moving. The tears were streaming down my face because it was so uncomfortable. Then I started silently thanking Jesus that He is the light of the world. I remembered the verse above and the wonderful hymn “Leaning on the Everlasting Arms”.

The doctor said part of my vitreous (like jelly in my eye) is covering the retina like wrinkled plastic wrap. There is nothing he can do about it, so we’ll just “watch it”. My new glasses arrived this week and I am seeing so much better. Thank You, dear Lord, for my vision today!

I told Bee, one of my coworkers, that I know the Lord Jesus Christ will be my eyes if I go blind. She came up to me a few days later and said, “I wish I had your faith. I feel so guilty about not teaching my adopted son anything about religion.” I shared with her the good news about Jesus Christ and how much He loved her that He died on the cross for all our sins and rose again. He wants her to receive Him as her personal Savior. I also gave her some literature and a children’s Bible study for her son.

August 10, 2005

I thank the Lord for a refreshing vacation with two ladies from church at beautiful Lake Tahoe in California. What stunning mountain scenery! We even caught some fish in the sparkling deep lake. The nursing home becomes my new employer tomorrow!

The Lord gave me a refreshing vacation at beautiful Lake Tahoe in California.

Reflection

I enjoyed my next five years of working in geriatrics at the nursing home. Every day was a new experience and challenge as I progressed in my knowledge of assessing and treating older adults. I also learned that I needed to communicate clearly with the family members since the resident often couldn’t remember the information I gave them. Even though I didn’t stay with the insurance company very long, God used that to get me in the door at the nursing home and guided me to a much more manageable job with less stress.