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.

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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.

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.

 

Why am I so weak?

Occupational Health Nurse Practitioner – August, 2002

I have now been working in this very busy clinic for 4000 employees of the insurance company for several months. One of my duties is to give routine vaccinations to employees when they request them. During an unusually slow afternoon, I checked my vaccine stock to see if I needed to order any more. I am praying about doing some medical mission trips, so I decided to give myself a Hepatitis A vaccine. Hepatitis A is common in many developing countries and is transmitted by unclean food or water.

The next morning, my alarm awoke me at the usual 5 a.m. I tried to move and get out of bed, but I ached all over and was overcome with weakness and dizziness. By 6 a.m., I felt the same so I called my boss and said I was too ill to come to work today. I knew there was no way that I could survive a busy clinic day.

The terrible weakness, dizziness, and aches continued, so by the third day I went to see my personal physician. He drew blood tests and said my blood pressure was low and to try and drink more fluids. I was thankful my friend from church could drive me to and from the appointment.

These symptoms continued day after day, until a month had passed. After the first week, I had no paid time off remaining since I had only worked for the company a short time. My physician could not determine the cause of my symptoms, so he sent me to a neurologist, chiropractor, and endocrinologist. I became very discouraged and cried out to God for mercy in my weakness.

September 17, 2002

On September 17, my doorbell rang. The postman had me sign for a registered letter from my employer. I sat down on my couch and opened it with trembling hands. “We regret to inform you that due to your prolonged absence, you are no longer employed at this company. You may begin collecting unemployment after you recover from your illness….” Because I had not worked for the company for 12 months, they were under no legal obligation to continue my employment.  The tears flowed as I asked God to help me and teach me all the lessons He had for me. I asked Him to give the doctors wisdom in finding out what was wrong with me, heal my body, and provide my every need.

Why art thou cast down, O my soul? And why art thou disquieted within me? Hope in God; for I shall yet praise Him, who is the health of my countenance, and my God.” Psalm 43:5

I began reading books by other Christians who went through their time of suffering with victory. Corrie Ten Boom was imprisoned in the concentration camp during World War 2 because she sheltered Jewish people. She suffered from starvation, cold, beatings, and watched her sister die. After Corrie was released due to a clerical error, she wrote a book called “The Hiding Place” and traveled the world telling people that no matter how deep the pit, the love of God was deeper still. She also said,

Faith = Fantastic Adventure In Trusting Him!

Joni Eareckson Tada, who has been confined to a wheelchair because of a diving accident when she was a teen, wrote, “People with disabilities are God’s best visual aids to demonstrate who He really is. His power shows up best in weakness. They persevere. They love, live, trust, and obey Him. Eventually the world says, “How great their God must be to inspire this kind of loyalty!”

September 30, 2002

“Show me Your ways, O Lord; teach me Your paths. Psalm 25:4

God encouraged me with this verse.

“Your weakness will be your strength if you accept it with a lowly heart. Trusting in God is a simple resting in God’s love, as a baby lies in its mother’s arms. The point of trusting God is not to do great things that you can feel good about, but to trust God from a place of deep weakness. Nearly all God’s jewels are crystallized tears. All I ask is that you rest in faith with a teachable spirit.” Fenelon

“Lord, give to me a quiet heart that does not ask to understand but confidently steps forward in the darkness guided by Thy hand. Mercifully, God does not leave us to choose our own curriculum. Let the Lord of the Universe do the worrying! Wide soaring gives wide seeing! Keep looking down from your heavenly position.” – Elisabeth Elliot (widow of Jim Elliot who was martyred in Ecuador)

“Godliness with contentment is great gain…. Having food and raiment (clothing) let us be therewith content.” I Timothy 6:6-8

Reflection

And so began the most difficult time in my nursing career and in my health. After many tests, my endocrinologist finally determined that I had developed adrenal insufficiency from the Hepatitis A vaccine. The adrenal glands control all the hormones in your body. If a person does not produce enough of their own natural steroid, they experience low blood pressure, severe weakness, and dizziness – all my symptoms. I had to take a low dose of steroids for the next six years. How I thanked God that I finally had an answer!

I called Dr. A., my former coworker at the psychiatric hospital who also conducted vaccine research. He confirmed that in very rare instances, vaccines can effect the adrenal glands like this.

After much prayer, I decided to sell my dream house that I had built a few years previously. By God’s grace, I made enough profit on the sale of the house to pay cash for a small condominium where I lived for the next four years. It was a huge financial relief to be rid of a mortgage and a good lesson to hold everything with an open hand to God. My real home is in heaven above with Him for all eternity! After six months, I recovered enough strength to seek employment part-time. Next post, I will tell you how God wonderfully provided again.

Will God Provide?

October, 2001

Dr. T., my manager, called me into his office. “Pam, I’m afraid I have some bad news for all of us. The parent hospital has decided to close this campus in the next few months because they are losing so much money at this facility. Next month, they will decrease our hours to 20 hours per week. They have offered us positions at the parent hospital on the psychiatric unit, but we will need to be on call at night and weekends. Let me know what you decide to do. I think I’ll be looking for another job closer to my home.”

This news took me by surprise. I knew the hospital was struggling, but I didn’t know it was this dire. Three years ago, I built my dream house because Dr. T. told me my job was totally secure. I so enjoy living here because it is close to church and work and I host guests frequently. But I will not be able to pay my monthly bills on half my salary. I think this is a good time to leave psychiatry since I don’t want to work weekends and night shift again.

When I arrived home, I opened my Bible and asked God to show me the next step and to provide for me. Certainly God, who created the universe, can supply my every need. This is my time to trust Him and see His provision.

God calmed my heart as I read Matthew 6:25-34, “Therefore, I say unto you, Be NOT anxious for your life, what ye shall eat, or what ye shall drink; nor yet for your body, what ye shall put on. Is not the life more than food and the body than raiment?…For your heavenly Father knows that ye have need of all these things. But seek ye FIRST the kingdom of God and His righteousness, and all these things shall be added unto you. Be, therefore, NOT anxious about tomorrow; for tomorrow will be anxious for the things of itself. “

“Be anxious for nothing, but in everything, by prayer and supplication with thanksgiving, let your requests be made known unto God. And the PEACE of God, which passes all understanding, shall keep your hearts and minds through Christ Jesus…. But my God shall supply all your need according to His riches in glory by Christ Jesus.” Philippians 4:6-7, 19

God encouraged me with Philippians 4:19

Dear Lord, You know all about this situation and my finances. Show me the next step. I’m trusting You to provide my every need. Use me for Your glory and honor. In Christ’s Name, Amen.

December, 2001

I have had a desire to teach nurses again in some way, so I applied to teach at a Christian college 1000 miles away. I visited the campus for ten days  to observe the classes, speak with the nursing professors, meet with the Dean, attend several different churches, and look at a few houses to buy. The Dean said they would love to have me join the faculty.

I returned home and asked God to show me His will. If I joined the faculty, I would not have time to keep working as a Nurse Practitioner and would eventually lose my NP license. Because it took me so many years to become a Nurse Practitioner, the Lord did not give me peace about giving it up. So I wrote the Dean and declined their offer.

I applied to a home care agency and was hired as a RN to do psychiatric home visits after I finish my four hours daily at the psychiatric hospital. I drive to the worst parts of the city, enter smoke filled apartments with blaring TV, assess the patient, and fill his locked med box for the week. Some of the patients are quite unstable mentally, so I ask God for protection as I quickly work. The agency said I can leave a patient’s home at any time if I do not feel safe. I always keep myself between the patient and the door and keep my cell phone in my pocket. How I thank the Lord daily for His protection! I continue to look for a full-time job as I know this is not the right job for me long term, but I thank God for His provision in the interim.

May, 2002

I interviewed for a job as a Nurse Practitioner to run the employee clinic of a large insurance company. The manager grilled me on how I would handle emergency situations. She said I answered all the emergency questions correctly and offered me the job. The pay is more than I made at the psychiatric hospital, but I’m a little hesitant about the 45 minute commute. I will need to leave my house daily at 6:30 a.m. to arrive in time. But since this is the only NP position God has opened, I accepted the offer.

August, 2002

I was trained at the downtown office by an experienced NP, and then was sent to the suburbs to run a busy clinic alone for 4000 employees.  I have a receptionist, but no medical assistant to help me with vital signs or electrocardiograms (ECGs). The supervising MD comes to the office once a week to review my notes. He is also available by phone whenever I have an emergency.

I am amazed at all I am expected to do. For every new employee, I do an ergonomic assessment of their desk, chair, phone, and computer to make sure it is in proper alignment for them to prevent carpal tunnel syndrome and other repetitive use injuries. The majority of the employees work in a cubicle and are on the computer and phone eight hours daily. We also hold health fairs for the employees periodically where we check their blood pressure, cholesterol, and glucose.

And then there are the daily clinics. Sometimes I have a line of 15 employees out the door waiting to see me. They come to work so sick because they don’t want to use any of their sick time or waste time going to their own doctor. If a Vice President comes in, they get to go to the front of the line. In the four months that I have been here, I have had to call the ambulance about a dozen times for emergencies ranging from chest pain and asthma attacks to hemorrhaging.

I also draw routine labs for patients who bring a prescription from their regular doctor, give vaccinations, and run and interpret ECGs. Since I did not need to read ECGs in my other job, sometimes I need to fax them to my supervising MD to have him confirm the interpretation. But if I don’t have time and it is an emergency, I just call the ambulance. “When in doubt, send them out” is what my boss told me.

Every morning I ask the Lord for wisdom in every decision and a quiet heart in the midst of whatever emergency situation walks through the door. I don’t enjoy the stress of this job. I have never worked in the emergency department or intensive care unit. Some days, this feels a little too much like that.

Reflection

How I thank God for carrying me through that challenging period of job changes and providing so wonderfully for me. Little did I know that an even more difficult trial lay ahead of me where I learned to trust Him in the midst of utter weakness.

The Psychiatric Hospital

December, 1998 – New England, USA

I have now completed my first six months as a Nurse Practitioner in a 120 bed psychiatric hospital. I thank God for my boss, Dr. T., who is a Family Practice Physician and an excellent teacher. The hospital has an adult unit for acute psychiatric problems, a second adult unit for detoxification of patients from alcohol and opioids (heroin and oxycontin mainly), a teen psychiatric unit, and a pediatric unit for ages 5-12. I thank the Lord that He closed the door four years ago to the Adult Nurse Practitioner (ANP) program and redirected me to a Family Nurse Practitioner (FNP) program. Otherwise,  I would not be qualified for this job since I need to treat the medical problems of the children and teens.

When patients are admitted here, Dr. T. or I must do their admission physical examination and record it in their chart within twelve hours. We have a full time MD who works all night and does the exams of patients who are admitted after we leave. I am becoming an expert at doing a neurological exam of the twelve cranial nerves. I am also improving in my examination of ears and eyes with the otoscope and opthalmoscope.

Image result for nurse using otoscope

I developed my skill in using an otoscope for ear, nose, and mouth exams.

In addition to being certified in cardiopulmonary resuscitation (CPR), I also had to be certified in handling violent patients without hurting them (Nonviolent Crisis Intervention). I learned how to break a strangle hold in case a patient tries to choke me. I never wear a necklace or scarf to work since a patient could use it to strangle me. If I feel uncomfortable about being alone with a patient in the exam room, I request one of the aides to be present with me for safety. I always keep myself between the patient and the door so I can escape the room if I feel threatened.

The hospital is under investigation from the state because a child died last year. The staff did a face down restraint when the child came violent, and he suffocated. Tragically, they were unable to revive the child. So the state investigators come every day and read each providers’ progress notes, including mine. How I ask God for wisdom in my job! It is sometimes difficult to work under such scrutiny.

“If any of you lacks wisdom, let him ask of God, who gives generously to all without reproach, and it will be given him.” James 1:5

Dr. T. and I write the admission orders for the patients going through alcohol and opioid detoxification. The nurses use a scale to measure the patient’s withdrawal symptoms which guides them to administer the correct amount of medications to prevent the patient from having a seizure or dying.

It is so sad to see patients’ lives wrecked by alcohol and drugs. Only the person who receives Jesus Christ as his Savior can truly be delivered from these deadly addictions.  I pray for each of them to look unto Jesus Christ and be saved. How I thank God that He has put a song in my heart and prevented me from ever using alcohol or drugs by His grace. By following Him, He has spared me so much heartache and grief.

“And be not drunk with wine, in which is excess, but be filled with the Spirit, Speaking to yourselves in psalms and hymns and spiritual songs, singing and making melody in your heart to the Lord.” Ephesians 5:18-19

Reflection

I thank the Lord for all I learned while working in psychiatry for those four years. It was sometimes difficult to see lives so broken. But my experience with psychiatric assessments was  extremely helpful in every other job I had the remainder of my nursing career. A person’s mental condition often strongly impacts his physical condition.