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.

 

September 11, 2001

Psychiatric Hospital, Tuesday, September 11, 2001 – New England

I walked across the campus of the psychiatric hospital where I was working as a Nurse Practitioner to make morning rounds. It was my first day back from a week of vacation and I wondered if the workload would be extra heavy today. After visiting my family in the Midwest, I caught my connecting flight in Washington, DC and flew over New York City before landing in New England yesterday. Today was such a beautiful day with a sparkling clear blue sky. I admired the blooming flowers beside the walkway as I took my key to unlock the door to enter the secured unit. After completing several physical exams on the new patients who had been admitted overnight, I left the building and started walking toward the next building. I met Dr. A. on the sidewalk who was covering today for my boss. I always enjoyed working with Dr. A. since he loved to teach and share his latest research findings with me. He said, “Pam, the janitor just told me that a plane flew into the World Trade Center in New York City.” “Really? Are you sure?”, I replied. I learned to double check anything I heard at a psychiatric hospital since it was often unreliable information. Dr. A. said, “Let’s go turn on the TV in the health clinic since there are no patients there right now.” We quickly walked together to the clinic and turned on the TV. We could not believe our eyes as they showed the smoke pouring out of the World Trade Center. All of a sudden, the newscaster said, “Oh no! Another plane just hit the other tower!” We stared in disbelief and shock.

After about an hour, we knew we had to continue our rounds on the other units which we did together. Somehow, neither of us wanted to be alone in the midst of this uncertainty when no one understood what was happening. The hospital director had informed the staff to turn off all the TVs on the units so the patients wouldn’t be upset since a number of them were psychotic (out of reality) or going through alcohol or heroine withdrawal. The children and teens had all been through so much trauma in their short lives that they didn’t need any additional stress. Not even the adults understood what was happening. We were located two hours from New York City, so a number of the patients may have family members effected by the crisis. I could hardly believe that I had just flown through Washington DC and over New York City the day before.

As the day wore on, we heard that the Pentagon had been hit and another plane crashed in Pennsylvania. When would it end and who was doing this? There were so many questions and no clear answers in all the confusion. As soon as my work day ended, I drove home while I listened intently to the radio. Upon arriving at home, I turned on my television and watched the scenes unfold in shock and sadness. I prayed for all those involved and for the rescuers at the sites. All the planes had been grounded in and out of the entire country.

Friday, September 14, 2001

So much has happened this week. It is raining today and the mood on the hospital campus is as dreary as the weather. I decided to drive across the bridge to the next town to get some lunch to try and get away from the bleakness for a short time. I eagerly listened to the radio to see if they recovered any more survivors from the wreckage of the World Trade Center. I stopped at the red light and looked to the left before turning right on the bridge. There was no one coming, so I slowly started turning. I looked straight ahead, and all of a sudden there was a man and a woman standing in front of my bumper. I slammed on my brakes and then turned off my car. My heart was racing at the horror of having hit two pedestrians. I approached the couple and asked if they were hurt. The woman sat on the curb, glared at me, and started screaming at me, “WHY DID YOU HIT US??? DIDN’T YOU SEE US???” I quickly dialed 911 on my cell phone and the police and ambulance came within a few minutes. The police took down the information. The woman refused to go to the hospital, so the ambulance left. The policeman pulled me aside and said, “This couple hangs out on this corner often and hides behind the tree. Then they jump out in front of a car as it begins to turn so the driver will hit them. Then they collect insurance money.” My blood boiled to think that they had done this numerous times. I silently prayed and asked God to quiet my heart. After receiving my ticket, I returned to work and contacted my insurance company.

Reflection

The woman sued my insurance company about six months later for back pain. She was awarded an undisclosed amount of money out of court. But my encounter with them was nothing compared to what others suffered on September 11, 2001.

Nearly 3000 people died and 6000 were wounded that day. It seems hard to believe that it has been nearly 16 years since that tragic day. An entire generation has been born since then. I recently visited the Flight 93 Memorial in southern Pennsylvania where 40 brave crew and passengers attacked the terrorists and took down the plane in a grassy field to prevent it from flying into the Capital building in Washington, DC.

Flight 93 Memorial in Pennsylvania

None of us knows how many days we have remaining here on earth. But God knows. How I thank God that He would have all men to be saved for eternity. Just like those 40 men and women gave their lives to spare others, Jesus Christ died in our place on the cross and paid the penalty for our sins so all those who receive Him as Savior will not perish.

“For God so loved the world, that He gave His only begotten Son, that whoever believes in Him, should not perish, but have eternal life.” John 3:16

If you have not received the Lord Jesus Christ as your personal Savior, I pray you would receive Him now. How He wants to give you eternal life and have a personal relationship with you for all eternity!

 

 

Rejection and Sorrow

April, 1995

My interview for graduate school seemed to go well. I will learn next week whether or not I am accepted, so the waiting which began last September is almost over! I hope the fact that I did well in my first two courses at the State University will help with my admission. But the competition is very strong with hundreds of nurses applying for only 15 positions.

May, 1995

I received my letter today from the State University, and I was not accepted. They invited me to apply again next year, because they just don’t have room. It was quite a blow and a shock, and I feel like a total failure. It’s kind of like preparing for the big game for nine months and then being thrown off the team or having the big game cancelled. I guess I thought that since I will probably never marry, I could at least work on my career, but that door appears closed also. I haven’t had the courage to tell my parents or sister yet. I cried all day yesterday and today. I asked God to comfort me and show me what He wants me to do now.

“Make haste, O God, to deliver me; make haste to help me, O Lord.” Psalm 70:1

July, 1995

I attended a Bible seminar with ladies from church a few days after I received my rejection letter. One lady suggested I search for other MSN programs that offer the Nurse Practitioner tract. I discovered a small private college that is a shorter drive than the State University and is just starting a Family Nurse Practitioner program. I have not had any pediatric experience since I received my BSN other than volunteer camp nursing, but I guess I could learn about it again. I decided to apply and I should learn in August whether or not they accept me. If they do, they will allow me to transfer my two courses I completed at the State University, so those courses would not be wasted. I should be able to complete my Master’s of Science in Nursing degree (MSN) in three years by taking two courses in the evening each semester while continuing to work full-time as a visiting nurse. My employer will continue to reimburse me my tuition for up to two courses a semester as long as I receive an A or B grade. The price per course hour is the same as the State University. Right now, I feel like all the ambition for school has disappeared, so I really don’t care one way or the other.

Dear Lord, Please make my heart right concerning school if You want me to continue to study for my MSN. Amen.

I also finished an intense Spanish course at the local community college with an emphasis in medical Spanish. Some folks at church are fluent in Spanish, so they let me practice talking with them which was helpful.

September 30, 1995

So much has happened since July. I was accepted at the College into the Family Nurse Practitioner program. My brother was married on August 20 which my parents were able to attend. My mother’s cancer spread to her liver last January, but her dying wish was to attend my brother’s wedding. It was sad to see her barely able to sit up in her wheelchair. It was bittersweet to say goodby to her on what is normally a happy occasion. My parents flew back to Florida where she died at home on August 28. I flew to her funeral and then started school as soon as I returned to New England. Some nights I can’t sleep and cry for several hours. These feelings are so strange with the sorrow of missing her and yet joy in knowing that she is home with the Lord, rejoicing in Him, and free of her old broken body. I miss hearing her voice and talking with her on the phone.

I was accepted into the MSN program at a small private college.

I was accepted into the MSN program at a small private college.

I started school the week after Mom died. I wasn’t sure I could concentrate enough because of my grief, but somehow, God is giving me the strength and concentration. I like it much better than the State University. I am taking graduate level statistics and have a wonderful instructor who makes it very clear. Hopefully, I won’t fall asleep in statistics class this time like I did 22 years ago when I took it for my BSN! We are also having to solve problems on the computer with a 5 inch floppy disc that corresponds to our textbook. I am thankful for my personal computer at home so I don’t have to do all my homework on campus.

January 1, 1996

“That I may know Him, and the power of His resurrection, and the fellowship of His sufferings, being made conformable unto His death…I follow after.” Philippians 3: 10,12. “Man of sorrows, and acquainted with grief.” Isaiah 53:3. “The Lord is near unto those who are of a broken heart….None of them who trust in Him shall be desolate.”  Psalm 34:18, 22

As I reflect on 1995, I believe it was my year to become acquainted with sorrow. It was one year ago yesterday that Mom found out her cancer had spread to her liver. I thank God for the work He has done in my heart this past year through my new friend, Sorrow. It is an acquaintance I would not have chosen voluntarily, but God chose this friend for me to press me closer to His heart and make me more sensitive to others who are sorrowing.

I thank God for helping me complete my two courses in graduate school with good grades. I was amazed that I received one of the highest grades in Statistics, my old foe. That was purely by the grace of God for which I praise Him!

God helped me conquer my old foe, Statistics, in graduate school!

God helped me conquer my old foe, Statistics, in graduate school!

I also met with the Dean and found out it will take me four more years of attending school part-time before I can complete my MSN degree.  I have now completed three semesters. I’m not sure I have the strength and ambition to attend eight more semesters, so I guess I will just take it one semester at a time and trust the Lord. I am claiming God’s promise in Psalm 84:11.

Psalm 84-11

Dear Lord, I commit this New Year to You. Cause me to know You better and follow You. Amen.

Reflection

So ended my year of rejection, acceptance, and sorrow. It was a challenging year, but I have learned since then that God seems to use the most difficult times in my life to cause me to lean harder on Him. I grow in His grace as I experience His loving kindness and strength in a new and deeper way. I pray you may be encouraged to draw near to Him if you are going through such a time as this today.

 

You Better Belize It! Part 1

February 18, 1990 – Belize (Central America)

Last October, Dr Pete and Judy and I decided to sign up for a two week medical mission trip to the tiny English speaking country of Belize, formerly British Honduras. It is located on the Caribbean Sea just south of Mexico bordered by Guatemala on the west and south. February is not the rainy season there, so we’re hoping our bus doesn’t get stuck in the mud like it did in Honduras! And we’re hoping to communicate with the patients in English in the clinics without an interpreter.

Map of Belize - a tiny English speaking country in Central America

Map of Belize – a tiny English speaking country in Central America

1a Belize

Our Eastern Airlines plane was delayed, so we arrived a day late in Belize City. It took me 8 hours to fly there from the Midwest through Miami. It was great to leave the snow behind and step off the plane into 90 degree heat! The mission leader, Larry, who also led the Honduras mission in 1989, met us at the airport. It took two hours for Dr Pete to get his surgical equipment through customs. The airline lost my checked luggage again, like when I went to Honduras, but this time my carry on bag was well packed! I brought enough dried food for 2 weeks, 3 pairs of scrubs, toiletries, swim suit, my blood pressure cuff, stethoscope, and gospels of John to hand out.

Took 2 hours to go through customs with Dr Pete's surgical equipment. My suitcase was lost for a week...

Took 2 hours to go through customs with Dr Pete’s surgical equipment. My suitcase was lost for a week…

Larry drove us to the capital city of Belmopan where we had a delicious dinner at a Chinese restaurant. It seemed strange to be eating Chinese our first meal in British Belize, but apparently there are Chinese restaurants all over the world. Judy and I said goodbye to Dr. Pete since he will be doing surgery for the entire two weeks in the city hospital of Belmopan while Judy and I work with the medical and dental teams in the villages.

We piled into the small Datsun pickup truck and drove on dark paved and dirt roads, passing some citrus processing plants. We came upon a stranded high school bus with 57 teens sleeping in the middle of the road for the night while they waited for a clutch to be brought to them from Dangriga. We took one, Berta, one of the chaperones with us and arrived in Dangriga at midnight. As I bid her goodbye, I gave her a gospel tract to read.

Judy and I tiptoed into a two story house by flashlight, trying not to awaken the other women on the mission team who were already asleep. We found two empty mattresses on the floor, tried to clean up a little in the barely working bathroom, and thanked God as we stretched out on the floor.

The next morning, I awoke as the sun streamed into our room through dusty windows. I noticed some dark blobs on the ceiling as I gazed up. I put on my glasses and gasped as the blobs came into focus–Tarantulas on the ceiling as big as the palm of my hand! I nudged Judy and pointed, and she gasped also. I silently prayed and thanked the Lord that I didn’t know I was sleeping under tarantulas all night. I got up and went to the bathroom which I could see better in the light now. The water trickled out of the faucet, enough to wash my face. I brushed my teeth with my bottled water. Then I looked at the bathtub and saw worms crawling out of the drain. I gagged and left the bathroom. No shower for me today! A sponge bath will do. I asked the Lord to help me be flexible and adjust to all these tropical creatures in Belize.

Tarantulas as big as my palm were over my bed all night!

Tarantulas as big as my palm were over my bed all night!

After putting on my scrubs, Judy and I walked with the other women a few blocks to breakfast where we met the men on the medical and dental teams. Judy and I and two other women spoke privately with Larry about the tarantulas and barely working bathroom. While we work in the clinic today, Larry said he would try to find other accommodations.  Apparently this house has been vacant for awhile and no one had time to clean it before we came.

We enjoyed our 7 a.m. breakfast at Pastor Chester’s home under a big tent. Because the church is too small to support him and his family, he works several jobs. His wife has a small restaurant and made us fabulous fresh bread! I also had instant oatmeal that I brought with me. I’m praying I can tolerate the food here better than I did in Honduras in 1989. I had to take antibiotics for a month for an intestinal infection after I returned from Honduras, so that is why I’m being cautious.

Fabulous meals were prepared for us by the Pastor's wife who owned a restaurant.

Fabulous meals were prepared for us by the Pastor’s wife who owned a restaurant.

Judy and I introduced ourselves to the rest of the team. I was assigned to Team I and Judy will be on Team II. A separate bus will take us to a different village daily so we can give more people medical care and the gospel. There are a large number of retired people on the teams and about half are from Canada. There are some young people from the Mennonite Church who will share the gospel with the patients. I will be the triage nurse again which I enjoyed doing in Honduras.

We boarded the bus and bumped along until we arrived at Silk Grass Village. For some reason, they didn’t know we were coming, so the residents helped us set up the clinic in the community building. The people are very friendly and speak British English, so I’m having a little trouble understanding their accent. I found two children who would like to be pen pals with my Bible Club children back home, so that was fun! A kind lady made stew for us for lunch which we ate in her kitchen. Their homes are built on stilts and have shuttered windows without screens. The mosquitoes are plentiful and biting! We saw about 50 patients in the clinic today, so it was quiet compared to the clinics in Honduras. But I guess that isn’t too bad, considering they didn’t know we were coming!

Our first clinic was held in Silk Grass Village Community Center

Our first clinic was held in Silk Grass Village Community Center

7 Pam checks boys temp

I check a boy’s temperature.

Dinner back in Dangriga under the tent was excellent with chicken and rice, and broccoli cheese soup. Larry was able to find another place for us ladies to stay at a small hotel in town. It’s a simple place above a bar and restaurant with a co-ed bathroom down the hall from our room. Judy and I fell into bed at 10 p.m. What a long day!

Reflection

Next post, I will continue to tell you about our other clinic days. My flexibility was tested to the limit in this rather rough start to this mission trip between the delayed plane, lost luggage, and difficult sleeping quarters. It seems like adjusting to frequent change is a way of life. The one constant is the Lord Jesus Christ.

These verses in Hebrews 13:5-6, 8 have comforted and encouraged me so many times:

Let your manner of life be without covetousness, and be content with such things as ye have; for He hath said, I will never leave thee, nor forsake thee. So that we may boldly say, The Lord is my helper, and I will not fear what man shall do unto me….  Jesus Christ, the same yesterday, and today, and forever.

From what I have read, Belize has made good progress in their infrastructure since I was there in 1990. It has now become a popular retirement place for expats because of its warm location on the Caribbean Sea and being an English speaking nation.