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.

 

Behind Locked Doors

Senior Student Nurse in Psychiatry – June 1976

I drove through heavy iron gates and parked my car at the large state mental hospital campus on the edge of the city. After I studied the campus map my professor had given me, I walked toward the locked mens’ ward where I was assigned for the quarter. As I walked, I silently prayed, “Dear Lord, Please protect me and put your hedge around me. Give me wisdom in every situation, and let your love shine through me to these men.” I looked at the old red brick building apprehensively and pressed the buzzer on the intercom beside the door. “Yes?” answered a woman. “I’m a student nurse reporting for duty from the University.” As the door buzzed, I pushed it open and entered.

My professor told me I would lead therapeutic groups with six men who had been institutionalized here many years. Some had a history of rape and murder. After entering the locked nurse’s station, I began to read each patient’s thick chart and took notes. I observed the long line of somber looking men as they lined up at the nurse’s window to receive their medications with a glass of water. After each man swallowed his pills, he opened his mouth so the nurse could inspect to make sure he had not pocketed any pills to hoard them for an overdose.

After the patients received their medications, I walked into the large dreary day room. The sickly pale green walls, single bare light bulbs hanging from the 12 foot high ceilings, and iron bars over all the windows would make anyone feel depressed. The men wandered aimlessly around the room or sat at the table staring into space dressed in their shabby pants, shirts, and shoes. There was a hot wire running around the perimeter of the room where they lit their cigarettes. Some of them spit on the floor. One man took off his clothes, seemingly unaware that there was anyone else in the room, and wandered around naked. The stench in the smoke filled room was nauseating.

I asked the staff person to point out the six men I would have in my small group.  I approached each of them and pointed to the small room where we would meet. After we all sat in a circle, I introduced myself and asked each of them to tell the group his name. I then asked an assigned question and waited for each of them to answer. I was trying to learn the skill of “therapeutic silence” and wait for the person to answer. I waited and waited and waited, but some of them never answered! The whole group was rather pointless in my opinion.

I dreaded my clinical days and began to lose weight. I saw the depths of the depravity of man as never before and continually thanked God for saving my soul. I concluded that reformation does not work, because it does not deal with a person’s sin nature. The only solution is regeneration, a new birth spiritually, as Christ said, “Marvel not that I said unto thee, Ye must be born again.” John 3:7 I am so thankful for God’s promise to all who receive Him as their personal Savior, “Therefore, if any man be in Christ, he is a new creation; old things are passed away; behold, all things are become new.” II Corinthians 5:17  But I am grateful I had this quarter, because it taught me more about the importance of communication, and how to talk with people about sensitive topics.

I also took Personal Finances (3 hours) and Audio-Visual Teaching Techniques (4 hours). I had the joy of attending the graduation ceremony of my roommate and her brother in the University football stadium. I will miss our sweet times of fellowship, but I know God will lead her to the right teaching job.

Reflection

As I reviewed my classes in the college of nursing, psychiatry was definitely the most difficult course for me emotionally and as a believer in Jesus Christ. Amazingly, after I became a Nurse Practitioner, my first job was at a 120 bed psychiatric hospital, age 5 through adult. I was responsible for the admission History and Physical examinations, and diagnosing and treating their medical problems. I also managed the patients who went through alcohol and heroin/opiate detoxification.

The medications that are available today to treat mental illness are much more effective than the few that we had in 1976. I believe some types of mental illness are from chemical imbalances, genetics, poor diet, and side effects of other medications. Other types of mental problems are a direct result of sin that only salvation by Christ Jesus can solve. Still others are from demon possession. As I read about the demon possessed man in Mark 5, it says that no man could bind him with chains, and he lived in the mountains and tombs, crying, and cutting himself with stones. Oh, the agony of that man! But after Jesus cast out the demons, the people came and saw him “sitting, and clothed, and in his right mind.” Mark 5:15 What wonder and joy that each of us can now have the mind of Christ!

“For God hath not given us the spirit of fear, but of power, and of love, and of a sound mind.” II Timothy 1:7

I worked at the psychiatric hospital for 4 years until it closed. I recently stopped by to take a photo of the campus and there were large “NO TRESPASSING!” signs everywhere. The owner approached me angrily and asked why I was taking a photo? I said I used to work there, and it was for my memory book. He asked which doctor I worked with, and after I told him, he grudgingly said, “OK”. So I still don’t have very good memories of psychiatric hospitals…. Here is my one photo he permitted. This is the administration building behind all the trees.

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

If you would like to comment, have a question for me, or a prayer request, please feel free to contact me at pamela.aprn@gmail.com  Have a blessed week of looking unto Jesus!

Behind Locked Doors

Senior Student Nurse in Psychiatry – June 1976

I drove through heavy iron gates and parked my car at the large state mental hospital campus on the edge of the city. After I studied the campus map my professor had given me, I walked toward the locked mens ward where I was assigned for the quarter. As I walked, I silently prayed, “Dear Lord, Please protect me and put your hedge around me. Give me wisdom in every situation, and let your love shine through me to these men.” I looked at the old red brick building apprehensively and pressed the buzzer on the intercom beside the door. “Yes?” answered a woman. “I’m a student nurse reporting for duty from the University.” As the door buzzed, I pushed it open and entered.

My professor told me I would lead therapeutic groups with 6 men who had been institutionalized here many years. Some had a history of violent crimes, such as rape and murder. Upon entering the locked nurse’s station, I began to read each of their thick charts and took notes. I observed the long line of somber looking men as they lined up at the nurse’s window and were handed their medications with a glass of water. After each man swallowed his pills, he opened his mouth so the nurse could inspect to make sure he wasn’t pocketing any pills to hoard them for an overdose.

After the medication time was finished, I walked into the large dreary day room. It was painted a sickly pale green and had single bare light bulbs hanging from the 12 foot high ceilings. There were iron bars over all the windows. The men were dressed in shabby pants, shirts, and shoes and wandered aimlessly around the room or sat at the table staring into space. There was a hot wire running around the perimeter of the room where they lit their cigarettes. Some of them spit on the floor. One man took off his clothes, seemingly unaware that there was anyone else in the room, and wandered around naked. The stench in the smoke filled room was nauseating.

I asked the staff person to point out the 6 men I would have in my small group.  I approached each of them and pointed to the small room where we would meet. We all sat in a circle and I introduced myself and asked each of them to tell the group his name. I then asked an assigned question and waited for each of them to answer. I was trying to learn the skill of “therapeutic silence” and wait for the person to answer. I waited and waited and waited, but some of them never answered! The whole group was rather pointless in my opinion.

I dreaded my clinical days and began to lose weight. I saw the depths of the depravity of man as never before and continually thanked God for saving my soul. I concluded that reformation does not work, because it does not deal with a person’s sin nature. The only solution is regeneration, a new birth spiritually, as Christ said, “Marvel not that I said unto thee, Ye must be born again.” John 3:7 I am so thankful for God’s promise to all who receive Him as their personal Savior, “Therefore, if any man be in Christ, he is a new creation; old things are passed away; behold, all things are become new.” II Corinthians 5:17  But I am grateful I had this quarter, because it taught me more about the importance of communication, and how to talk with people about sensitive topics.

I also took Personal Finances (3 hours) and Audio-Visual Teaching Techniques (4 hours). I had the joy of attending the graduation ceremony of Jane, my dear roommate, and her brother, Allen, in the University football stadium. I will miss our sweet times of fellowship, but I know God will lead Jane to the right teaching job. Her brother, Allen, who also attended the Bible class on campus, asked my sister, Linda, for a courtship, so that was exciting! I pray they will honor the Lord and seek Him first in all things.

Reflection, 2014

As I reviewed my classes in the college of nursing, psychiatry was definitely the most difficult course for me emotionally and as a believer in Jesus Christ. Amazingly, after I became a Nurse Practitioner, my first job was at a 120 bed psychiatric hospital, age 5 through adult. I was responsible for the admission History and Physical examinations, and diagnosing and treating their medical problems. I also managed the patients who went through alcohol and heroin/opiate detoxification.

The medications that are available today to treat mental illness are much more effective than the few that we had in 1976. I believe some types of mental illness are from chemical imbalances, genetics, poor diet, and side effects of other medications. Other types of mental problems are a direct result of sin that only salvation by Christ Jesus can solve. Still others are from demon possession. As I read about the demon possessed man in Mark 5, it says that no man could bind him with chains, and he lived in the mountains and tombs, crying, and cutting himself with stones. Oh, the agony of that man! But after Jesus cast out the demons, the people came and saw him “sitting, and clothed, and in his right mind.” Mark 5:15 What wonder and joy that each of us can now have the mind of Christ!

“For God hath not given us the spirit of fear, but of power, and of love, and of a sound mind.” II Timothy 1:7

I worked at the psychiatric hospital for 4 years until it closed. I stopped by today to take a photo of the campus and there were large “NO TRESPASSING!” signs everywhere. The owner approached me angrily and asked why I was taking a photo? I said I used to work there, and it was for my memory book. He asked which doctor I worked with, and after I told him, he grudgingly said, “OK”. So I still don’t have very good memories of psychiatric hospitals…. Here is my one photo he permitted. This is the administration building behind all the trees.

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

Psychiatric Hospital where I worked as a Nurse Practitioner 1998-2002

If you would like to comment, have a question for me, or a prayer request, please feel free to contact me at Pamela.aprn@gmail.com  Have a blessed week of looking unto Jesus!