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.

 

 

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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.