Archive for March, 2013

I have finally found my spot in a private family practice in my small town. There had been several interviews, but one name kept coming up when I spoke to people I knew. I called this physician and we set up an interview.  We spoke at length, he told about his practice philosophy: treat the whole person, emphasize prevention and health maintenance, look for the underlying cause and treat that, not just treating the symptoms, spend time with the patients.

Gee, I couldn’t have said it better myself. At the end of the interview he said he would pray about it and call me. He did, I accepted. I moved into my office (my OWN office, with my own desk and everything… and 2 windows). My name is on the sign out front. The office is 10 minutes from my house,  I can go home for lunch. The staff is great, my employer is wonderful: supportive, likes to teach, has a great sense of humor and is just a downright nice guy. I guess my prayers have finally been answered.

As far as my blog is concerned, I am seriously thinking of stopping. The journey of school was a wonderful, hair-raising adventure. Blogging was a way to relieve some of the stress. I am glad it has inspired people, and my readers seemed to enjoy my little rants and stories. It is just that I am so darn contented now, I am puttering around in the garden planting stuff, playing with the dogs, looking at my goldfish in their little pond, riding my trike. Our kitchen and most of the rest of the house is done and looking good (well, not the Pepto-Bismol guest bath and the master bath, either. But they can wait for awhile). There doesn’t seem to be that drive to put stuff down on paper anymore.

I still have my moments of not knowing what to do, but my Doc is great and backs me up. There are still those 2 AM wide awake panic moments when I think of something I might have done wrong that day. In general, though, things are going well. There are several patients that followed me from the rural health clinic, and some from this practice that prefer to see me now, where things just clicked between us as NP and patient. (There are also ones that insist on seeing only the doctor, my head isn’t getting too puffed up).

There have been moments that stand out where I feel lucky to have really helped a patient: to manage their diabetes, overcome grief and depression over the loss of a family member, found a lung cancer in time for cure, recognized pneumonia in a 89 year-old with no symptoms other than fatigue, loss of appetite and blood tinged cough. He felt wonderful within 48 hours of starting the Levaquin, told me “You’re great Doc, you really fixed me up”. (Am I going to be committing a felony now by Florida law, if I don’t correct him and say I am not a doctor but a nurse practitioner? I always tell them I am a nurse practitioner, but some patients just like to say Doc, I think).

Other patients have not been so easy, like the one who came in not feeling well for a long time, was losing weight, but was hungry all the time. We dipped her urine because it was burning, found glucose and then discovered her blood glucose was in the 400’s on doing an Accucheck. We started her on Lantus, gave her a glucometer, instructed her thoroughly in how to monitor her sugars and titrate the Lantus accordingly from the base rate we started her on. She was to follow up in a week. The next week she came in looking like death warmed over, felt horrible. Turns out she had not checked her sugar after the first day, “I didn’t feel well enough”, but had kept increasing her Lantus anyway. Her sugars had dropped into the 40’s. “Was I supposed to call you when I felt so bad?” She asked. Lord, give me patience. She did finally get it and is doing well now.

I have found that in a small town, options for specialties to refer to are somewhat limited, so we do a lot in-house. News gets around fast, your reputation is important. It is good to hear that word is getting around and we are getting a lot of new patients who hear this practice is good. It is a happy place to be, I just have to get over the feeling of waiting for the other shoe to drop after so many trials and tribulations. I believe maybe it is all going to be okay now.

It’s been great. Thanks readers, you helped me through it all.

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