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Update


Sorry I haven’t been around to post recently. We just bought a house, a fixer-upper and have been completely busy and exhausted putting in the new kitchen. The results are good, it came out beautiful, but I would never want to go through that again! You should have seen us covered in insulation fluff when the drop ceiling turned out not to be a “dropped ceiling” and just a seven foot ceiling opening directly to the attic. Not only did we have to replace cabinets, etc. , we had to basically gut and rebuild the whole room.

As soon as we are all done unpacking, setting up the house and my sewing room/office, I will be back on track again. Soon, I promise.

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One of the hardest things to do when starting a new job, is to get a handle on the office politics. The difficulty level is higher when there is a large group of physicians, other mid-levels and a large assortment of assistants and office personnel. Add some new services being set up and the mix gets a bit volatile.

I have never been a real political person, so I would have had a real problem with all of this only a few years ago. After the rigors of post-graduate education, and the “Project”, it seems that I have developed some new skills in dealing with the politics, and a higher level of personal confidence. So far, things are going relatively smoothly, and I am learning who the movers and shakers are, how to keep myself in the loop, who are my allies and which people I need to be careful around.

All in all, considering the amount of people in the practice and the sheer amount of patients seen and procedures done, this three-ring circus operates quite smoothly, and I am feeling more comfortable each day in my new role. We are settling into our new community, making new friends and enjoying the outdoor activities and beautiful surroundings we have here. There is a 43 mile long bicycle trail which runs past lakes, parks, and forest near by which we are enjoying each weekend. Life is good.

I need a new bicycle…

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During my first week as an NP, everything seemed difficult. The computer system was unfamiliar, the routine and forms also new and unfamiliar. I was a bit unsure of myself. The specifics of GI, a new territory, even with patients who had simple stuff like constipation, it just felt difficult.

Today, the first day of my second week, the routine is more familiar, the computer program do-able, the paperwork and forms are now not problematic. I am much more relaxed and able to interact with the patients in my normal way. I wrote my first order, woohoo! I get to see the patients first, then the physician gets my report and finishes up the plan. It is really nice when you tell the patient “I think the doctor will give you such and such drug/treatment”, and when he comes in, he says the same thing. Yes, validated! I guess I know something after all. There were a couple of times when he didn’t go in after me at all. Sweet.

Life is good. I have arrived. Still inexperienced in my new role, but I am feeling more comfortable. Everyone here is very nice, I couldn’t have found a better group of physicians to work with.

Clothing stores used to be hell, but now seem a lot more fun!

And, on a different subject, I went clothes shopping. I recently lost some weight on a low-carb diet. This is the only diet that has ever worked for me. My pants were getting a bit baggy, and besides, I deserve some new clothes. It’s been a long time! So, I go to the store and troll around looking for “professional clothes”, (and not in the “women’s” section this time) no more scrubs for me. I find some pretty tops and pants that looked good. I go to the fitting room with piles of stuff to try on, and….the best part is that I picked out some pants a size smaller than my usual, and lo and behold! They were too big, I had to go down another size! That has never happened before. And, they were long enough for a change (I am 5’9″).¬† For once in my life, I came home smiling with bulging bags after a clothes-shopping trip. I take all of this as a good sign. ūüôā

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I passed my final exam…..only the presentation of my project is left.

I suppose I will have to change the blog title soon to “Trials and Tribulations of a New NP”. I have found a position with a group of GI physicians, this ought to be interesting! It is not easy to find a position when you are a new grad, I was lucky to get more than one offer, of which this one worked out the best.

The cool part is, I get to hang out in the cushy doctor’s lounge in the hospital between patients. ūüôā If I have time to hang out that is… Will keep you all posted.

 

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Wow, I can’t believe it. I posted my clinical hours fron the last 2 weeks, and I get a response from my instructor:

You are officially done.

Really? Already? Have I really put in over 660 hours of clinical time? I am conflicted about this. Part of me says, “You don’t know shit” and another part of me says “Wow, cool, I have learned a lot. ”

I think I will stick with the second part, I did learn a lot.

It’s funny, when I¬† just looked back at what I wrote, the negative feeling was in the third person, and the positive in first. Goes to show that I really do believe in myself and a little voice by my ear is telling me the bad stuff. My heart knows the amazing amount of knowledge I have gained, and experience.

There must be a point in this observation. Don’t listen to that little voice in your ear, listen to the one inside.

¬†One interesting thing, I got to meet a real live alligator wrestler on my last day, he¬†had a bad shoulder. Why am I not surprised? He did tell us that¬†alligators were easier to wrestle when they weren’t hungry…

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Well, my last term starts Monday. I just got back from a week of vacation in upstate South Carolina, again. We do love it there. I managed to wash and dry my cell phone (we thought the dryer was clumping kind of loud) and so no-one could call me. That actually was kind of nice. We took walks in the woods with the dogs, explored the area and discovered some new things. Generally relaxed and lollygagged (also gained a few pounds, oops). I took several school books with good intentions of doing some reading. Yea, right.

Now, I am home again, faced with the pile of books I meant to do some reading and studying in and the new term looms. I was good today, read a few chapters in my orthopedic book. Orthopedics is one of my weaker areas and I need to bone up a bit. It seems strange that there is only one more term, 15 more weeks. I am so not ready to go out there and BE a nurse practitioner. Emotionally scary, that. I suppose that is how all new grads feel when they go out there, so I will try not to perseverate about it.

My big concern this time is the SCHOLARLY PROJECT…..the dreaded thesis of yore. A classmate who is a term ahead of me stated she almost threw up when she read the syllabus and expectations of the scholarly project. Okay,¬†I suppose that is good to know ahead of time. She did say to really work your ass off the first week to fill in the “matrix” and the rest would flow.¬† Now if I could just think of a good subject, which is a little hard to do if you don’t know the expectations. I have fiddled with the ideas of diabetic foot care, the shingles vaccine, medication compliance issues¬†and fall prevention in the elderly.¬†

Last term I was still excited about getting the books and prepping my work space. This term is different, motivation seems to lower. The difference must be pretty much sheer exhaustion, mental and physical, and also the realization that, once this is done, I need to go out there and apply for jobs. Yuk, I hate applying for jobs. In the past, every time I thought I was getting a good one and the people seemed nice and all that, the job turned into a disease. The employer owned you for a salary, and always took advantage. I am too damn old for those games now. I hope that I can find a nice quiet little corner to do my thing, working with nice people who appreciate me. Is that too much to ask? Hopefully not. I work hard, I am honest, I care about how and what I do. Sending up prayers, God, that the right place will come up for me. Heaven knows I have worked hard enough to get to where I am educationally.

So, here we are, sitting at the desk. It is dusty, there are coffee rings on the surface. The books are stacked a little haphazardly. The pencils are not sharp. Piles of old clinical log sheets and papers take up half the space. The laptop is new, the old one fell off the sofa and died a spectacular death. I never saw such weird patterns on the display before…at least that was after I took my final. Do I feel like making it all pretty and tidy? Not this time. The piles of papers will have to go on the floor to make room for the new ones. I will push enough stuff aside to make space for the new stuff, and I will continue to plug away at all of this, including the “matrix”, until is done. 15 more weeks…

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One thing I have learned is that the presenting complaint is never what you think it is.

Foot pain: An elderly lady came in complaining of foot pain. She had told the nurse it was bothering her a lot and wanted to know what to do about it. On examination there appreared to be a crusty area between the last two toes of one of her feet. She points out “It was pretty swollen up for a while”. I try to gently clean away some of the crusty stuff and just see a little bit of a macerated area. I questioned her if she had a podiatrist as she was diabetic and she said she did.

¬†“He operated on that toe a while back, and the nurse came and dressed it and they took out the stitches last week”. Okay……..Well, I advised her if it was still sore she should check with the podiatrist. She agreed that was a good idea, she denied any other issues when I asked if there was anything else she wanted to talk about.

I left to give my report to my preceptor, the good doctor….he agreed the patient should return to the podiatrist to have it checked.

We go back in the room. “So,” he says, ” I hear you are having some trouble with your foot, but that you are going to get the podiatrist who operated on it to check it out.”

“That’s right”, she says, “But that’s not why I came in today, I wanted to talk about my cough.”

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