The TOP memorable patients in my career

Ok I am sure Jay Leno is known to all especially with his Top 10 whatever...so this gave me an idea to post the Top most memorable patients that I have come across thus far in my career:

16 year old female who was raped by her father became pregnant and is raising the child..

20+ year old female who complained have not having her menses for 6months and claimed she never was sexually active in her life....guess what...yep she was 6 months pregnant

26 year old healthy male who came to the office thinking he had a cold...chest xray revealed empyema

80 year old women never wanted a hernia repair ....it literally hung down to her knees

Elderly female who thought she had the virus came in with nausea vomiting back pain...ekg showed inferior MI...to the hospital with you!!!

Amish male came to office with nail from a nail gun through his leg

Schizophrenic young adult male came in for his depokote shot and closed the exam room door and cornered me and was irate...then he runs out of the office building onto a busy highway

Homeless man complaining of foot pain...unwrapped the soil dressing he had covering the painful area to find and foul smelling magot infested wound

so it is only 8 but I am sure I will have many more found memories to be added to this list

Delirium and awful place to be

So I have to say my 2nd week of the year at work proved to be very eventful...The 3.0FTE provider positions are now 2.5. ..myself and attending and 0.5 PA who unfortunately was not on the floor all week because he was covering another PA who is out sick...best laid plans...and the day this went into effect our census jumped from 16 patients up to 26 patients and still going...yep...another best laid plan...so 2 days into this I found myself attempting to convince an 87 year old delirious patient to have his vitals taken and his pulse ox...He refused saying we poisoned him and we aren't doing for him...I pulled him into a very very quite room and tried to reason with him that we were helping him and not hurting him...he started to get a little agitated and I had asked the nurse to give him haldol...despite all efforts we needed to bring in more troops to get this accomplished....at this point his anger became directed at me saying I poisoned him and he didn't want me to take care of him...I also took away his dentures and broke them as well as his hearing aide....he became a little loud and started to take swings at me...we finally calmed him down and gave him his haldol...he slept for a good 1/2 hour...by lunch time he was up and eating his lunch...he was a little more cordial to me but still believed I was no good and against him...my feelings were hurt because he and I were really getting along very well prior to the earlier incident...thankfully the psychiatrist came in to help sort this out for me and we changed some of his medications...this proved to be a positive thing...he finally got a good night sleep( he had his days and nights mixed up) I went in early this morning to find him back to his old self...he was smiling and was very apologetic to me and told me he would never hate me and loved me and my smile...now that was a good moment and one to cherish...

Growing Pains...journey of a career path

I am writing this blog before I title it so hopeful once I am finished I can come up with a suitable title...I am having a writer's block on what to write anymore...this is bad news since I have only had this blog for a couple years...So I was doing some deep soul searching this morning on what I can write about...actually I was in church while I was doing this...call this my morning meditation....as I was thinking an looking around at the people surrounded me I got this overwhelming felling I have really grown into myself...I am saying this not only personnally, spiritually and also professionally....Personally I look who I have become....not the same person I would have pictured in my early 20's ...at that point all I wanted to do was be a med surg nurse, marry young and have a family...not that I didn't do that ...but I took some detours on the way...I did become a nurse(working part time), I did marry...and I did have a family...the glitch and first detour was when I was 25....the happy ever life as I knew it ended...horrified when my husband told me that he didn't want to be married anymore...and leaving me with a brand new house and an 18month old daughter...I had no idea what I was going to do...needless to say...the part time nurse idea was out the door...I had to work full time to support myself and my daughter...hopes of living in the brand new house was also out the door and I was back living in an apartment...my self esteem hit rock bottom...It took several years to pick my ego out of the basement and wipe myself off and realize it was all up to me of how the rest of my life was going to pan out...this is when I did my double challenge take on a new job as a nurse educator and go to school part time for my Masters in Nursing...still a single Mom this was a challenge. By the grace of God and the help of my parents and 5 years later I had a MSN next to my last name and to add to my credentials...during this time I met my best friend and husband...He has proven to be a rock to me ...He made my family true family and we married in 1992...I continued to work in the hospital setting as a nurse educator...but something still didn't seem right to me...I was bored...can you imagine...bored with a family and full time job...plus hospitals were re organizing and the nurse educators were the first on the chopping block...so that is when I decided to go back to school again for my NP and post masters...2 1/2 years of working full time and keeping a house and family I succeded...jobs were not plentiful or were well known at this time for NP's I literally sent out letters with my CV to all the family doctors in the area...I got that one bite and I was on my way to my current career...granted it wasn't all sweet and nice in the beginning...I actually worked a full time job as a Disease Manager in a hospital and part time in the evenings as an NP for the first 6 months...then another family practice approached me to work in their office...so I was able to quit the hospital job and work the two family practices at the same time for a full time job....the first year I worked 60 hour weeks..ugh..and the pay was lousy...after a year I quit the first job I landed and worked the second job ...was lucky to add hours to this job to make it a full time job....During my first 2years as an NP I had a lot of growing pains....fears of not knowing a lot and of possilbly making an error...I wouldn't sleep at night...was constantly reading and looking things up ...I would wake up in the night and think about a case I had during the day doubting myself...it was awful...plus office practice was not the end all and be all for me...the pay was lousy and benfits were nothing...and the docs just didn't get us...that is when I started looking for something different and even 2nd guessing if I made the right choice to be an NP....that is when I ran into a fellow NP collegue at a conference who introduced me to her boss...they were looking for a new NP at the nearby VA....I got an interview the next week and the rest is history...almost 11 years I have been there...they do get it..and I am very happy there...I can honestly say.. I don't feel bored ...I learn something everyday...the docs I work with get me and me them...and I love the patients...working for the VA gives me a sense of security with my practice and with my ohm....I doubt I will ever return to the private sector...the VA has come a long way...it works very hard to provide quality care...it is built in to every providers work day...we are constantly provided tools to provide this for our vets...I can honestly say that I am where I want to be now...I wouldn't even know where else to go nor do I have a desire to go...I do get up everyday and dread getting up only because I can't sleep in but I do look forward to going to work...it is always a new adventure and a great opportunity to help those who otherwise would not be able to get good health care in the private sectore...plus it is my way to give back to those who gave to our country...so now that I wrote this what should I call it?

Happy New Year

Well in looking back to last year I kept my promise to write more...so I am going to try to live up to it again this year...I have already promised myself to organize my closets and kitchen cabinets...done and checked off the list..trying to exercise more...shall be a challenge ..and eat healthier....OK now what should I do for my career...hmmmm...this is always a struggle...I have found myself to be in such a routine anymore...I don't want to go back to school...I have had enough of that...I don't want to change my job...I love what I do...so maybe I can promise myself to read more...educate myself more...maybe I can stick to doing a couple CME's once a week...I think I can do that.....
I always like to self reflect on how my year was in the past with caring for my patients...I have had some real challenging cases in this past year...Some of my challenges were with those patients who lost their battle with life...suffering from chronic diseases, cancer, cirrhosis...Some patients I was able to help and turn their life around...like giving them another chance in life...others remain in the cycle of no return with their poor health and addictions...these are the ones I wish I could make a difference and hope that someday the light will go off and they will get it....Hopefully 2012 will bring more challenges that I can face head on and make a difference in more lives...in a good way...I hope that you too have a very Happy New Year and may it be blessed with good health