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NewFNP felt the magnitude of her decision to leave her clinic as she saw the crestfallen look on her clinic manager's face when she told him that her last full-time day is fast approaching.  It's not that she didn't imagine that the transition from community health to academic medicine would be insignificant; it's just that she is ready to leave and has only been focusing on that.  But to see this young man's shock and disappointment, to hear him say, the patients are really going to miss you to have him say that he is sad - ouch.  

He also told newFNP, "But you are Franklin," the (fake) name of our clinic site.  Maybe yes, but that's part of the problem.  NewFNP just can't put her heart and soul into it any longer.  It's too hard and the forces against change are too great.  

"Two days?" he asked when newFNP told him that she would still be working part-time.  "Can't it be three?"

It absolutely cannot.  Somewhat sad though newFNP may be, she needs only to read her own blog to be reminded of what drove her decision.

NewFNP, apparently more of a pessimist than she had imagined, had feared that her medical director would be upset or feel betrayed or tell newFNP that it was all or nothing as she sat down with her today to tell her that she was hoping to stay part-time.  Instead, she was the perfect mix of happy and sad - happy for newFNP that she has this new, exciting opportunity in academic medicine at a top ten university and sad to see newFNP go.  She was absolutely supportive of newFNP staying two days per week and on newFNP's terms.  She even hugged newFNP.

Did newFNP dream this?  She hopes that the rest of the management team will be as supportive. 

As newFNP goes through her days, seeing her patients and thinking about the patients for whom she has cared over the past three years, she feels a heaviness in her heart.  She is choosing to give up being a primary primary care provider.  She is making herself unavailable.  She is choosing an amazing opportunity for career advancement, professional growth and day to day organization... all with meth addicts!  But meth addicts who want to quit and who are enrolled in a Phase 2 clinical trial - a controlled environment indeed.  She can walk or ride her bike to the clinic site.  She doesn't have to be to work until noon, allowing plenty of time for hiking and gym and yoga and grocery shopping.  Hell, she might even shave her legs more than once a week!

Although newFNP has been near tears thinking about making this change, it's the right decision.  

And please, newFNP knows that this is off topic and that she has made this plea before, but can she please go on What Not To Wear?!?!  Will someone please nominate her? She is starting a new job after all.  And even though dressing well is religion to newFNP, even she has fashion ruts - hell, she has three white v-neck tees and lives in her Juicy sweats every weekend!  Clinton and Stacy can tell her that she can still wear a pencil skirt even though her calves are thick and tattooed, they can tell her that she needs a new bra and they can drop her off in front of Theory with a $5000 visa card.  Carmindy can teach her how to do the smoky eyes and Nick can teach her to coax her curls into ringlets.  Please!!  For the love of flattering trousers!!