Tuesday, October 27, 2009

Saved yet again

Last week, newFNP had had it. She never wanted to return to clinic again. She had one especially bad encounter with a patient that left both parties feeling upset and involved newFNP telling the patient, "Pregnancy is not a disability - you do not need to quit work yet" in a not-so-nice tone and the patient telling newFNP, "You don't understand -- your job is easy." To which, of course, newFNP had an internal fit of apoplexy. It is a damn good thing that newFNP does not know how to say, "You have got to be fucking kidding me" in Spanish.

That, coupled with a few other institutional issues, prompted newFNP to send her resume out early yesterday morning.

And then, newFNP'll be damned, but wouldn't you know it if a patient reached out and touched newFNP in a way that made her love her job all over again. No - in a way that made her want to stay in her job.

This patient is in her 60's, she is a university retiree from newFNP's public health alma mater, she has Crohn's disease, is a breast cancer survivor, fell and had a major knee surgery two months after her chemo ended and was determined to be unable to care for herself post-operatively in her home as she lived alone. Thus, adult protective services placed her in a hella ghetto senior's community a stone's throw from newFNP's clinic which, in case anyone has been sleeping for the past four years, is in one hell of a shithole area. Prior to this determination, she was living in a peaceful suburb in the foothills of newFNP's city. She hasn't had a mammogram in two years and she is only three years post-mastectomy. She hasn't had GI follow-up in over a year. She feels as though she cannot turn to her children for help.

As she recounted her story to newFNP, newFNP just took a moment to acknowledge the hell this woman had been through and asked her if she wanted to talk to a counselor. She made an expression that spoke of her pain, of her sorrow and of her relief in being offered .

She shook her head slowly, ruminatively. "I could use it," she replied, nodding. "It has been a really hard couple of years."

NewFNP put down her pen after having filled the past medical history form and then some on this woman's encounter form, leaned forward toward her patient and said, "I am going to help you." And she meant it -- she meant it more than she usually does. And she felt the importance of helping this woman more than she has in quite some time.

And she did help her. She got her a mammogram even though mammograms are booked through 2010. She got her a counseling appointment. She overstepped her bounds and gave her a friend's email address in the hopes that this friend had some insider knowledge regarding other communities available. She listened. She cared.

But equally as importantly for newFNP is that this woman helped her. She saved newFNP from utter desperation and frustration with her job.

What a wonderful gift newFNP received today. She is so thankful.


sonia said...

Dear NewFNP,

Nursing was a mid-life career change for me. I didn't become an RN until I was 47 and I am now 52. I work in an urban community health center offering primary health care to uninsured, low-income adults. It sounds just like the place where you work. I love what I do; I can't think of another job that would suit me better. I want to become a FNP to advance professionally while continuing to work in community health.

I've been following your blog as I go thru a master's program to become a FNP. I am hoping to have another 20 years in nursing. After graduation, I will seek a job just like yours. Thank you for the honesty with which you describe your workplace experiences, good and bad. I can feel your frustration and fatigue on your worst workdays, and I admire the energy and compassion you put into patient care. Your writing inspires me to continue in the pursuit of my career goals.


T Rex Mom said...

Hats off to you. I could not do it! I'm in FNP school right now and I could not imagine going to a job like that every day. However, it does sound like that dear, sweet woman was just want you needed. And it is patients like her that make it worth it.

Be well.

Anonymous said...

Isn't that the way it is. Just when you are really hating your job some patient comes along to remind you of choices you made, and why you are here.

DamselFish said...

No me jodes.

You just made me almost cry a little. Don't quit your job at the clinic. There aren't enough talented people who are brave enough to do that work (or insane enough, whatever). I'm sure you hear that all the time, but seriously, most of us work in an office and our daily battles are with Microsoft Word's autoformatting.

Linda said...

I've been following your blog for three or so years since I graduated. I totally can identify with everything you experience...this story reminds me of how sometimes it's so easy to lose touch w/ our compassion even though that's why we all got into this gig. and then when we find it again, it is so powerful.
I want to share with you and everyone who reads this about a book I've recently read called "Trauma Stewardship:An Everyday Guide to Caring for Self While Caring for Others" by Laura van Dernoot Lipsky. As soon as I read it, it changed my life. It is so so so helpful to remind us how to take care of ourselves despite all of the crap we face every single day. It has helped me to be able to have more of those moments you had with your second patient today - where i can be grateful that compassion was able to flow again.
Thank you for your courage and honesty (and humor!!!) in sharing what you do. I think the most important thing is that we have to remember to take care of ourselves, even if that means moving on or whatever, so we can continue to find that compassion that sometimes gets stomped out by the vicarious trauma we experience through our work.
much love to you and best of luck w/ your decision about next steps :) :) :) and check out the book if you can!

BostonFNP said...

What? Pregnancy isn't a disability? It's just like the arguement I got into with one of my patients where she insisted that her 3 pack a day smoking and 2 bottles of vodka a day habits make it impossible to pay her rent and I should sign her paperwork for public housing...

Hang in there, sister. For every one of them, there is another one who needs and deserves our work and support. They seem to come just in the nick of time.

Rick said...

For every patient that clubs me with a water pitcher, tells me to not wipe his arm before administering his insulin, and every victim who has a "fall" that resembles an assbeating-of-a-lifetime, there's one of these that makes it all worth it. Great post.

Nurse Practitioners Save Lives said...

Glad to hear that you will stick it out for another day. It's all we can do but get through it day by day at times. I love my job in rural health but seeing some of the unnecessary stupidity drives me a little crazy!