FNP

So as of lately I have had some miraculous free time and have been enjoying catching up with friends over drinks and the occasional live sports game. Vino, friends, and sports? Who could ask for anything more? The only difficulty I have run into as of late is the “So are you going to become a doctor?” question.

The scene has been almost the same all four times. Guy comes up to engage himself with my friends and I by asking what we do, etc. Always give the same reply, I work part-time in the Emergency Department and I am a full time student in the Family Nurse Practitioner program.

Inevitably I have to explain what a masters prepared nurse in the Family Nurse Practitioner program does, what we are allowed to do within our scope of practice and my goals. Honestly, I feel sometimes like it is a mini interview, only I am not for hire, and not giving out my number.

So, why do I feel like I have to educate the world on what a Family Nurse Practitioner does and why do men find the need to ask me about becoming a physician? I have no idea, but we should get this straight.

I work with amazing physicians; in fact two have inspired me to want to further my career. That being said, I appreciate the lengths of which they went to school and learned their practice. In my personal education I also have a deeper understanding of the nursing philosophy and want to continue on in the profession I have spent 12 years working in. I will never forget where I came from and yet hope to work hard and achieve more. To this day I stand-up and lobby for registered nurses and I have strong opinions about Nursing Policy and Politics. But I don’t feel like getting beat up for four years then again during an internship to do what I want to do which is own my own practice that works with patients in a holistic manor.

So why does anyone think that I would dedicate two more years of my life, time energy and focus only to turn around and gain 8 more years of let’s face it debt and career change?

When all is said and done, I usually reply “because I love nursing and I want to stay in this field”, it has been met with a nod, um-hm, “really?” and “cool”. And really it all boils down to this .People should do what makes them happy; become engaged in whatever they were called to do. I am not in a competition with any profession or even human being (other than myself, what can I say I like to push myself). Everyone has a place and job in life. The idea is to do it well, and if you don’t like it, move on. There is plenty of inspiration around the world to motivate anyone to change their lot in life.

As for me, I will stick to the mentors of my life: past, present, and future. I will continue to be more than just a nurse, and hopefully open the clinic and still take time each year to pack a backpack and travel to other countries to do what the British call “Pro bono public” and make others smile. And every once in a while drink vino with my friends and laugh at strangers ;)

Check out this website if you like the picture, it is actually a sticker and you can get this and other funstuff here: http://www.cafepress.com/+nurse_sticker,84659190

More than a Nurse: My thoughts...Rural Health

More than a Nurse: My thoughts...Rural Health: "Tonight I am just about to head out the door to a Christmas party, but my heart is full of thoughts so here it goes: Today was my last d..."

My thoughts...Rural Health

Tonight I am just about to head out the door to a Christmas party, but my heart is full of thoughts so here it goes:

Today was my last day of clinical for the semester. In the words of one of my awesome peers “1/3 done!”…so what have I learned:

1. The “definition” of rural per an on-line dictionary: 1. Of, relating to, or characteristic of the country. 2. Of or relating to people who live in the country: rural households. 3. Of or relating to farming; agricultural.

2. My hearts definition of rural: were we come from, where we go to, our friends, our neighbors and even those in between

3. Glimpses of this clinical rotation: The shy patient who couldn't drive “Into town”, the wealthy business man who “likes” his check-ups here(.), the beautiful pregnant mother excited and nervous about her upcoming birth. All of whom are thankful to see the Nurse Practitioners I learned from.

4. I learned that working with patients will sometimes mean asking them questions that might make them cry, offering a shoulder, getting to the real problem and have them leave feeling re-assured and truly cared for.

5. Clinic work means working with “Big Brothers” who request three stickers one for them and two for their sisters. “The pink princess ones please”…

6. Clinic work means finding a lump in a woman’s breast, who is at a loss for insurance and came to you after not being seen for 5 yrs because she “saved up, and its time I had an exam, I turn 60 tomorrow”. My mind kept drifting back to her, and with help from friends and an awesome social worker (you are both beautiful souls) I found a place for her to get her mammogram for free. Thank you

7. I have gone from the student to the teacher, to the mentor and returned to the student (while still occasionally mentoring on the side). But as I breathe out, I am slowly returning to that place were my soul feels good. It has been a long year. I have walked away for some people and some things, while opening new doors and hugging old friends. What lies next I have no idea.

~m

Pre-Nup Finger Scanner

This is an old Blog I wrote but the conversation was brought up during dinner with friends a few nights ago, so I thought I would post it here, just to make people, laugh, think, argue or what have you.

Everyone I have talked to lately is in the process or has been divorced. It is a simply crazy situation: alimony, division of goods, who takes the dog, and custody. The list of items you have to review, agree, or disagree with is astounding. Seriously, no one goes into a relationship thinking that they are going to get a divorce, but lately it makes me wonder. What the heck happens if I ever get married? To pre-nup or not pre-nup that is the question.

Should you ever go into a marriage already planning for its demise? On the other hand, if you don’t plan ahead could you be taken to the cleaner by someone who transforms right before your eyes?

In a perfect world there would be the finger scanner. If you where thinking about getting married you would simply place the perspective individuals finger in the scanner and in seconds the future would be explained in three simple choices:

1. No problem. You can marry this one and you are guaranteed to grow old together.
2. This one is going to cause you trouble a few years down the road. Probably not a good idea to marry unless you are looking for a short term commitment.
3. This one is too crazy and exciting to know for sure. Again enter at your own risk.

See, this way you would know if you should marry this person, and if you need a pre-nup. The way I see it you could get the pre-nup if they are a 2 or 3 and just see how life takes you. No guarantees like #1 but you would at least know if the person is likely to take you to the cleaners. Say you wanted to know and your significant other did not want to do the finger test (you know those old traditional types) go ahead and put it on their finger while they are sleeping. Then you pop the question and they have no idea you screened them already.

The truth is, it is sad that we even have the desire to figure out if someone is crazy or not. But look at our society. We have created the internet which has allowed us to communicate with others in a strange and fake manner. We have various “profiles” for on-line dating resources,Facebook, Myspace, E-Harmony, etc., all of which can portray a very different person that who sits down across from you at the dinner table. I know a girl who is a completely different person than who she portrays on her Facebook page. On her page she is an eloquent and terribly poignant person, full of very “book smart” educated opinions. But in real life, let’s just say she is not as “perfect” as her profile presents.

Add to that a society that is self obsessed. The dating waters get murky. What happened to good old courtship? Sometimes I think guys are too afraid to be chivalrous due to the explosion of right wing Feminism. And then what happens to the women of the world who decided to break the glass ceiling and become successful in their own right? They still want to be courted.

The point is that dating and courtship suck. Add to that the ever presence of failing relationships all around and you can’t help but wonder if your relationship will break the mold or become a statistic. Nowadays you can’t help but worry. Is there any harm to putting a per-nup into a relationship if you have decided to get married?

I have heard many opinions on the pre-nup. The first being why get married if you need one? But there is this: I don’t want to marry you for your money and I would hope that you don’t want me for my money either. Marry me and spend the rest of your life with me as a partner, lover, friend, sex slave… (Kind of kidding). The thing is, if we are meant to be, then the pre-nup will never matter, and if for some odd reason we need to go down different roads later in life I would like to end it without any questions of who gets what. I will marry the “one” for me because of who he is period (.)

So bottom line: Marry the person you love because YOU LOVE THEM! Not what they are worth economically (If you are a gold-digger please re-read this and pay attention this time. Also, get a job yourself you lazy ass). Sign a pre-nup and laugh because you will never need it. Edit your “profile” to show who you really are, not who you wish you were in real life. And for those out there with special powers…invent the finger scanner for those who are less capable of filtering out the real from the unreal.

National Nursing News | Army Nurses Brave Afghanistan’s Combat Zones

National Nursing News | Army Nurses Brave Afghanistan’s Combat Zones

Lost in thoughts

Today, I felt like not matter what I did, I would be harped on.

I am sitting in the library attempting to focus on the task at hand (my policy paper) thinking to myself; did I sign up for this?

Today was trying day in the assessment class. I take pride in doing things well, and making my patients feels comfortable and at ease, but I feel as though I just performed the worst exam ever. Not the that patient said anything, in fact she smiled and said I did a good job, but my instructor harped on me as though I was a target ripe for the plucking.

So here I sit, computer at my finger tips, pondering what to do next. Obviously I need to re-evaluate my techniques (widget work). Or, as my friend said “understand that the instructor was having a bad day”. Still no excuse in my opinion to focus on me. I was not one of the students who discussed her lack of appropriate behavior via professional correspondence (email), nor did I say in class disparaging comments about the grades she dealt out like a stack of stale cards. My grade was good in fact, strictly speaking, still above average. I think my issue is that as an instructor you are also considered a leader, and as such you should form a congruent interpretation of results and present them in a professional manor. As such she missed the mark. That being said, at the end of the day, I am not sure why I was the focus of her attention. Nor should I care. But in my heart of hearts I have that desire to always succeed and do well. And by well I mean I want to give the best care. I push myself internally more than any one person can outside of me. Believe me, what one person says in critic is about 10% of what I critic in my own thoughts and contemplation.

At the end of the day, my friends, whom I do respects will say “don’t be so mean to yourself” “don’t beat yourself up over this” or any other number of “encouraging” phrases. I get it, but what it comes down to is that if I don’t push myself, if I don’t have the desire to achieve or be better then it won’t happen. I compete only with myself, because only I can make that change. I stopped proving myself to the imaginary ghost. Instead I traded in that ghost of approval for a family that loves me and friends that appreciate me for me. The nerd, the contemplative, the girl who is “emotionally incontinent” at times, the woman who turns pale at the site of pain on another being, and who likes to wear fun socks and snorts when she laughs.
Deep breath in, death breath out. The view is still out the window, the Rockies, sitting lazily against the horizon. They too feel peace and calm. One week to reflect and a few moments to relax...

And now policy…
~Mika

More than a Nurse: Community Service

More than a Nurse: Community Service: "Hello Everyone! So it has been a long week or two. I am still loving every moment of my clinical rotation. But this week I also focused o..."

Community Service

Hello Everyone!

So it has been a long week or two. I am still loving every moment of my clinical rotation. But this week I also focused on a different goal. I was introduced to an amazing organization by my friend Maren called: Cuidando los Niños. http://clnkids.org/ Check out their site! Anyhow, writing a letter of intent and making my Curriculum Vitae user friendly was a brain challenge. Thank God for great friends! (Luv you guys!). Until next week! Here is a snippet of my letter, please put me in your prayers!

"Coming home to New Mexico this year gave me the opportunity to reconnect with friends and regain my roots in the community I was raised in. A few months after I arrived and started school, I was given the opportunity to go to the “Not one child, not one night, not New Mexico” breakfast event. I have attended charity events throughout my career, but this event was not just about the gift of charity, it was the gift to help others grow and develop. I left the charity event resonating with the Cuidando los Niños goals to provide care for homeless children in a way that would help them for more than just one night or even a week. I feel as though your organization has the key to success in helping the whole family for a life time.
My intent is to not only support your organization through time, and resources, but I would like to help your program continue to grow and succeed its mission. I not only have seen the effects that homelessness and lack of resources has on the body physically through my work in Emergency Departments here in the States, but also through my service in Afghanistan, Iraq, Germany, even during the devastation of Hurricane Katrina"

More than a Nurse: Small Rural World

More than a Nurse: Small Rural World: " Normal 0 false false false EN-US X-NONE X-NONE ..."

Small Rural World

Day two of my clinical rotation in “rural” New Mexico. My drive to clinical is always my me time. I think about things I have learned, review goals, but in the end I just stare out my windows and see the town I left behind. It’s hard to believe that I “grew up” in this small rural town. And even odd still is that it has brown since I was here. I don’t remember a grocery store, or street lights, of street lamps for that matter. The road was two lanes, and now it is four. Even the highway has reflection lights and new signs for stores. So is it a New Rural New Mexico town?

My living room is larger than the clinic, and warmer, but I am starting to enjoy my white lab coat and the long sleeve shirts I use to use for my scrubs. As I walk in the door the quite air makes me feel a sense of peace. My clinical instructor, ever the whirlwind of energy gives me the first chart of the day and as I read a diagnosis of Hypertension and “Medication Refill” I think to myself, what a nice slow start.

I walk into the room and introduce myself and start to ask some questions and realize a simple medication refill is more than this man needs, and then I jump feet first into a 35 min assessment. Then another patient, another assessment and questions on health insurance, and billing. Can you afford these medications? What two things can we work on today? For the next month? What goals do you have? How can I help you with those goals? What is normal to you? How many do you take in one day? How bad is your pain?

Every room and every encounter is a stark contrast to my busy ED second life. In the ED I recommend patients follow up with their Primary Care Provider, here I am that person, I make those plans, I suggest those medications, I see what they can afford. It all feels so surreal, but yet so fulfilling.

I stopped by the grocery store that didn’t exist when I lived here; I wondered the endless isle and looked at everything. It brought back memories of riding my bike to the gas station to pick up candy and bread. “Are you Missy or Dani?” I heard from behind me. I turned “Missy” I said in reply. I didn’t recognize the man standing before me. “It’s me Jason, we grew up at Mountain View together” and instantly I saw the little boy I use to hang out with. We played war and shoot our BB guns the whole gang of us that lived there.

“I remember how are you?”

“Fine, fine just picking up some things for my family, we live just east of here. I have two boys”

“That’s awesome”

“I heard you joined the Navy”

“Army”

“Oh and are you home now?”

“Yeah, going to school and doing clinical out here at the clinic once a week”

It’s a small rural world and people might not change. Every day it feels strange to be back, as though I have seen rural, gone to big cities, gone to even smaller villages, and now my life is full circle. Giving back felt great today and I learned more tools for my bag of knowledge.

It’s time to go read now, have a test next week….until then, maybe I will see you around…..

Picture Day

Decided to re-share a link. This is my self and a medic cleaning in Afghanistan, it seems like worlds away now, but then I am reminded with emails and pictures from friends. Every time I think I am having a tough day, or I worry that I might not have made the right choices to follow my dreams, I take a step back and think...just one more step forward.

http://www.msnbc.msn.com/id/33797723/ns/news-picture_stories/displaymode/1247/?beginSlide=1

Choices

It has been a while, so here it goes. Today was my first day with my preceptor. I drove the 35 min (or so) to the clinic. The drive was long and I passed by my old middle school and elementary school. I drove by the gas station I use to ride my bike to. I drove along the slightly curved Route 66 and made it to a small building with a sign: College of Nursing UNM Family Practice, Midwifery and Pediatrics. The wind blew me from my car to the front door where I met a welcoming nurse. She hurried me into a small office where two nurse practitioners shared a modest space. I sat in silence waiting for my preceptor. I started to review my History questions, review my physical assessment techniques. I was nervous, excited, and honestly wondering if I was taking a step forward or a step backward.
I met my preceptor; she entered like a whirlwind and laid her bag out with supplies she took on a recent home visit. Her energy was transferred to me and as I went through my histories and physical assessments she guided me through each step with encouragement and feedback. The last patient of the day was a home visit. And I ended the day with my reflection and Ah Ha moment.
There are times when you make a life changing decision or choice and you ask yourself is this what I really wanted? Did I do the right thing? I have to say, that today was enough to re-energize my personal goals. Working in rural health care as a Family Nurse Practitioner is not the same adrenaline rush you get working at a Level 1 trauma center, but the personal gains of helping families, and being your own provider, those are high’s all on their own.
I ended the day with Lasagna from mom, just another reminder of how good it is to be home and an early Christmas gift, Flannel sheets. It feels good to have a family that loves me and to live in the house that my hands rebuilt with the help, love and guidance of my family. So at the end of the day, I can breathe out and say “You made the right choice”….

Day One

I have decided to blog again. Whew! It has been let's see, two years since I did this. Blogging was my way of getting things off my mind. Why so much on right now? Well, I have started school again, I am in the Family Nurse Practitioner program and back from Afghanistan. So, I think writing will be my gentle escape.