My first week on the job

This has been a very busy first week.  I started my job at CVS Minute Clinic.  Monday was my first day working independently.  For those of you who don't know about  Minute Clinics, I will tell you what they are.  There are over 600 Minute Clinics in America. They are independent clinics set up to treat common primary care complaints.  They hire both NP's and PA's.  They are somewhat limited in their scope of practice.    They are great because if you are unable to get a sick appointment with your PCP, you can always go to the nearest minute clinic.  They were designed to fill in the healthcare gaps and provide access to people who can't find a PCP.

I felt that my judgement was good but I still needed to look a lot of things up which slowed me down.  I have decided that even though there is a lot of pressure to produce high numbers, it is more important for me as a new NP to take my time and do the job right and avoid making mistakes.  There were times when I looked in the waiting room only to see 10 people waiting to be seen.  I managed to see everyone.

On Monday, I saw 35 patients alone.  I did all of the insurance verifications, treated patients, gave flu shots, ordered supplies, kept the books and cleaned.  Needless to say, I was so tired after the 12 hour day.  I work 8-7pm plus travel time which makes for a long day.  I work 30-35 hours/week.  Most weeks, it is only 3 days.   I do like working with the public.  Most people are so grateful for any help you give them.  I would like to share some of the stories from this week and the people who touches my life.

There was an old man who came in for a second visit because he still wasn't feeling well.  After doing his history and PE exam, he confined in me that he had lost both his wife and grand-daughter in the past 2 weeks.  He began to cry.  I held his hand as I fought my own tears.  I could feel his pain.  After giving him a new script, I gave him a hug.  Sometimes just validating someone's pain is all they need.  It was apparent that this man who had been married for 50 years was facing grave loneliness and was so grief stricken.

Then there was the young woman who came in for throat hoarseness.  She was receiving treatment for breast cancer at the tender age of 32.  Unfortunately, I had to refer her out because her condition was not in the scope of practice within the Minute Clinic guidelines.  She told me her plight and I listened.  Fortunately there was a lull in the schedule, so I could give her extra time.  She was the mother of 5 children.

There was the elderly couple who had been married for 62 years coming into the clinic, arm and arm getting their seasonal flu shots.  When I asked how long they had been married, the husband pipes up and said, "62 years."  I asked, "What is your secret?"  His reply in a very serious tone, "You have to always put the other person and their needs first and lots of laughter." 

Then there was the grumpy middle aged man who demanded antibiotics for a sinus infection.  It is so funny that people will self diagnose and then demand what they want or think they need.  When I informed him that he did not have a sinus infection  and that he had an upper respiratory infection/ allergic rhinitis caused by his allergies he got mad.  I told him what the s/s of a sinus infection are.   As I tried to explain to him that giving antibiotics for a virus/allergies can cause more harm than good, he stormed away dissatisfied.  I realized at that moment that you can't always please everyone and unfortunately he will go somewhere else and the next provider he sees will end up giving him the unneeded antibiotic.

When I was a student, we talked about the pressure health care providers are under to dispense antibiotics.  In some ways it would be just easier, but most primary care complaints are caused by viruses and not bacterias.  We need to prevent antibiotic resistance and stop prescribing them unnecessarily.

There will more stories, more lives that will touch mine.  I just hope that my dedication to this work will persevere.  My family has been so supportive especially Mark who has picked up the slack at home on the days I work.  My girls are so lucky to have him for their dad.  I am blessed to have a wonderful family and to be able to do this great work.