Memoirs of an FNP - A Week in the Clinic

Frontier Nursing Service Quarterly Bulletin, Spring 2006 by Froemke, Heidi

Driving home from an outlying clinic last week, I was thinking that probably, in my almost 13 years here, I'd seen just about everything. I never learn. Thus began my week as an FNP at the Dr. Anne Wasson Rural Health Clinic. I returned that afternoon to find a child who had pushed "something" (its true nature uncertain) up his nose. A fishing expedition ensued. I took a call from the radiologist to tell me the CT scan on a "dizzy" patient revealed brain metastases - its original source unknown. I visited a patient in the hospital and we mapped out a plan for her care at home upon discharge. Numerous phone calls later there was oxygen at her home. Papers were faxed to and from to obtain a motorized wheelchair, only to be informed that, after all, I didn't have the correct forms. I began again.

There was the woman with asthma who needed medications, but no money to pay for them. I did what any Frontier provider does almost daily......... improvise (how much can be accomplished in the clinic alone), scrounge (who has the medication samples needed and how long will it take to get them) and make do (okay...it's not ideal, but it's the best that can be done under the circumstances). There was the gentleman with severe weight loss, fatigue and frightfully abnormal lab values. A quick consult with Dr. Begum and he's sent for further diagnostic testing. There was the patient with scoliosis needing a photograph of her deformed back for the medical record. (Okay, where's the camera?). There is another suspicious CT scan of the chest -lung cancer? The 13- year-old whose parents want to take him out of public school for home schooling because of health reasons and.... what do I think? The gentleman with a massive infection of a finger occurring only 48 hours after clipping his fingernails. . . A brief search and his blood sugar is found to be 4 times the limits of normal and, at the age of 82, now a newly-diagnosed diabetic. Today, we start the process of teaching him how to live with this disease. A trip to a grade school to discuss first-aid with 4th and 5th graders. Their enthusiasm and energy are wonderful. I left the elastic bandage with them to practice wrapping wrists and ankles. ("No, this bandage cannot be wrapped around someone's neck!"). Oh, yes.....Dr. Tan and I shared recipes for Mediterranean cooking. That was my week. Yours?

by Heidi Froemke, ARNP