Checking out the "real" NP world

I have to admit, as a military FNP, I am a little sheltered from the “real world” of NPs. In our community, FNPs usually work in primary care and, occasionally, pediatrics. We don’t typically specialize in areas such as surgery or dermatology. There are programs in the military for our PA counterparts to branch into specialty practice—most common is surgery or orthopedics—but they are not available to us. Why this is, I cannot answer. I would think it has much to do with the current shortage of primary care providers, but if that is the case, why do PAs occasionally specialize?

Over the last few months, I have met more and more civilian FNPs and am frequently surprised by their ability to specialize. One works in general surgery at the Veterans Administration (VA) facility in town, and prefers to specialize in breast surgery. I was thrilled to hear this because, historically, the VA has been a “man’s world” where there were few services tailored to the female veteran. Another friend works in oncology, both inpatient and outpatient. She talks about how removed she feels from “regular” medicine, and my head spins thinking of all the complicated medication regimens she prescribes.

The one that surprised me the most? A friend who is a women’s health NP recently interviewed for a job in pain management. My first question was, “Can you really do that? Take care of men, too?” And, apparently, she can!

As my time to leave the military slowly approaches—I have just three years left!—it is a little overwhelming to think I will have to go looking for a “real job” and that there are more options than family medicine. I still don’t know that I would choose something else. I enjoy the variety of what I do. But, you never know what door might open when the time comes!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The speed bump that became a high spot

Friday was one of those days that will linger in my mind for quite awhile.

It was the end of a long week. Sick children, life stressors, work demands—all the typical things that pile up in the face of an approaching weeklong vacation. I thought I had the week pretty well planned in advance—a few days of “sick call” and a wide-open Friday afternoon to ensure a few quiet, patient-free hours to tie up loose ends before leaving the nurse in charge. (I hate leaving too much for my covering physician to deal with. He has his own daily demands and, as we all know, covering for another provider can destroy your week.)

Then, as only the military can do, a huge speed bump was put in the middle of my well-planned road! In response to the events occurring in Japan—the earthquake, the tsunami and, now, a nuclear threat—the military was offering voluntary evacuations to family members located in that country. The evacuees—mainly women and children—were being routed through various cities, and our location was chosen to support this mission. The request was for a provider to be on site at all times to provide acute care and address any medical concerns that might arise as the families were routed to final destinations elsewhere in the United States.

I scrambled to find someone to come to the house in the early morning hours and get the kids off to school. A few good friends have made the offer to “call anytime,” so I took one up on it, and he was quick to say yes. (Proof that the week wasn’t all that bad is that it reminded me of the wonderful friends I have made here in a short six months!)

When I arrived at the site, I was pleasantly surprised to see how organized the event was. The USO and Red Cross were there with food, hygiene items and a bank of computers and phones for the evacuees to utilize. The support staff had established play areas for the various aged children (everything from playpens to a bounce house to Wii) and staff to supervise them. They even had military members in place to walk the animals that were accompanying the families.

As the evacuees arrived, it was awesome to watch young soldiers, sailors and airmen assist the travel-weary women by carrying their baggage, pushing strollers and cleaning up after pets. The women were free to complete all the necessary paperwork and arrange their follow-on travel, knowing that everything else was covered, and the kids—and pets—were able to spend all their stored-up energy in a safe environment.

Except for treating some nausea and hypertension and handing out lots of Band-Aids, I provided very little patient care. In the course of the day, eight to 10 new moms and their babies came through—one just 6 days old—and I touched base with most of them to ensure they were doing OK and didn't need additional support. In general, I just watched and was so proud to be a part of this organization that sometimes can frustrate me to no end but, at the end of the day, can put together an operation to support our own that is second to none.

Although the evacuation initially added stress to an already stressful week, I am so glad I had the opportunity to assist in this massive undertaking, talk to these people, hear their stories and provide what little relief I could. It may have started as a road bump in my busy life, but it ended up being one of those experiences that will stick with me as a highlight of my time in the military.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The search continues

I am still looking for our “forever” house. My military friends will understand this.

We live in many places while serving our country. Most members of the military move every 3 to 4 years. We adapt to new communities, new cultures, new norms. Our kids adjust to new schools, new friends, new sports teams. And, through it all, we live in dorms or base housing, apartments or rental homes, and we occasionally purchase homes, usually knowing it is only for the duration of our relatively short stay in that community.

When we buy we look for something that will “do” for those few years, with a relatively short commute, safe in case we have to leave our spouse and children there alone during a deployment, something in which we can acquire some sweat equity, something with good resale potential.

Now, with a relatively short time remaining for me in the Air Force, I am considering the option of staying put in this community, allowing my hoodlums to finish high school with friends with whom they attend elementary school. The decision is tough but, when my retirement rolls around, they will be in middle school, a tough time in any child’s life and a tough time to start over.

So, we spend our weekends looking for “the one,” the house that won't just “do” for the duration of the assignment but maybe “forever” (or at least until the boy child finishes high school). We have found a few that are OK, that meet our basic needs. But we haven’t found anything yet that is on a quiet street, has enough beds and bathrooms to accommodate my parents’ frequent visits, has a backyard big enough for impromptu soccer games but not too much for me to keep mowed and a reasonable price that enables me to keep the kids in their current elementary school! Do you think I am asking too much?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.