Planning for the Future
I am into my sixth month in my role as a primary care provider and every day has been a unique and challenging experience. While enjoying my role in the corrections arena, I find myself always looking for more. Am I the only one who does this? now that I have a little experience under my belt I want to go out and prove that I can do something else. I have been looking into the Army National Guard; ironically I called the recruiter and she has yet to return my call. I have been reading books on becoming an independent practitioner with my own business with a launch date of 2012, and I have also been looking to return to school to complete my DNP.
My collaborating physician is very supportive in dispensing knowledge when I have gone to her for help but I find her at times to be discouraging of my long-term plan. Just the other day I mentioned my thoughts of returning to school because I was planning to ask her for a letter of recommendation, and she asked me how long have I been practicing. Now, I believe she will write the letter, but even though she said she meant in no way to discourage me, her words implied I needed more experience in the arena where I am currently working. Little does she know, I have never let anyone discourage me from doing something to better myself that I really want to do. Even before I mentioned to her the possibility of my returning to school, I knew it was not a good idea. I decided not to mention the idea of the possibility of owning my own business.
This past week she was on vacation and it was both exciting and fun. In the back of my mind I wondered when she returned what would she find to criticize, but to my surprise there was nothing! Until the other day; now keep in mind I am an ACNP and my specialty was to manage the acutely ill in a timely manner but the type of patients I see have chronic conditions — almost nonexistent conditions — and I have all the time in the world (so to speak) to make decisions on their care: They are in jail; where are they going?! So any time there may be something that is acute, I get excited. I had a patient who had scleral icterus, so I ordered bloodwork and educated the patient on the risks after reviewing his history and taking a physical.
I also called over my collaborating physician, who was not impressed. Her perception was that I should not get anybody alarmed until there is a reason. In corrections there are many factors that go into someone being placed in isolation if hepatitis is suspected. My collaborating physician is not warm and fuzzy and that is OK — she is only looking at the bigger picture. I can appreciate that. She is stimulating my learning and helping me to become a better clinician. I will get the results of the lab work this week and if the results are negative then I should have a plan B. She expects me to be a conscientious, cost-effective, evidence-driven practitioner and that is definitely what I expect of myself.