I have been at Doctors Care for 14 years and have seen so many medical problems it would take many pages to list them all. Currently I am the Mental Health Medication Manager and, although I find this work rewarding, it is very challenging. I am not good at blogs, nor do I consider myself to be technologically adept. With that in mind, I am attempting to write my version of a “blog”, and since it is the first blog I have ever written my topic is, “A Day in the life of a Provider”.
7 a.m – Wake up. I try to bike to work as much as possible; it helps me maintain my sanity, but it means I have to be up earlier than I would otherwise.
Do laundry, pick up after teenagers, and feed my dog who happens to be very ill so I have to give him some extra special food to keep weight on. Get clothes ready, fill cycling pack with 20 lbs of stuff for work. Check on dog, he wags his tail, and proceeds to barf all over my cycling shoes. Clean shoes, off to work on my bike by 7:50. I climb Chatfield Dam on my bike, grateful to live in Colorado as I gaze in wonder at the Platte River, and think about my patients for the day, along with my kids, my life and all my friends at work. Cycling gives me plenty of time to think, and is my respite (along with snowboarding in the winter).
I arrive at work 8:40, change, clock in, return messages, return emails, curse and praise our new Electronic Medical Record system which helps a lot with patient care, but I still haven’t totally grasped. First patient is late; 9:00 appointment starts at 9:15, already 15 minutes behind. The next three hours consist of a blend of patients with medical and mental health problems. I see a case of depression so severe for one patient that getting out of bed is almost impossible. Medications are helping a bit but patient notes he is not taking them consistently because he can’t remember. I go to my personal store of medication boxes, and together we put his medications in labeled boxes so he can better track doses. He says he can work with this plan. Next patient is crying because of bipolar disorder and social anxiety so severe that getting out of the house to fill medications is impossible. So, we call a friend and come up with a plan to get the medication. Next patient is crying hysterically because of severe panic attacks. I walk patient through how to make a panic attack “card”, an idea I came up with using resources including deep breathing exercises, and calling a friend to help with knowing when to take medication. I let the patient know about all the resources available on this disease, and walk him through steps to deal with the next panic attack. Whew, check my time and find I am running only 10 minutes behind now. The next patient is incredibly happy that the medications are working and tells me about a recently obtained job, followed by a patient with severe bipolar disorder who is there with her boyfriend. They are so happy she is doing better and are now engaged. I enter the room to see the next patient, and get a book thrown at me by an angry ADD youngster. I think, “Oh great! I almost got knocked out by Elmo.” The youngster and I come to an agreement that we will all have a lollipop if I can have some time to talk to his mom. “How much time?” he asks.
It is only 11 a.m. My absolutely wonderful Medical Assistant that I could not do my work without tells me I have two electronic messages of urgent refills, a patient who called in tears because they forgot their appointment and needs to be seen despite no openings in the schedule, and also reminds me it is our day to water the plants in front of the building. I wonder to myself why we can’t we have plastic flowers like I have in my backyard….tacky but easy. Onto the rest of the morning’s patients which include a sore throat, severe abnormal neurological movements and more anxiety and depression.
Noon: It should be lunch but patient care is actually done at 12:25 leaving 35 minutes to run up to the Clinic department meeting which is also important. I eat on the run mostly.
1 -5 p.m. A full afternoon of patients, no open slots. By 2:00 p.m., I’ve seen someone who has a mental health disease who will be losing their home soon, and we problem solve some solutions as we discuss the medications. Social issues are interwoven with medication management on a daily basis, and life skills and coping skills are taught as needed. Working with emotions ranging from happy to sad to elation to crying all day makes me in dire need of something……like COFFEE. I look at my medical assistant without saying a word and she says, “If you see room 7, I’ll get the coffee”. We have worked together for five years. She is my right arm and we are a well-oiled team. I come around the corner and am greeted with a huge hug and scream of, “Donna!” from a 16 year-old patient who I have seen since age 3. She says rather than draw me a picture like she did when she was little she brought me her latest high school picture. She says she misses me and wishes I would talk to her mom to explain why it is okay for her to date boys. They are from Vietnam, and I look over at her mother and see what I call “the mother look” as she rolls her eyes to me, pleading for help. I stop dead in my tracks. This is it. This is why I practice medicine. No matter what culture you are or where you are from, we all want the best for our kids. I laugh as I know the mother look, and the mom laughs, too. I am happy. I have had a profound effect on this family’s life and they on mine. I can’t stop smiling the rest of the afternoon which is packed with the same type of patients that filled the morning sans the child with the great right arm and the Elmo book.
5:00 – 6:30 p.m. Finishing patient care, followed by charting on Electronic Medical records which takes a significant amount of time due to my patient load and content. I return phone calls, write out paperwork, return endless emails, sifting out what are immediate priorities, refill medication, call patients about overusing medications, have difficult conversations about folks taking better care of themselves and have good conversations about the progress patients are making.
6:30-7:30 Ride home from work. Thoughts of the day fill my head. Now tons of people are on the Platte River Trail and all are passing me as I am TIRED. I climb the Chatfield Dam, take a look at the lake, and think about all the good that happened today. What I want now is a nice cooling rain as the skies open up and I get to ride home in rain and cool off nicely.
7:30 Open the door, teenagers assault me with questions from the day and tell me how their lives went. Check my phone, three messages from coworkers stating what a hectic day it was, and how grateful they are that we work together, which makes me smile. I step out onto my deck not wanting to do anything but eat a burger and watch TV, knowing I will have salad and finish up work from home. Along comes the dog, wagging his tail. He comes up to me and barfs on my cycling shoes. The circle is now complete for the day.
Blog post contributed by Doctors Care Mental Health Medication Manager, Donna Nelligan, PA-C.