Full Circle...

I've had many folks ask about my job, how I like it, and how it all transpired. Well, it is actually a fairly long story but I wanted to write about it because I feel it is also a really interesting story, too. So, if it's just too much to read I don't blame you. Sometimes my eyes cross when I see a long posting to read. However, if you're interested or just curious or just a blog stalker (I know I have a few of those, too - thus far all are welcome), just read on.


In the beginning...


When I graduated from college in 2002 I had two bachelors degrees in science - nursing and psychology. Initially, I had thought I wanted to be a psych nurse. However, during my psych rotation I just did not feel it was what I wanted to do forever. I did learn in nursing school that I loved the clinic setting and that hospital nursing was just not for me. Hence, out of school I wanted to be a clinic nurse.


I found a wonderful job working at a gastroenterology office. I started off floating, then a nurse went on leave and I covered the busiest practice for about 6 months - it was so wonderful. I LOVE being super busy - I know, sad but true. It passed the day along and I genuinely felt like I was helping patients and the physician I was working with. Then the other nurse returned and I resumed my float responsibilities until a new physician came on board right out of fellowship training. He had never been in private practice. It was my job to get Dr. M up to speed on the workings of the clinic and ensure all "t's were crossed and i's were dotted". I did this. However, going from working with the busiest provider to the newest and least busiest, and not changing my pace, I quickly found I had too much time on my hands during the day.


I tried to work with my management staff to devise extra projects. I took charge or orienting and training new medical assistants and other nurses. I also took over cataloging and organizing all sample medications and working with the pharmaceutical representatives who visited the clinic. The extra projects were not always encouraged, though. At this point the clinic was looking for a new nurse practitioner and I was trying to get them to pay for my schooling so I could come back and be the clinic's NP. However, it did not work out as they wanted someone right away and schooling does take time. I did know, though, I could be a nurse practitioner. I was devising complex care plans for at least a dozen patients each day. I was just getting frustrated that my care plans had to be physician approved as some items were bordering outside my scope of RN practice.


I was at the GI clinic for three years when one day a pharma rep came in with his manager. I assisted them with something, not sure what but I guess it was kind of a big deal because the next time I saw this rep he said his boss wanted to hire me. I chuckled thinking he was totally kidding. Then he looked at me and said, "No really, we have an opening and he wants you for the job." He told me details and I agreed with him I would probably enjoy the job. I began the very long interview process. It took several months and many interviews. In the middle of it I did tell Dr. M what was transpiring and he agreed to write one of my recommendation letters. He said he was torn because he did not want to lose a great nurse but could see that I was growing beyond my role at the clinic.


I was down in Nevada attending my grandmother's funeral when I received the call from the person conducting the interviews - Mike - that I was being offered the position as pharmaceutical sales specialist. The exact office I was working in would become my biggest customer base. I took two months to train the person replacing me and devising a triage protocol book. Then my manager threw me a beautiful going away party and I went home to enjoy a long Christmas break.


In the middle...


In the new year of 2006 I began my training with my new company AZ. It was a three month orientation and training process much of which was spent in California and Delaware. I did my time traveling and T Rex Dad joined me at the end. We came home and I began my new career. I was in the field for exactly 3 weeks when Mike told me the company was restructuring and forming a new respiratory division. Since I was the newest person I would be the one transferred to that respiratory position. I will say I was pretty upset. I was a GI nurse, not a respiratory nurse. The other down side, I'd be getting a new manager and a HUGE territory. I would have the third largest territory in the country among the 400 other reps. And no partner. And my boss would not be local but a thousand miles away.


I thought long and hard. Dr. M said I was always welcome back at the clinic for any reason. However, I took a deep breath and said to Mike that I would take the transfer. Off for another 2 months of training.


The first day in my new position I decided to start with a bang and visit my biggest customer - Dr. J at the asthma clinic. I showed up bright and early on a Monday morning. He happened to be in his office and had not yet started seeing patients. I introduced myself and talked a little about my products and launched into a discussion about some clinical studies I had recently read. (Yes, I read clinic studies for fun thanks to my friend Shell). He asked about my background having looked at my card and seeing I had RN after my name. I explained where I'd worked and with whom. He knew that group. Then he asked, "Why are you doing this job?" I explained I wanted to go to nurse practitioner school and the pharma job would allow me to save money so I could do so (the pharma company paid over twice what I was making as a clinic nurse - but I did not mention that). Dr. J nodded and explained he had experience with my company (AZ) in the past having completed some of the drug studies for their products. I was intrigued by this because I knew those drug studies inside and out so I was glad to have someone who could help me learn the disease state better. I left the office feeling inspired and able to tackle the new role I had been thrust into.


As it turned out because it was a new role and territory few restrictions were placed on me. I did not have to do some of the standard things the company required because I simply could not. There was no way to make 10 customer visits in a day when I did not have 10 within a day's driving or flying distance. I still had to log 8 hours a day but I would fill those hours with other special projects. I started to get involved in asthma workshops and asthma camps. I partnered with the local lung association on a couple of projects. Then I talked to Dr. J about getting him and his partners to help me with some free asthma screening programs. As it turned out he really was a wonderful resource. Particularly after my son was born and my pediatrician (who was also a customer) told me my 9 month old son needed to see an asthma specialist. I was totally in denial thinking I was imagining his symptoms because I talked asthma all day.


Dr. J took incredible care of my little guy. He taught him how to do knuckles and exploding knuckles. To this day he still asks if he gets to go see Dr. J. Our daughter is bummed (we're not) to be totally healthy.


I was hitting a good stride with AZ being the respiratory rep. I launched a new drug and yes, Dr. J conducted some of the studies for it, too. We were nearly top in the nation. At this point I had a partner working in the eastern part of the state so I actually was able to be home every night. Then we received word the company was restructuring and going to eliminate the respiratory division. I received the call from my boss (another awesome person I was so happy to have on my side). He said I was fortunate because I had two options - take the severance package or transfer back to the GI team. He said to take a few days to consider.


I thought about it. I prayed about it. I remember taking with a dear friend. She happens to be the wife of Dr. M. I told her what was going on and she said, "You've always wanted to be a NP and you would make an exceptional one." She had a point but I had not considered this because of the financial burden it would place on our family. T Rex Dad and I held each other for a long time in our upstairs spare room - I go there sometimes to think. I simply stated, "I have to go back to school." He concurred and the decision was made. I called my boss, told him what I decided, and he wrote my first letter or recommendation for school. As it turned out, I had about 2 weeks to get all the paperwork in before the deadline for school applications. Dr. M wrote the second and Dr. J wrote the third.


On my last day with AZ I took Dr. J, his partners, and all his staff to lunch. I told them about my decision and he said, "So you're going to come work for us, right?" I replied, "I'd love to." The partners looked at me and all smiled. Of course, I thought he was just kidding. After that day, I'd see Dr. J every few months when I was at the clinic for T Rex or when I was getting my allergy shots. He'd ask about school and throw out that they needed a NP and were hoping I'd consider working with them. I started to believe he was really in earnest.


About a year before graduation I set up a clinical rotation to work with Dr. J's NP. I told him of this and he said, "Let me know if you like it and we'll talk more." My final semester I began by revisiting the GI clinic - as it happened they were looking for a second NP. They hinted at me applying for the position and I will admit, I was tempted because treating those patients came so naturally. However, it is an adult only clinic and my favorite patients are pediatrics (something I discovered being in graduate school). Plus, I was pretty certain I had a job at the asthma clinic should I want it (and I really did). Once again, I bid farewell to my old friends at the GI clinic. I told Dr. J about the GI experience and that I really wanted the job at the asthma clinic.


My time as a student at the asthma clinic was like a dream. Working with H the NP was amazing. She was so knowledgeable and experienced. She has been with the group for 13 years and came as a new grad. Most of the office staff has also been there for quite some time, too. Plus, many of them I knew from my pharma days. By the time my 5 weeks were over it was pretty much a done deal I would be joining the practice. It was just a matter of time.


Full circle...


T Rex Dad had a lovely graduation gathering for me. In attendance, Dr. J and Dr. M. They met for the first time. Then Dr. J told everyone how we met. Dr. M spoke of my days at the GI clinic. Fast forward a few weeks, things are lined up for me to begin my first day as a nurse practitioner at the asthma clinic. I would start orientation by seeing patients under Dr. J's supervision. That first morning a pharmaceutical rep showed up. As it turned out, it was Mike, the AZ person who hired me. I smiled, hugged him, and informed Dr. J of the connection. They agreed they both had exceptional taste in hiring employees. Then we all chuckled together and remarked how incredible it all came full circle.


About the job...


My job, how do I like it, you ask? I LOVE it. It is my dream job.


Fully 50% of my patient population are kids. I've already become known as a toddler whisperer. The hours are great. I work two days a week or about 16 hours a week. I get a lunch break. Plus, I have a unique perspective being the mother of an asthmatic child and having seen my child suffer a severe reaction to peanuts. My knowledge base is still rapidly growing because it is a specialty clinic and I am trained in family practice so my knowledge is more generalizable. However, I am so enjoying the learning process.


My kids are still thriving. When I leave work, I am done - nothing comes home with me. It is amazing how much more time I have for the kids, with T Rex Dad, for me. Liberating actually. I smile a lot these days. Or as T Rex says, "Mom, do you still have you grumpy face or did you put it away?"


The learning curve is steep. The physicians I'm working with are incredibly knowledgeable and phenomenal clinicians. (No, they don't read this so I'm not just saying this to earn points.) All the staff have been so kind and patient as I learn. As Dr. P, one of the partners said, "Some of us think it is more of an art. You just need to develop your particular style." Hence, I am currently developing my art and style.


The other cool aspect, they are actually encouraging me to pursue extra projects like become an asthma educator or develop protocols and templates or work on patient education. Some of these things I used to want to do at the GI clinic but not really encouraged. Seriously, my dream job. Oh, and I'll be doing asthma camp in conjunction with the lung association this summer but in the different capacity - as a nurse practitioner. Did I mention this is my dream job? And this all would probably never happened if I had not taken that pharma job or even started my career at the GI clinic.


Prologue...


I am a firm believer that if you allow, you will be guided the path you are meant. As I say, "Don't fight the river, just go where it takes you." It all happens just the way it was meant to happen, if you allow. It was not always an easy path to get there but oh so worth it.


I am most grateful to all those individuals who have inspired me and encouraged me along this path and to Him that inspired the dream and paved such a path in the first place.