My Nursing Thesis is Published

Pamela, APRN

Jan 1

September 1998 - New England, USA

After I completed my thesis in graduate school, my advisers encouraged me to submit an article summarizing my research findings for publication. The unwieldy title of my thesis was, "Coping Strategies of Successful Caregivers of Nonambulatory Family Members". Nonambulatory means that the person is unable to walk.

My parents and one of my patients that I had followed as a visiting nurse inspired me to do the research. After my mother had a major stroke which left her paralyzed on one side and with the mind of a ten-year-old, my dad stepped up to the plate and cheerfully became her full-time caregiver. He had to assist her in the shower, dress her, learn to style her hair, do the grocery shopping, cook, drive, and pay the bills. Prior to her stroke, my mother was an avid artist and gardener. She grieved that she could no longer do these hobbies. The Lord took her home to heaven to be with Him five years after her stroke. I thanked God that she was no longer suffering.

"...Death is swallowed up in victory...But thanks be to God, who giveth us the victory through our Lord Jesus Christ." I Corinthians 15:54, 57 (KJV)

My parents were my inspiration for my research.

Another patient I visited at home was an elderly lady who was paralyzed from the waist down from a blood clot that went to her spine. Her husband faithfully learned how to provide all of her care and purchased a van equipped with a wheelchair lift. He struggled at times with sadness over his wife's loss of many abilities, but he did all the household tasks and driving. Other patients with similar disabilities ended up being admitted to a nursing home because their caregiver simply couldn't cope with all the extra responsibilities.

During my research, I interviewed nine caregivers of family members who were unable to walk and then summarized their problems and coping strategies. I repeated similar research that was done with caregivers of home hospice patients to see if they had the same problems and used the same or different coping strategies. A comparison of the two groups showed they only had one problem in common (stress) and three coping strategies (social support, cognitive reformulation, and respite). I developed an educational handout for nurses to give new caregivers of family members who were unable to walk.

I submitted my research article to The Nurse Practitioner journal and was thrilled when they accepted part of it for publication. They condensed my year of research and 48-page thesis into a mere three paragraphs. Such is the world of publishing... They included it under Practice Pointers and named it Lending a hand to caregivers.

"If you need to counsel a caregiver of a family member who has recently lost the ability to walk, use these suggestions to ease the load. First, tell him not to try to give care alone, but to ask for and accept help from family, friends, and health care professionals. To relieve stress, suggest that he try exercise, massage, eating out, music, prayer, reading, and napping.

Make sure he asks a physical therapist for assistance in choosing a wheelchair, if his family member can use one. Suggest using cordless and cellular phones, a lifeline necklace, and a pager to communicate with his loved ones when the caregiver is out of the house.

Finally, when traveling, recommend the caregiver pack a travel kit with a list of medications, provider phone numbers, straws, wipes, and other supplies."

I can't recall the last time I saw a layperson use a pager, and cordless landlines are disappearing rapidly. Cell phones are commonplace now, but they were rare in 1998.

After I entered the full-time work world as a nurse practitioner, life seemed to become too busy to continue to do research. However, I have participated in the Nurse's Health Study 2 since 1989 conducted by the Harvard School of Public Health. Their findings collected from surveys every two years of thousands of nurses have contributed significantly to women's health. http://nurseshealthstudy.org If you are a nurse and were born after 1964 and live in the USA, they are looking for participants to join Nurse's Health Study 3. I hope you will do so and continue this wonderful research that was begun in 1979.

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The Nomadic Pediatrician: 2022 in Review

The Nomadic Pediatrician

Dec 31

Y'all, it's the end of 2022. I wrote this preemptively sitting in an Airport Lounge sipping an Espresso Martini waiting for a flight back from vacation in Cancun, MX to Boston, MA. I'm still here, and I'm still The Nomadic Pediatrician. What. A. Party.

I have loved every damn minute of it, am NOT sick of the travel, AM sad to ever have to move on from my new friends and the loveliest state of Maine, and always annoyed by the communal washing machine... But, It's time to reveal the biggest surprise which will come with more info later... In July 2023 I will be starting a new chapter in my life at my top choice of places:

Neonatal-Perinatal Medicine Fellowship at Children's Mercy in Kansas City, MO

If you had told me when I finished Residency in 2020 that I would be wandering around as The Nomadic Pediatrician for this long after training, I would have never believed you. It has been an amazing rush and this last year has been such a great period of growth and changes in career trajectory for me. I have had some unreal experiences and seen some of the most majestic parts of the United States.

For anyone following along, I appreciate all of you so much and all of the support! I started this blog just for fun in the summer of 2020 to show my mom's pictures of Huntsville, Texas, and it has grown so much. I've also branched out with some Locum Tenens Agency PR departments to do some interviews for social media channels and podcasts, including Student Doctor Network. I am always so humbled by the continued journey and excited to see where things will take me. I spent a majority of 2022 in Augusta, Maine and fell in love so desperately with the state.

On January 1st, 2022 I woke up in North Dakota
On December 31st, 2022 I road into the new year with my closest (and i might dare to say rowdiest) bunch of nurses in Central Maine.

But, things are complicated, so for many reasons, including missing the intensity and acuity of sick newborns, I applied for Physician Fellowship Training to sub-specialize in the care of sick and premature babies: I'm literally going to save babies for a living, and my heart is so excited, nervous and ridiculously anxious. But to re-cap another FULL year doing professional locum tenens work, here goes! I share the transparency and numbers for anyone interested in embarking on a similarly incredible journey. As change in my life approaches, I am indeed regretful to take a hiatus from the adventure, but... It's only a few years, right?

The Stats

State Medical Licenses = 10 (NM, TX, ME, CA, ND, MO, PA, WI, NC, MA) - Added 2 this year!
DEA Certificates = 5 - Added 1 this year!
States Worked In = 6 (ME, NM, NC, WI, MA, CA) - Added 1 this year!
Total Hospitals Worked In To Date = 13 (+1 clinic)

Nights on the Road = 359 (YES, Three-hundred fifty-nine)
State with the Most Work = ME (139 Days)
State with the Least Work = MA (1 Days)
Rough Total Time Worked = 2755 Hours (~50 Hours/Week)

Total Loans Paid Off = >$300K since Residency Graduation in 2020
Total Reimbursed Value in 2022 = >$30K
Vacations:
- Washington DC (March)
- Seattle (May)
- Acadia National Park (June)
- Waterfall Trip in Central Maine (July)
- Northern Maine and Santa Fe, New Mexico (August)
- Salt Lake City (November)
- Cancun (December)
- AND for the first time in years I got to celebrate my birthday with my best friend in Oakland in July!
Podcast Appearances = 5

Hilton Honors Points = 2 Million (One year closer to Lifetime Diamond!)
Marriott Points = 300 K (Titanium Elite )
Favorite Car Rental = National (Executive Elite)

medical (and not) Highlights

Intubated my first baby at a neonatal code under pressure at hour 70 of 72 of an in-house crazy shift
Participated and helped to problem-solve the delivery of a baby with a myelomeningocele at a community hospital
Explored every inch of the beautiful state of Maine
Worked near my family in Califronia
Took sometime off for vacations as above
Had some amazing pork steaks in St. Louis, Missouri
Explored some amazing desert finds and art in Santa Fe, New Mexico
Listened to deep accents in Whiteville, North Carolina
Placed my first chest tube for a pneumothorax
Discovered my love for and obscession with alpacas
Made the best of friends and coworkers throughout the country and matched into the next chapter of my life in Neonatology

Looking forward...

The future of the Nomadic Pediatrician is always unsure. Recently I met a hospitalist that told me she couldn't do what I do because she needs Stability. I have become used to my life, I am stable in instability. I live in hotels, I travel with all I own, and I thrive in instability realizing that everything is more similar than you think. People are the same no matter where you go, hotels are similar, and Medicine is Medicine. I have honed skills of adaptation and flexibility and at the same time, am more anxious of each new intense job and continually pushing my boundaries and realizing my limitations. I am still a new doctor and still have so much to learn and have become incredibly humbled. I don't know if they'll ever read it, but the most significant part of my last year was meeting, working with and learning from so many brilliant doctors all over the country: Drs. Harpell, Snow, Walton, Montgomery, Abbey, Baker, Parsons, Habib, Monaco, George, Bossie, Gruchala, Ellis, Wathen, Eyman, Carter, Singh, Abebe, Simmons, Avula, Srindhi, Tompkins, LeBlond, Walsh, Perfosky, Mittal... The list could honestly go on and on, but if anything, I have learned in the last year that I know so little, and it is an amazing and scary feeling. I get really emotional writing this thinking about all of these people and how much they have changed my life.

In July 2023 I will officially be taking a break from working as a traveling locum tenens doctor as I spend the next 36 months working on learning the art of Neonatal-Perinatal Medicine (aka Neonatology). Until then, I will be working primarily with Mayo Clinic in Wisconsin, Tufts in Boston and Maine General in Maine. I plan to take a large vacation in May-June internationally after grinding out the next few months of working >20 shifts per month with multiples being 24 hour in-house shifts. The future is uncertain but I am excited and hope you are too. I am not against settling down, but I will never settle; and, I do hope to return one day to the work I have come to love meeting new people and seeing new things all over the country. Stay tuned, big things are in the works!

Sincerely, The Nomadic Pediatrician.