Heading to Haiti: February 15, 2010 Please Pray

Dear Friends Family January 20, 2010

I am the passenger in my vehicle as we are speeding down I-24 toward Congressman’s Whitfield’s office to see Andrea P’Pool who is my angel at this point and making sure my passport (that had my married name on it) is taken care of and issued in 2 days. It could have been issued yesterday if I could have driven to Chicago/New Orleans (unfortunately, I had to be home for EK at 3 pm, therefore traveling to Chicago or New Orleans was out of the question)! I feel the need to share what only God could do the past couple of days of my life. Doors and opportunities have simply lined up, ready for me to step through.

As most of you know I lost my job last Wednesday unexpectedly. One day prior to my dismissal, an earthquake devastated Haiti. It was almost immediate that while in my pity party for approximately 24 hours, I felt God tugging on my heart to “get up and go to Haiti”. Just so happens that during a women’s conference this weekend at Heartland Worship Center I felt an overwhelming calling to do as I was being instructed. Not an easy pill for me to swallow, as many of you know: I am not famous for obeying God’s clearly obvious signs he gives me!! I wrangled with the idea and how on earth I could afford it, the children, the student loans that are scheduled to begin February 1, the bills, the inconvenience of leaving, worrying about EK and if she might be ok with me gone, the now necessary job search I must do…..but as God would have it, he gave me one more chance Monday morning at 7:30 am to commit to doing something for others, instead of whining about how unfair my situation was.

The details of what I was doing and whom I was meeting with are not important (actually they are, but in the essence of time, I will leave that information for another time). The bottom line is that after discussing my situation professionally and putting feelers out for a job; I mentioned to Bonnie Schrock, whom if you don’t already know is VP of Patient Services at Western Baptist Hospital here in Paducah, KY; that I have been convicted to go to Haiti but couldn’t figure out how to afford it or even whom to contact……

Fast forward a few hours; my email alerts me that I have an email and an anonymous sponsor is underwriting the cost of the airline tickets to get me to Haiti (no matter how long it takes to get me over there), and on top of that WBH is donating supplies needed for the specific group I would be traveling with. All I needed to do was find a medical team to take me!! If you don’t think God moves mountains….all I did was mention to Bonnie my conviction….God took over from there.

Finding a medical mission team has been extremely difficult that could use me. Who would have imagined? I have now been confirmed to leave with Medical Missionaries. Please see the link: http://www.medicalmissionaries.org

Dr. Irwin confirmed this morning that I will be leaving February 15 and returning around March 8/9. I don’t have the logistics yet. I will be doing whatever is needed. A surgical team left today.

Therefore in the spirit of giving, U.S. Bank and Susan Ybarzabal have helped me set up an account earmarked only for Haiti Relief. If anyone is interested in donating (no donation is too small), I will have the contact information listed below. Be aware, that the donation is NOT tax deductible, because I am not a (not-for profit organization). Actually I am, but not to the government!! HA! Maybe that is in my future, to run a non-profit relief agency?!….ALL donations will be used for whatever the Medical Missionaries team tells me we need for the Haitians. I wanted to set something up that has a paper trail if anyone ever wanted to see my receipts or donations. If you have a substantial donation and need a tax deduction, then I would suggest donating to Medical Missionaries (the information is on their website) or to the agency of your choice.

I am scared, uncertain, not sure I have the proper clothing and shoes, broken hearted before I even get there (praying to God that he DOES NOT convict me to bring home 4 Haitian babies (one on each hip, back and front)!!!, excited, wondering what in the world have I gotten myself into and overwhelmed by God’s power to open up doors that I am used to kicking in!! How much easier is it when you do as instructed, instead of following your own wants and desires. I have been humbled twice in 7 days. Once in humiliation, the other in God’s Grace…I don’t have to tell you which one is more gratifying. It took me 44 years to listen to the whispers in my heart….

The fury has begun, what I (God has) have accomplished in 48 hours in incredible! Please pray that the date does not change and we are allowed to enter Haiti as planned. I am in the process of taking care of my personal affairs (in case the unthinkable happens). That has been an eye opening experience.

My goal is to raise $5,000 for extra supplies, socks, shoes whatever it is I am told is needed. If you know me at all, you know I am like a dog with a bone when my mind gets set to something!! True North Yoga is going to help me with fundraising as well (check out their Face book page for details).

Below is the contact information for donations. Please don’t’ hesitate to contact me with any questions.

Dani Williamson

Philippians 4:13

U. S. Bank has an account set up under:

Dani Williamson

"Haiti Relief"

Susan Ybarzabal is my banker in charge.

(270) 575-5578

Send donations to the address below, or go to any U.S. Bank branch and make a donation under my name with Haiti Relief in the “Memo” line.

U. S. Bank

333 Broadway

Paducah, KY 42001

Attention: Susan Ybarzabal

Donation to:

Dani Williamson

"Haiti Relief”

Rising from the Ashes.....Once again!!

January 13, 2010

So, as of 1700 this afternoon I am no longer employed as an ER NP. I was in the middle of seeing patients when asked to go to the lounge with two of the doctors. I was released of my duties as an NP. I must say I was shocked that after only 33 shifts a decision like that could be fairly made. It seems that I am the only person that has been hired as a mid-level in the ER who has not done clinical rotations of some sort in the ER. My CNM/FNP background did not train me for the acute care and more detailed knowledge needed apparently to be able to jump right in without asking questions and asking for help (which I was specifically told the first day on the job was something to never be scared to do: asking questions was encouraged). I specifically asked if I had any patient complaints against me. Apparently not. I was told (in the letter that had been prepared for me) that the partners felt that the “amount of time it will take for you to become familiar with patient care in the Emergency Department, and to function at a level commensurate with the other mid-levels will be too lengthy to allow continued affiliation with our group.” I was told that if it took 3 months, 6 months or a year to train me, that was too much time and they simply could not do that.

I prayed the entire time for God to keep the tears from flowing. As the doctor was talking: I was thinking about the 2,500 monthly in student loans that begins in February, the rent I am paying currently, the bills due, the humiliation of having to tell everyone I was fired from a job after 33 days for not learning the skills as quickly as the partners desired (or at least that is what they told me, although I wonder if there is something more they aren’t saying). Somehow God gave me the strength to say “you have made a huge mistake”, “I love this job, and was in this career for the long haul, I turned down two job offers with contracts to move to Paducah to challenge myself in a field I was not trained for.” I was told immediately by one of the physicians that “no one loves their job in the ER”, people just do it because they have to. I completely disagreed and shared that I loved the pace (and was told maybe that’s what I loved, but again no one loves their job in the ER)!! WRONG, I told them that I am too old to work in a job that I don’t love. I did love this job and felt that I was never properly trained (2 hours of following another NP doesn’t count as orientation) and therefore I was at a disadvantage from the beginning. Not to mention that I came in with Women’s Health and Family Practice as my background. They understood that, but felt that with the understaffing issues that they currently battle with, I was basically only making things harder for the doctors (by being a new graduate and needing to ask questions, that I thought would make for good patient care) especially when there would only be one doctor and me scheduled. I was dumbfounded! And am still in shock…for many reasons!

I had been able to develop my own little niche of women’s health in the ER. It was often that when a women’s health issue came through I got the chart handed to me. And I loved treating those patients. And the patients loved me. I was thrilled to get to humanize the ER for a very short time indeed. I am finding comfort in the fact that even though I might have been fired today, I know for a fact (from patient’s mouths as well as from other nurses telling me) that I made a difference in the lives of my patients. Maybe I am not cynical enough for the ER, maybe I fall into some of the frequent flyers traps of wanting more pain meds, maybe I hugged a patient on occasion, or asked too many questions to the RN’s making me look like I didn’t know what I was doing (I am a new graduate after all, maybe I was to “touchy, feely” with the staff my first week on the job (touching is not encouraged, I was once told to stand “2” floor squares away from a doctor), I never missed a shift, came early, stayed late and spent hours putting together a “cheat sheet” of ER notes so that I could quickly try to know what 5 different doctors might want to order for different ER complaints (that work won’t be in vain, I will make sure students, new NP’s, and myself have that information to use in the future).

I have to believe that God is telling me loud and clear to take this time to spend with my daughter. Two days ago she somehow got confused when walking out of the house after dropping off her things from school (like she has done since November). Instead of turning left off of our porch to walk 3 doors down to the babysitter (and the woman that has been like a mother to me for years): she somehow turned right and began walking, she became disoriented and ended up near the middle school (about a ¼ mile away), phone in her pocket (that was dead), she was scared and trying to get to a gas station she saw: when a man and his family stopped to ask her what she was doing walking (in the freezing cold). She was apparently scared and disoriented and he told her that he was a firefighter and youth counselor, and thought he should call the police to help her get home. EK says she got scared and got into the car with him and his family and they brought her home. The babysitter was heading next door to get her because she wasn’t answering her phone and as she was walking out the door, EK pulled up in the car with a stranger!! He told her what had transpired and how worried he was for EK and “something didn’t seem right”. He swore he didn’t harm her and brought her straight home (she did remember where she lived). Apparently EK was so nervous, she was soaking wet and exhausted. She had her bag of books with her she was taking to the sitter. What happened to her? How could she not make it 3 doors down? I have been horrified and had her immediately (as soon as I found out about the incident) taken to the ER to be evaluated for any sexual assault or drugs in her system. Everything was clean. No signs of assault. Even if the man who brought her home didn’t harm her, who knew what happened to her from our porch to the moment she was picked up? I am devastated; she has been trained not to ever get in the car with a stranger. She said when he said he needed to call the police, she thought it safer to go with him and his family than to have the police involved!! I have cried more tears the last two days than I have cried in a long time. Anyone who knows my history with EK (read the Marching to the Beat of a Different Drummer blog) knows I have fought for her safety and security and advancement in school since she was in first grade. She was given a bit of freedom in the afternoons before she would walk to the sitter (the sitter had just spoken to her on the phone), to try to increase her self- confidence. Now, we are back to square one. Did she have a seizure, did she just get confused and not have the maturity to turn around as soon as she discovered she was heading in the wrong direction, is there an underlying process we aren’t aware of? Whatever happened Monday may never be known, but the first person I called tonight while walking out of the hospital with my tail tucked and humiliated was my childhood friend Margo who shared with me that possibly this is God’s way of telling me that the 1pm-1am shift is not conducive to raising a daughter that “Marches to the Beat of a Different Drummer”….maybe she needs her mom on a more consistent schedule. She showed up here tonight and listened as I cried about my pity party (still wearing my scrubs and nametag from the hospital). The she out of the blue said, “Dani, it could be so much worse”….we could be searching for my baby tonight, we could be in the hospital with her, or worse we could be at the funeral home tonight having visitation for her very short life. If that doesn’t bring my “firing “ into perspective, nothing does….

Therefore, 2010 has not at all been what I had planned (is it ever what we planned?), I have had some rather disturbing personal issues come to light, relationship issues (things are on the upswing in that department), moved twice (to have a better place for me to sleep when coming in from the ER (HA!), car broken down, favorite Uncle died this week, grandmother had a stroke (light one) this week, daughter disoriented this week and riding around with a strange family (my family is strange enough, no need to find another one to ride around with), got fired today….but guess what? My baby girl is lying beside me (snoring none the less) while I am listening to Nancy Grace, my cat is on the foot of the bed and my dog is on the couch snoring as well….my friends have called, come over, my dad and stepmom brought pizza tonight and two bottles of wine (still unopened)….and I am still alive (I know I am because I have been sobbing and my heart hurts as I type this). Damaged goods (yes Ralph it’s true), bruise, ego destroyed, confidence shaken, questioning my education, my decision to take on a challenge people told me I was crazy to do, my decision to move home and wondering what the silver lining is in the events of this week…..

Unbeknownst to me as to why, I posted this quote this morning on my Face book page: maybe a God thing huh?

"You are braver than you believe, and stronger than you seem, and smarter than you think." ~A. A. Milne

Dani

10 Things I have Learned/Learning in the ER: Some are easier than others!!

Things I have learned and or learning in the ER:

!. The definition of a fungating carcinoma (look it up and look at a picture)

2. That it is impossible to diagnose everyone with something…sometimes “of unknown etiology” is the best you can do…arrrrggghhh!!

3. If you can see a patient , get lab results and/or x-ray results, and get them discharged in under two hours…you have hit a home run!

4. That the patients WILL NOT stop coming in the door, therefore it is up to me to go get something to eat or go to the bathroom…because there will never be any downtime!

5. Just LISTENING to a patient apparently makes them feel better…I have had several patients and their families tell me I am a great listener and appear to care…of course all of the caring in the world is useless if I can’t figure out what is actually wrong with them!! (See number 2)

6. A seemingly harmless tooth abcess can actually turn into a major abcess that prompts the radiologist to call looking for the one (me) who ordered the CT of the head….lesson learned! If in doubt, order the darn test!! It’s never good when the radiologist calls to give the report over the phone instead of wait to dictate it!!

7. Just because someone doesn’t act like they are in much pain (even if a horse rolls over the top of them), they just might actually have their whole darn elbow broken off!! (Another lesson learned, don’t always trust a patient if they say they don’t really hurt)!

8. Apparently one can be too friendly to people (not patients)…and get themselves in trouble without even realizing what happened….(very hard lesson learned)

9. Do not EVER as a new NP pick up the chart that says room 1!! Room one if for the very sick and the trauma patients…embarrassing lesson learned!!

10. Having a background in women’s health has been what has made me feel confident on the days that I just want to go cry in the bathroom (and sometimes I do). My women’s health patients give me the incentive to carry on and hold my head up when I feel inadequate….

Baptism by Fire...My FIRST day as a nurse practitioner in the ER!!

My FIRST Day as a Nurse Practitioner in the Emergency Room!

November 23, 2009 at 1:00 pm began the first day of my new career; a career that I had been preparing for almost non-stop the last 4 years. It was with great uncertainty that I walked into the emergency room with my backpack full of reference books, blank notebooks and Soy Joy bars for nutrition and the trusty lavender colored stethoscope I used all during my clinical rotations at Vanderbilt.

Baptism by Fire doesn’t even come close to the next 7 days or 84 + hours I spent in the ER praying for a simple otitis media, sore throat or sprained ankle to pop up on the patient screen. Injuries or disease processes that I felt confident I could assess, diagnose and treat as a newly graduated NP. I was hoping that I could at least be orientated for a day before being set loose to stumble my way through the maze of beds, rooms, and hallways that make up the ER at WBH. As luck would have it (and I am certain it isn’t because I seemed so competent), I observed 3 patients and was basically on my own. Words can’t describe the terror that shot through my body as a fellow NP handed me a chart and said “Ok Dani, go assess this patient and do the physical, then come back and dictate his chart”! WHAT??? I haven’t even learned how to use the phone for dictating yet?

Case 1: Patient #1!!

CC: Neck pain x 2 days

My first patient as a newly certified NP!! I will never forget him as long as I live. Neck pain and stiffness x 2 days. No known injury, woke up with stiffness across the shoulders and down the neck. Do you do a CT of the C-spine if no known injury is documented? Do you simply examine and make the diagnosis of “Acute cervical strain” and either prescribe a muscle relaxer or have the patient take OTC NSAID’s for pain? All questions that I was unsure of (a feeling I am becoming VERY familiar with)!

What would you do?

As I was leaving the room, he told me how nice I was and could tell I loved my job (a job that wasn’t even 2 hours old)! Certain I shouldn’t tell him he was my FIRST patient ever, I decided to tell him anyway. He told me he was going to tell anyone he knew that had to come to the ER to ask for the “red headed lady”…oh my….

And so, I began my new career with a satisfied patient (not often is an ER patient happy, I have discovered) and a totally botched up job on the dictation!

The learning curve is steep (Mt. Everest steep), the staff and doctors have been great, the hours are long and the patients don’t ever stop coming through the door (therefore there is NEVER a good time to eat or pee)……I love it!

Tomorrow's the day I've worked toward for 4 years....

So, here I sit on the last day before I become an employed nurse practitioner. A goal I have worked toward for the last 4 years after I went back to school to get my pre-requisites that I needed to start nursing school. Pre-requisites that my MS in Fashion Design didn't require!! (Not much microbiology, chemistry, A/P, statistics needed in fashion)!

I am quietly reflecting (as I drink coffee and listen to my Bulldog Harlan snore beside me) on the path that landed me where I am at this time in my life. Five years ago I was recently divorced with two children (ages 7 and 8), just went through the emotional distress of closing my beloved maternity and children's retail store of 11 years, trying to survive while teaching yoga and swallowing my pride to go to the state of KY and ask for food stamps and insurance for my children, starting community college to take classes required to apply for Vanderbilt School of Nursing, struggling with a new relationship, applying for VUSN, getting accepted to VUSN (incredible), selling the only home my children had ever known, moving our life to Nashville in a U-Haul and starting the nursing program that I often thought must have made a mistake when they accepted the country girl from Gilbertsville, KY with a degree in fashion design.... on food stamps and TN Care (probably one of the few at Vandy). So, here I sit on a Sunday morning with a lifetime of stories to tell about the triumph, tragedies, tears, turmoil and tenacity of pulling oneself from their bootstraps in order to stand tall again!

I am debating on how to spend my final eve of unemployment. My instinct says study, study, study for the unknown of the ER. My friends say relax, go in to work a clean slate tomorrow and enjoy my day , my dog says take me to the park and throw a ball. Maybe I will balance my day out with a little of each.

I have been blessed more than anyone can ever imagine. It hasn't been easy, and I don't expect it to get any easier (although a paycheck will certainly be a plus). But, it has certainly been eventful and the memories I have made can never be replaced!! I hope that someday when I am retired (only after my 174,000 in student loan debt is repayed) I can use these past 5 years of rebuilding my life (and my children's) as a tool to encourage others to NEVER GIVE UP!! Down DOES NOT mean out!!

Thanks to all of you for your prayers (especially when I would send out mass messages for prayer warriors during exams, boards etc), emails, cards and occasional care packages of food, money, clothes! I couldn't have gotten through the past few years without ALL of you and my faith in God!

Onward to the next chapter.....

Love to you all,

Dani Williamson MSN, CNM, NP-C

"I Can Do All Things Through Christ Who Strengthens Me"

Philippians 4:13

One week from today.....

So here I sit in my new tiny, tiny 900sf home I have rented. Most of my boxes are unpacked (not a big deal since the majority of my life is in storage!). I got my daughter up at 5:50 am today to get ready for her first day of school, we got there at 7:00 am and they wouldn't let her start since I had failed to turn in her paperwork last Friday!! Can you imagine? Not taking a child wanting to start school! Well, probably not wanting to, but certainly up and dressed and not happy about being turned away! So, we have had a good day hanging out and getting ready for her second first day at LOMS!!

I went and opened my banking accounts, saw the CPA and found out how much to expect to be paid to Uncle Sam (at least 36%) of my income!! Since I am an "independent contractor" I am self employed and pay more taxes than if I were "employed"! So, one paycheck for bills, one for student loans and one for the IRS!!

One week from today at 6:30 pm I start my first shift as the newest ER NP (with NO ER experience just women's health and family practice). I am a nervous wreck! Words can't even describe the turmoil in my stomach at this time. I pray to God it isn't as traumatic as I am expecting! Looks like I will be on the whole week of Thanksgiving and then off for a week.

Looking forward to next Tuesday making my first official blog entry as an NP!

Oh and did I mention that I have NEVER dictated a thing in my life, and that is ALL you do at the hospital! I am horrified. And must go practice my "speed dictation"!! I pity the transcriptionist at the other end of my dictation the first week or so! My mom has transcribed for 30 plus years, she has told me horror stories of new graduates!

Moving Day 2009......

Harlan Howard Jones and me on the way to KY.....more later on the events of the moving day!