Once again... I have found myself 3 weeks status post my last entry. Well, hello 2012. I am really hoping you are going to be better than your predecessor.
I've officially been a primary care provider for two entire months. I've been living in Portland for 86 days.
Being a primary care provider has been an interesting ride thus far. I am thankful on a daily basis that I have put in my time as an ER nurse. In the emergency department, you quickly learn the tools of deciphering if someone was FOS and drug seeking. I could smell a drug seeker from a mile away... but at the end of the day, it wasn't ever my decision to order a narcotic... my job was to get it out of a pixis station where I had to count how many pills or vials were in the drawer and then waste with another RN the portion that was ungiven to the patient. Now, I hold the cards. I decide whether or not to prescribe pain medication, how much, length of time and if the patient returns to my exam room... whether or not I'll authorize more refills. With this power comes a great deal of misery. I have already had one irate patient call the office repeatedly, yell and hang up on the front desk staff, angry that I refuse to refill his vicodin... last week I was seeing a gentleman as an ER follow up only to find he wanted refills on Percocet and Methadone... I told him I wouldn't charge him for the visit but I could not help him... this of course was followed by a long diatrabe of: how could I just let him suffer like this? and oddly enough, he was moving in a few weeks and why couldn't I just help him out this one time? He was going to go into withdrawl... wasn't I concerned? No sir, I am not concerned... now this is the shit they don't teach you in school.
Portland continues to be a place I enjoy... but it still hasn't totally sunk in that I live here. The other night my friends Amiee and Matt and I had an inkling for something sweet... Amiee and I went out to a neighborhood coffee shop/dessert cafe called Palio Dessert and Expresso House. Normally, I try to steer clear from sugar (key word being 'try') but I was overcome by their blackberry cobbler. Amiee tried the vegan oat cake and Matt the German Chocolate cake... but the best part of this entire experience was observing a fellow patron of this said dessert spot. A man in his late 30s, heavy set, bearded (but that goes without saying in Portland... everyone has a beard here, even the women), was sitting at a table blowing bubbles. Honest to God bubbles. Nothing ceases to amaze me in this town.
My dear friend Felice and I started a tradition of focusing on one word for the new year in place of making a list of resolutions. This year I've decided that my word is: "proactive". The impetus for this word is that I have realized I need to really embrace this transition to a new city and attempt to form a community and to start actually living IN Portland. In light of this proactivity, I have decided to join two meet up groups: a running/beer drinking group and a cycling group. Mind you... this isn't my first rodeo with meet up groups... I joined like six of them in Seattle but I have yet to actually show up to one event. So tomorrow, January 4 2012... I am going to join the NoPo Run Club for a 5k and beers.
