Editor’s Note: To conclude our NP Week celebration, we are posting articles that show the daily life for three nurse practitioners who work in different settings. We think you will enjoy this look into the different roles NPs play in our nation’s healthcare industry. You can find the other Day in the Life articles as well as all our NP Week content on our NP Week 2012 page.
About the Author
Dr. Scharmaine Lawson-Baker recently became a fellow of the American Academy of Nurse Practitioners (FAANP). In 2004, she opened the first NP housecall practice in New Orleans. She has been interviewed by Katie Couric on CBS Evening News for her innovative ways to improve access to healthcare, especially after Hurricane KATRINA. Highly sought after for keynote speaking and countless other media venues, she is the CEO of Advanced Clinical Consultants and owner of The Housecall Course.
Morning
5 a.m.: I’m awakened by my daily Bruno Mars tune, and I instinctively check emails that have arrived during the night. I have 30 new messages but nothing urgent. I religiously check my email because my office’s answering service is tied to my account.
6 a.m.: I fix a quick breakfast for the family and color a few pictures with my two-year-old.
7 a.m.: I grab my grapes, almonds, and protein shake while balancing my laptop and gym bag on the other shoulder.
7:30 a.m.: I arrive at the office and check my schedule. I inspect my medical bag for adequate gauze, alcohol pads, and Otoscope tips before checking my email again.
8 a.m.: The office manager gives me a quick rundown of the patients who will be home today. She also tells me about any specific instructions for the house call, such as who is leaving their door open, who wants me to enter through the carport while ignoring the pitbull, and who has asked that I grab the mail from the mailbox on the way in.
8:45 a.m.: I drink a protein shake while on a conference call with an NP who is starting her first house call practice. She has a few questions about how to sell her vision to her new collaborating physician.
9 a.m.: I’m at my first home. Even though I was told to just walk in, I always announce that I am entering, ring the bell, or knock on the door prior to going into the home. One must always remember that when you enter someone’s home, it is their territory and it must be respected. This is an important pearl that must never be forgotten. It is the hallmark distinction between a traditional clinic visit and a house call.
9:45 a.m.: I stop to get gas and some bottled water for the tiny ice chest I keep in my care. I always try to be prepared for the balmy N’awlins climate. While the gas is pumping, I use these few minutes to update the business Facebook and Twitter accounts, check in at the office, and call my next patient to let her know I am 15 minutes out. I also scroll through lab results and messages on my iPad.
10 a.m.: I arrive at the next home and immediately snatch the mail from the mailbox. I head toward the front door that is almost hidden behind the most beautiful Crape Myrtle ever imagined. Even though the patient is bed-bound from debilitating rheumatoid arthritis, she has her sitter prepare my favorite cup of mint tea and Lorna Dune cookies as a small thank you for bringing the mail. We review her labs and I electronically prescribe her heart medicines before it’s time to go. With Gino the persian cat lightly whisking his tail past my calf, I reach across the bed rail for a warm hug before dashing off to the next patient. I love house calls because you get to interact with the entire family and the environment, which often includes pets.
10:30 a.m.: I get to the home of a new patient and there are so many people in the home it is reminiscent of a family reunion. I am warmly greeted and offered lunch with a cold Sprite. I politely decline the lunch, but sip on the Sprite while gathering the patient history from the family. The patient is unable to speak secondary to his recent cerebral vascular accident (CVA). The family is extremely grateful for my visit because the patient has vehemently refused to go to his usual primary care provider. The family found our services on the internet, and his appointment was scheduled within 48 hours. I love supportive families because they make my job easier. They work together with me to develop a focused and deliberate plan of action to ensure speedy recovery to optimal health for their beloved patriarch.
Afternoon
Noon: I’m done for the day and I’m waiting at my favorite po-boy place for a local vendor who is interested in partnering with our company. I’m excited because this is a win-win situation. The best part about owning a house call practice, aside from the patient care, is the networking and creative meetings that are held over scrumptious southern cuisine. Something good always comes from a meeting that includes a cup of gumbo. This is what we do here in New Orleans. We eat. We make a deal. We eat some more. Isn’t that what negotiations are all about? You’re presenting your interpretation of how to make healthcare more accessible and the other person shares his or her idea as well. The gumbo just helps it all make sense.
1:30 p.m.: After wrapping up the meeting, I get a call from the office about a patient who has a mysterious rash. She lives close to the office, so I decide to make an urgent house call to check things out. It turns out she burned her finger while trying to clap her hands over a candle to put it out. This apparently worked before, but she is now 98 years old, and she admits that “some things are a little slower.” I treat the small area and electronically prescribe some medication before leaving.
2 p.m.: I’m now at the office. As I prop my feet up on the desk to take a break, a drug representative appears with some much needed blood pressure medications. I graciously meet him and put the medications away after he leaves.
2:30 p.m.: I begin addressing messages and emails from the day. I return all phone calls and completely finish all notes on my electronic health record (EHR).
3 p.m.: After reviewing more labs, filling out medication prior-authorization forms, and speaking with another local vendor about a possible business venture, I’m ready to leave for the day. I love the fact that I had the privilege of delivering primary care to patients who would have otherwise not received healthcare. I send my last superbills to my biller, and I jump in my car.
4 p.m.: I pick up my two-year-old from school and we head to the gym for my daily spin class. This is where I totally let go of the stress from the day. This stationary bike ride is an hour long, and it is where I recharge for the next day. No phones allowed.
Evening
7 p.m.: I arrive at my home office. I check my emails, update my business Facebook and Twitter page, finish reviewing a book chapter for a Publishing House, and dive on the floor to color a Christmas tree with my daughter.
8 p.m.: I have a salad and a fruit parfait with my hubby. I check tomorrow’s schedule, shower, and read a few pages of The Plot Whisperer.
10 p.m.: With heavy eyelids, I check my email one last time for any additional messages.
I can’t tell you what I read because the next thing I know Bruno Mars is singing again, and I am searching around with sleepy eyes for the phone, on the floor, in the dark, to silence the alarm.
5 a.m. seems to come early.
