Nicole Kendzierski, RN, MSN

A Day in the Life of Siloam: a Provider’s Perspective

Originally published in the Fall 2002 edition of Healing Waters
By Nicole Kendzierski, RN, MSN

Nicole Kendzierski,

RN, MSN

8:05 The first voice mail is from the health department. A home visit needs to be scheduled for one of our pediatric patients with a high lead-level. As I try to reach the family, prayer-time is announced. I quickly finish up my call and join the others to focus on God’s plan for our day.

9:00 Throughout prayer, the phone rings with patients needing appointments and the waiting room fills. After prayer it’s off to help Ellen (our only nurse) fill the exam rooms.

9:20 Most of my morning patients are Hispanic females. The first patient tells me she needs something to help her sleep. Also, she shares that she is nervous during the day and that her body aches – especially her hands.

She works in a factory from 11 a.m. to 8 p.m. and then goes home to care for her children and to start her second job -- packing construction worker’s lunches. She gets up at 3:45 a.m. to finish the lunches. She averages four hours of sleep a night interrupted by fear that she’ll sleep through the alarm. Caffeine pills are used to keep her awake during the day. We talk about her options … I wish I could do more to help this struggling, single mom who is exhausted and stretched to the max.

9:50 Check voice mail. Call from Meg at Dr. Moran’s office. He is willing to wave his fees and operate on an uninsured patient that needs an urgent hysterectomy. I call Meg back to get a tentative date for the surgery. We pick a day and while I call the patient to explain the procedure, Meg checks with the hospital. Next, there is another patient – another pap smear.

10:20 A volunteer pediatrician needs me to interpret for a Hispanic family. After reassuring the family that the absence of their teen’s menstrual cycle was normal and that the abstinent teen’s pregnancy test was negative, we find that the real question/concern is – could their daughter get pregnant by swimming in a public pool?

10:50 Yadira (our receptionist) alerts me that a patient who ran out of his controlled pain medicine has arrived upset. He is angry with me because I insisted he see Dr. Wills and because I would not refill narcotics over the phone. I bring the patient back to an exam room and we wait together for Dr. Wills who hears the patient’s outrage the minute he enters the room. The patient settles down as Dr. Wills kindly and respectfully explains why it is important that he be seen. I leave the room to see a waiting patient feeling guilty that I wasn’t able to keep this patient from being so upset. I’d like to run away for a few minutes to process how to better handle situations like this, but instead enter the GYN room for another pap smear.

11:10 This is a new Hispanic patient with multiple needs. Her social history reveals 15 years of binge drinking, multiple three-year relationships that have ended in suicidal thoughts or attempts more than once, plus she has a current financial crisis.

It seemed appropriate to get a spiritual history. Growing up, she had very little contact with any Christians or with church. She was referred to the clinic by her friend, a patient at Siloam, who had just recently returned to church.

We talked about how to find hope. I shared about the woman in the Bible who had been bleeding for years and how she was healed after encountering a certain man named Jesus. Using the “bridge diagram” I drew on the exam table paper, we talked about how she could encounter this man named Jesus and how he could give her hope, everlasting peace and healing.

She was eager and with the faith of a child, made a decision for Christ. It taught me a lesson about God’s strength being made perfect in my weakness. I had entered the room feeling weak and frustrated because of the previous patient’s needs, but God had used me to help meet the needs of this patient.

11:50 Time for one more patient – the fifth and final pap smear of the morning.

12: 30 I visit briefly with Betty, our upstairs neighbor, who faithfully comes twice a day to empty our trash. Meg called to say she was able to talk with the hospital. I call the patient to explain about the pre-op plan and give instructions on how to apply for financial help through the Daughters of Charity at St. Thomas . Then I call Wanda at St. Thomas to let her know that the patient is coming and to check on the progress of another patient whose application is pending because of a missing tax return page -- language barriers are making it difficult for the patient to understand.

1:30 Eat lunch while checking email and preparing for a 3 p.m. meeting.

2:15 Meet with Morgan by talking through the cadenza walls that connect the backs of our desks to review several patients’ charts that need additional follow-up and referrals. More phone calls and paper work.

3:00 Meet with Mark (our administrator) to try to work on a formal medical interpretation training that we want to offer in October. We have written for grant funding for the training and various resources which will help us provide better patient care – we are "trusting" we will receive the funding!

4:00 Where has the time gone? I still have stacks of mail and there are more emails to answer, but the phone keeps ringing or a patient shows up with a pressing need. I still have HIPPA information to review and I need to make sure everything is ready for the evening volunteer clinic. Need to call patients for tomorrow’s clinic, as well.

5:00 It’s been another incredible day and I just have time to run grab a bite to eat before our second Hispanic Women’s Support Group (Mujers Unido Edificando) meets at 6 p.m. This is a group for the women whose husbands must work long hours – leaving wives (mothers) often lonely, isolated and longing for fellowship. The group is shaping up to be a unique and rich time for women connecting and sharing how God has helped them through the challenges of living in a new country. I can’t wait to see who will show up tonight!