Chapter Text
She hears the alarm on her phone harkening another 6 am, but she’s nowhere close to silence it. She’s been awake since 4, laying on the couch, reading one of her “smutty books”, as her friend Lisa refers to them. Reluctantly, she pauses in the action between the main characters to place a bookmark on the current chapter and find her phone, lest the incessant blaring of that alarm that sounds like a nuclear test drill wake the whole building.
Coffee, shower, second coffee, then out the door; she’ll need that extra caffeine today. Sports physical day. Sure, the school nurse handles a lot of the student athletes’ physicals during the school year, but each summer, when school is not in session, that responsibility falls to the providers at the Montbonne Medical Clinic.
The medical clinic sits near the center of town, not far from the bakery, in a location easily accessible by car, bike, or – just once – by snowmobile. It’s a small building, but there is enough space for the mountains of files and file cabinets holding records for every Montbonne resident over the last fifty years. Paper charting is still very much a thing here; however, the clinic recently received an anonymous donation (a VERY GENEROUS donation) to help move to electronic health records. While the building is small, it holds enough space for the family medicine nurse practitioner, an office manager, two medical assistants, a small lab for phlebotomies, and a billing office. Sometimes, the clinic is lucky enough to have a visiting physician a couple of days a month to help with the workload.
She makes it to the door at 7:32am, hoping to review the previous day’s lab results before the office opens at 8:30. Nikki and Shelia, the medical assistants, will be in soon, and with them will come the gossip of the last twelve hours. How those two ever get anything done between talking to one another is anyone’s guess, but they are so efficient. The medical assistants handle the scheduling for diagnostic testing, referrals to specialists and home health, prior authorizations for medications, and medication refills. Together, they function like a two-headed, four-armed, four-legged oracle of clinical knowledge without the excessive cost of post-secondary education, licensures, and certifications.
Becky, the office manager, arrives promptly at 8 to make coffee, check the fax machine, and make sure everyone has their patient list for the day. Lunch will be the highlight of the day; they have a lunch and learn scheduled which means the extremely attractive instructor from the Canadian Red Cross who kept their CPR certifications updated every 2 years was coming to town and bringing some salads and sandwiches from the bakery to eat when training was complete. Free lunch is truly the best kind of lunch.
The first patient arrives promptly at 8:45 for their 9am appointment. Routine visit: check their blood pressure, ask about medication refills, see how they’re following their diet (they are not), and order some routine bloodwork. Six-month follow-ups are so easy. It’s those patients who only show up once in a blue moon that cause the most problems, making a 15-minute visit last over 30-minutes and includes at least 1-2 specialist referrals, diagnostic testing, and new medications on top of bloodwork. Needless to say there is something to be said about preventative medicine.
As the day flows by, a smattering of students come in with their parents for their sports physicals, including some of the U9 girls’ hockey team. The Vetrova twins made sure to get their physicals out of the way before their annual holiday abroad, so they would not be in today. Smart thinking on their parents’ behalf, she thought to herself.
The last patient before lunch is a newborn, just four days old, here for her first post-natal visit. That is the thing about being a family practice: you run the age gamut from birth to just about death with your patient population. The one thing that is a huge blessing is the midwife and obstetrician in town. That is one skill she never wants to even fathom; gynecologic exams are enough at this point. Once that proverbial bun is in the oven it is off to the obstetrician until that baby is done cooking!
Noon arrives and with it comes the hunky CPR instructor. Blaine can easily set women’s hearts aflutter with a wink or a kind smile. He sets up the Resusci-Annie and goes over the recent changes to the algorithm, then one by one the staff takes a turn asking, “Annie, are you okay?”, and proceeding to chest compressions and rescue breaths in a 30-to-2 ratio. Alicia brings over lunch once Annie has been saved at least 5 times at this point and the group breaks apart to enjoy their nourishment.
The back half of the day unfortunately comes with two tick bites and a hook in the cheek from two teenagers fishing and half paying attention to their surroundings. Once the boys are patched up, they are on their way home. The last patient of the day is Rachel. She likes the last appointment because she never knows when she’ll be able to find time to get in to the office during the hubbub of her normal day.
Becky closes and locks the office door at 3 pm on the dot. Any urgent care needs would be handled by the hospital emergency department at this point. Just because the office is closed does not mean the work is done. There are still a few prescriptions that need called to the pharmacy and chart notes that are half complete. Once that electronic health record is up and running, watch out! Becky will surely be happy as it can likely streamline the billing as well.
Around 4:15pm, she finally heads out of the office. Dinner is another question: does she want to cook or pick something up from Jacob’s? Tonight she’ll cook: breakfast for dinner! Eggs, a few pieces of turkey bacon, and chamomile tea then back to her “smutty book” until 10pm. Tomorrow’s schedule looked just as busy and Marisa – the nurse practitioner of the Montbonne Medical Clinic – wouldn’t have it any other way.