However, once again, I realize that my work in Internal Medicine seems to be what I was destined to do. The family connections are what I love. Learning the intricate spider-web networks of family dynamics are amazing to me. Which webs will fray and break...which ones are steadfast...all are interesting, to say the least. I never enjoyed the dis-jointed world of OB-GYN or other sub-specialties as much as I do now...in this world of human interaction. I often joke if we showed a family tree in the practice...it would extend the entire length of the walls of the building. Everyone seems to be related to one another in some way. Which can be good...or not so good. (smile)

I had the opportunity today to see a patient whom I had met in another time, in a past life, when I was a high school student...dare I say, 25-plus years ago. She was a former teacher of mine, and I was the lowly student. Now...I am the NP in her practice. I also see her extended family...parents, siblings, etc. Her one parent has a diagnosis that may be terminal. The other one has chronic illnesses with a ticking clock. Having seen her extended family on numerous occasions for treatment, I had only seen her for “acute,” seemingly minor illnesses. Until today.

We chatted about her chief complaint. The HPI was relatively benign. The exam...even more so. The REAL conversation stemmed around the family dynamics of the illness affecting her mother...the one that I diagnosed with lymphoma about nine months ago. We talked about the effects on the family, the patient (her mother)...and my patient opened up to me as never before. I was surprised at the openness she displayed, given her prior hesitance to discuss anything.

After the visit, which had extended well-beyond the next scheduled patient, she looked at me with a dead-serious expression. She expressed deep thanks for the care given to her family...and for listening. Followed by a big hug. My collaborating physician was astounded. He would have never guessed that she would have done that.

Neither would I...based on my memories of my teacher from long ago. However...we both needed it. All I did was listen...and offer support. I can’t change the outcome for her mother, nor offer the chemotherapy treatment that will arrest the lymphoma. I don’t have the magic cure-all. I’ll leave that to her oncologist. However, hopefully, my listening and support will be enough for my patient...here-and-now.

Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA.  Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings.  She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs.  She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health.  She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.

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