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Ambulatory Care

I am still a Nurse in Progress. In the beginning I was informed the learning is unending and it sure has been.

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TreeJ has 22 years experience as a ADN, RN and specializes in Ambulatory Care.

July 2020 marked my 21st year.  In my first years I did Inpatient Nursing for Med/Surg/Pediatrics.  Inpatient care took me to 4 separate areas of Nursing, including Contract Nursing beginning in 2004/2005.   

I transitioned to Ambulatory care after 2005.  Mainly, because at the time the Nurse need was there.  Inpatient Nursing was all I knew to that point, but now having been mainly in Ambulatory care since that is what I know now.  

I have also worked short terms in Home Health and over the last several years helped In the public schools.  

My greatest area of learning was in a rural location, where I had a great manager, along with great teaching Providers.  Here, as Nurses we covered regular Clinical Nursing to Triage/Urgent/Emergent care.  

My most rewarding area has been in Pediatric care.  Though, I never worked only Peds sites it holds a dear place in my Nurse heart.  

Current, my goal is to help where needed.  So, Contract Nurse mainly.  I still love this profession.  Not always easy, but I knew early human service was my calling.  

TreeJ's Latest Activity

  1. First, Im sorry for the New RN stress. I remember years ago ready to walk into the Med/Surg unit and not leaving the car a long time. Finally, praying and got the courage to walk the sidewalk into the building. I remember dreaming of those beeping pumps & jumping up in the middle of the night thinking “ shoot did I finish that new order!” Your feelings are all Nurses by certain degrees. Nursing is an acquired field that we choose. If your called to Derm, I encourage you to it. Here is my “but” though. Over the years I’ve been to varying areas of Nursing. What floor Nursing does that, to me will carry you is a foundation to multi task, critical think, and build your decisional confidence. Nursing specialties are allowing much autonomy, including Nurses in an office. My hope is you’ll hang in there and focus on Nurse skills, and not only actual hands on but hone your Nurse mind. Especially, with a supportive staff around you. Someday, you could take a job where all your years and experience is all you have as reference. Good Luck to you and to all new Grads. You can do it!
  2. TreeJ

    You Don’t Know How to Argue

    Great discussion point! I also do not have ANY social media outlets. That said I am familiar with the “drama” that accompanies social media. In the past, I’ve found it hard not to want to respond to what I think is an inaccurate statement. Only based on my life’s experiences, beliefs and knowledge of people. Only through this, I hold my comments. In thinking of responding to an argument, I always study the benefits it would have and whether its beneficial in elevating my “stress” level, and if I find it won't be I leave it be. Many a patient has approached me, based on human emotion only and immediately without an ounce of thought I have to immediately assess their environment and “where they are coming from.” Empathizing with your counterpart goes miles for me, as we all “are human” as they say. Allowing a person their emotion, at the same I will make an attempt to de-escalate. But, knowing when your line is drawn and how much energy I want to invest often is my most guiding tool for interaction. One final thought is “my thoughts will not necessarily be your thoughts,” so I also must automatically concede this with every discussion. I won’t always have the best viewpoint on a topic, and as with all things just listening to another individual’s thought on a matter helps me grow and I hope my talking point will reciprocate as well to the other person or persons. Guarantee, not all said will work, but without choice honing argumentative behavior is in the job description.
  3. TreeJ

    Covid-19 Among The Navajo Tribe

    Good Morning. Their are facilities mainly under the Health and Human Services who provide care, but if needed then Referrals are made outside of service area.
  4. TreeJ

    Covid-19 Among The Navajo Tribe

    An enemy on the reservation On the tribal reservation I live on there are probably greater than 488 cases of Covid-19 and 22 deaths. Enrolled members number roughly 352,000, with around 173,000 of that number on the reservation area. As you arrive here, I liken it to stepping back in time. People live in family clusters, 1 home, lack of running water, electricity in some parts. There are many elders who speak the native language only. No communication devices as a simple phone and some don’t have knowledge of the Internet. To say we’ve recovered from decades of great decline would not be accurate. Now, this enemy in the form of a virus here, targeting us. Unable to be reasoned with, debated with, but rather a realization that only with Global collaboration we will at least survive. I am worried As a Native RN, I feel part of a few with some knowledge, where I can be of assistance. I remember wanting to be in human service, and to help the people all I can. Where lack of PPE might only be the minor issue, it is concerning that general living conditions, health issues, language barriers the major battle here. How Covid-19 affects me just might erase so much of what I identify with by blood. I’m worried for the people so few in this Nation. The villain virus Researching past events as this is, disease is reported as causing more reduction of population of the North American Indigenous than human conflict. Having little exposure to diseases of other continents, the population is said to have been reduced immensely. Now, here in the year 2020, we are once again facing a villain virus, which is not only new to us but the World. When asked by new visitors, the disease processes present here. Without hesitation, I always relay that Diabetes & Hypertension I see so commonly. Care planning for this population always felt difficult, as you must consider can they buy the right food, do they live in the right conditions, will they even have transportation to their Provider’s next appointment. Recently, I remember an elderly non-English speaking woman hitchhiking to the clinic, and having to assist her in a way home. Working among this growing storm, I wanted to assist. So, chose to stay in this area, which seems to have the greatest numbers. It changes so drastically each day, higher and higher. I’m so busy to follow minute to minute, but know my locale is readying as best they can. Teams are in place, the staff has been divided to accommodate the surge they are sure is coming. I keep hearing the words, “I can't believe what is happening.” The older Nurses comfort the younger, and the younger appear ready to battle here. In the end ... I wonder how it will be and not as they predict. Though, of all tribal Nations in the United States, the cases here are highest, there are more tribes than whose numbers are less than 10,000 members. I pray each day for them, as well as all the World. All these years, believing that we can only have progression, then hearing statistics, we as a people could decline once again. The thought is disheartening. I am but one person Just like the rest of this country Nurses are few. My hope is being among them that I won't deter by becoming ill and can help that next Nurse with some relief. As I hear, we are all in this together. So, remember us, the smallest of people, also. Here there are no great metropolitans, but such rural communities and health care so basic it might depopulate us as a mini Nation. I’m one person, but indeed we all are. Believe you will make a difference, be it city, state, town, village.
  5. I see the headlines and note the worries and fears, but keep hoping to see care specifics, from the Nurse’s view. Nurses are being called in and the only information as prep are the News stories. Also, have read some of the Medical Research. Can I hear some Assessment findings, labs, medication experiences, etc. I’m confident the Nurses already on site have been Care Planning their ‘Care of the Covid 19 Patient’. Would sure be useful.
  6. TreeJ

    Article Contest: How is the Covid 19 Affecting Your Life?

    @eakirlin Thank you for the response. I was hoping not to sound defiant of any efforts to combat the response. Especially in light of safety. The only topics given begin with anxiety, fear and paranoia, etc. At this moment, those feelings are validated, even for me. Only hoped to offer inspiring words in the topic of Hope. People speak to me with anxious eyes. I won't add to that. Rather, encouragement.
  7. TreeJ

    Article Contest: How is the Covid 19 Affecting Your Life?

    I thought about your topics in relation to this virus. Honestly, they all seemed seeing a glass half empty type headings. For myself, reading history many Nurses and Nurses before being called Nurses pioneered such times as this. Do I worry about illness? Oh yes I do, in fact the last near 21 years I’ve been in this. Each day was probably a gamble. To the Aids patient, MRSA, VRE, Hepatitis, H1N1 exposures, but education and rationality saw me through. In the end, no virus made me ill, but instead I fight a Pancreatic Tumor, Parkinsons which for me is no guarantee that life will be at its best. So, being this is a new normal for awhile I hope to hear 30 years from this period, Nurses took the helm. That caring and loving resurged in this field and Nurses didn't become Nurses for the money & job security. That they realized they were called to it. Human servers is what we are. Nursing school was not easy, in fact this field is not. But, its the job or is it not. Nursing for me was always a Love and never worked a day of it. Salutatorians, above all during this period is what I’ll call you forever!