For the last 2 1/2 years, one day a month I travel to Paris to staff a colposcopy clinic. Paris, Texas that is. I look forward to this day each month. It offers me a change of pace and I enjoy working with the staff at the clinic. It is a 90 minute drive each way on most days. The WHCNP that is the clinician at the clinic was a student that I was able to mentor/precept five years ago and it is nice to watch her as she matures in her role. I enjoy the patient population and the role I fill in this community. This is what I really think I was meant to do when I became a FNP.
One thing that strikes me each time I go is the different expectations of the patients that I see. I am a big city girl, have always lived in or on the fringe of a large metropolitan area and have had easy access to all that I may want or need. The clinic is across the street from a feed store and next door to a car repair shop. The stockyards are a few blocks away and I can often hear as well as smell them. The patients that I see are medically indigent hard working people. Many haven't ever had adequate healthcare. Many haven't ever been anywhere but in Paris and the neighboring communities.
When patients come in to see me they are scared and feel overwhelmed by the whole process and the diagnosis that brought them to me. I will often be seeing women that haven't had any healthcare for years and they came in for an exam because of problems and were found to have an abnormal Pap Smear. The women that I see at this clinic have few resources and I rely on private, state or federal grants to pay for the colposcopy, unfortunately the grants don't pay for treatment. When the colposcopy and biopsies reveal a high grade dysplasia or an invasive cervical cancer I can usually get them emergency Medicaid if I was able to get them on a grant for the diagnostic procedures in the first place. Unfortunately the struggle doesn't stop there. It is difficult to find a physician that takes Medicaid for Gyn Oncology in Paris Texas, it is difficult to arrange transportation to Dallas if they need to go there for treatment and it is difficult to explain the urgency of obtaining care when they have the more pressing immediate concern of feeding their families and keeping a roof over their heads.
I feel good about what I do there, I feel frustrated by the situations I encounter and I feel angry that we make it so difficult for these hard working folks to get the basic care that they need. I will keep making that drive each month, I will keep on working to get the care that these women need and I will keep being frustrated. I will keep on loving my job!