My Story: Marilyn Seuffert FNP

I began working in Occupational Medicine in 2001 as a new Nurse Practitioner. I was introduced to the industry by Nancy Clover, owner of Occupational Health Connections.

This was the "Big Dig" era, when they were building the Central Artery/Tunnel Project.  This project rerouted the Central Artery of Interstate 93 in Boston,  a highway through the heart of the city into the 1.5 mile Thomas P. O'Neil Jr. Tunnel.   This was constructed from 1991 to 2007. This tunnel was opened in March 29, 2003 Northbound then December 20, 2003 Southbound.

During the Big Dig, I was working and treating  the men and women working on this project predominantly.  We saw many things including, but not limited to,  broken bones, multiple musculoskeletal injuries, performed Department of Transportation exams, tended to massive lacerations that needed sutures,  raging infections from puncture wounds and multiple head injuries. As a result, there were many occupational medicine companies springing up to help all of the people involved in this project. Needless to say, I became well versed at orthopedic injuries, wet reading x rays, suturing and splinting. This is where my Occupational Medicine career began.

In addition to the Big Dig Project, there were the hospitals that needed help to manage work related injuries, ranging from musculoskeletal injuries from housekeeping to needle sticks from the medical staff. In addition, industries such as the General Electric company needed help managing the injuries that were occurring in the shops on site.  I carried on my Occupational Medicine career from 2001 to 2008. I really enjoyed working on the Big Dig project and mastering orthopedics mainly and becoming very proficient at suturing and splinting.  I was very busy but had a great experience.

Given that I was still somewhat green in my Nurse Practitioner career, I wanted to broaden my scope of medicine. This is when I left Occupational Medicine and entered into Urgent Care at Massachusetts General Hospital then into Internal Medicine at Massachusetts General Hospital from 2006 to 2013. This was a whole new world of medicine.  The term internal medicine is quite literal. Instead of X rays, musculoskeletal injuries, suturing and splinting injuries that one can see, I began having to diagnose and treat people with internal problems. This ranged from interpreting kidney functions, balancing chronically ill patients, diagnosing autoimmune conditions such as Mixed Connective Tissue Disorder (MCTD), treating hypertension, diagnosing lung cancer,  being the first in my practice which was comprised of 9 doctors and one NP (myself) to diagnose West Nile Virus. We would chase unknown pain and tingling sensations in all parts of the body, interpreting rheumatological labs, and the list goes on and on.  This experience is what I refer to as my equivalent to a residency as all MDs experience. 

Internal medicine was a love/hate relationship. I loved learning and broadening my medical skills but the stress was profound.  I learned quickly cancer is quite insidious and life is very fragile. One day someone can be alive and well and the next, they could be dead. I saw the unusual, the things that no one ever thinks could possibly happen, but did. I liked learning but hated the stress, so essentially, I began looking for different NP opportunities early into my internal medicine experience .  I knew I did not want to go to an equivalent job with similar stressors.   I seriously considered enlisting in the Navy,  going as far as taking the physical exam. When I told my father, he bribed me not to do it, so I didn't.  I kept thinking and looking and then one day I remembered, perhaps in the first couple of years in internal medicine, an MD I worked with with was studying outpatient low acuity clinics and was studying Minuteclinics.  Wow I thought, brilliant, an easier NP job! I had my eye on Minuteclinic moving forward.

The tipping point for me in internal medicine was the introduction of Obama Care.

One year before Obama Care was implemented, MGH seemed to be preparing for an apocalypse. In addition to treating medically complex patients, dealing with doctors with complex personalities, now we had administration coming down on us.  No more support, no more 4% raises,  just pressure to do more and more. It was not with a smile either. Then I remembered again the Minuteclinic. 

I had stayed in touch with the Minuteclinic recruiter for 3 years and one day, I made the call and they were opening a clinic 2 towns over for me. That is when I decided to take the leap and move into the Minuteclinic position.

The Minuteclinic has been good to me.  I have been here since 2013.  the acuity of the patients is much lower however, includes children which rounds out my experience.   In addition, they can be somewhat accommodating with my schedule.

But, I always look at opportunities, see what pay scales are like for NP jobs.  When I left MGH, a practice with a high acuity, high stress level, Minuteclinic paid me the same as MGH.  So I get paid the same and similar benefits to work with less stress.  I was sold on the proposition.

It is my time now to take care of myself in addition to patients.  But always looking at the job market. Watching Jobs, trends, seeing how much they want the NP to do for how little at times. 

Sometimes, it isn't all about the money.  Quality of life is key and your health is the best investment.