Almost one year ago, on June 2nd, I passed my boards and officially became a nurse practitioner. Right after that, I went to the AANP national conference in San Diego. During that conference, I received my DEA number and my NPI number. I remember thinking, “This is it. I’m really doing this now.” After years of school, clinicals, exhaustion, sacrifices, and doubt, I was finally legitimate in the eyes of the system.

And now, somehow, I am already approaching my first year as an NP.

This year has been intense, rewarding, exhausting, eye-opening, and deeply human.

I started working in several different areas. I worked doing insurance physicals, which I thought would feel meaningful, but honestly, it didn’t fulfill me the way I expected. It took a lot of my time and energy, and I realized pretty quickly that I needed something more connected to people and long-term care.

I continued hospice work, which I still do. Hospice changes you. It forces you to understand what matters at the end of life, what dignity means, and how important simple presence can be. It teaches you that medicine is not always about curing. Sometimes it is about comforting, listening, guiding families, and helping people leave this world with less fear and less suffering.

I also started wound care work. I have not had as many patients as I originally expected, but I have enjoyed it more than I thought I would. Every role has taught me something different.

But primary care has become the place where my heart truly feels at home.

I work with Native American communities and many elderly patients. Sometimes I also care for children, which I absolutely adore. I genuinely love my patients. I love hearing their stories, helping them understand their conditions, encouraging them to take care of themselves, and sometimes simply being someone who listens.

The work can be heavy. Many of my patients have multiple chronic illnesses, financial struggles, emotional trauma, or years of neglected healthcare. I usually see around 10 to 12 patients a day, and honestly, that already feels like a lot when you truly care about doing things correctly. I have friends seeing 30 patients a day in a different practice, and I honestly do not know how they do it. Maybe some people can, but to me, healthcare should never become assembly-line medicine.

Sometimes I think hospice has changed the way I see disease progression. I tend to be realistic, maybe even blunt at times. I know what uncontrolled diabetes can do. I know what hypertension can become. I know how quickly small problems become irreversible ones. I think my patients sense that honesty in me.

Many of them tell me:
“You straighten me out.”
“You tell me the truth.”
“You care.”

Some of them even call me “doctor,” even though I always remind them that I am a nurse practitioner. But I understand what they mean. They are not talking about the title. They are talking about trust.

One patient especially stayed with me.

She is 90 years old. Last week, she came to see me and quietly told me she lives on a fixed income. She explained that she had to pay $40 to see me, while another physician in the clinic is fully covered by her insurance.

Then she said something that honestly broke my heart.

She told me:
“But I like you. You’re real. You’re nice. You care. I don’t want to change my care to anybody else. I just need to know how often I can afford to see you.”

Imagine being 90 years old and having to calculate whether you can afford the healthcare provider you trust.

I felt horrible for her.

I understood the reality of the clinic needing revenue, but at the same time, I also understood her reality. So, I told her we would make a plan together. I asked her to come back one more time after starting her new blood pressure medication and to bring me her blood pressure readings. After that, I told her I would personally call her to follow up instead of making her pay for unnecessary visits.

She was so grateful.

But after she left, I sat there thinking about how broken healthcare can feel sometimes.

People should not have to choose between groceries, medications, utility bills, and medical care. Elderly patients should not feel guilty for needing help. Healthcare workers should not feel torn between business realities and human compassion.

Something needs to change.

Still, despite everything, I remain grateful.

Grateful that after all these years of school and struggle, I finally get to do work that matters to me. Grateful that patients trust me enough to tell me the truth about their lives. Grateful that I can still feel compassion in a healthcare system that sometimes tries very hard to turn people numb.

This first year has not made me perfect.
It has made me more human.

And honestly, I think that may matter more.