Karla took on the multiple sclerosis providers, and their patient load, right after one of the providers left. That left a huge segment of patients who no longer had a primary MS provider and who were calling in with many questions and hard to address needs. Not only this, but Karla was new to the diagnosis of MS. She had a lot to learn. She had to learn about the disease. She had to learn about all of the standard treatments for the disease. She had to get to know all of the providers she would be working with. And she had to learn how to deal with the gap made by the provider who was gone. This all was in addition to being new to the UNMH system. She worked her way through this steep, multi-part learning curve with grace.

In the best of times, MS patients can be very emotional. They have a life-long, unpredictable, debilitating disease. This high level of emotions often means angry patients. This has been especially true for Karla because of the upset of losing a provider. But thankfully, as one nurse said, "With Karla, patients come in angry and leave happy." However she does it, Karla has developed a way of working with this patient population.

And she has to really work hard. The MS patients generate far and away the most phone messages and faxes. The number of phone calls or faxes necessary to get one patient on one medication can be phenomenal. These medications often require pre-testing, prior authorization, and so on. In addition, there are numerous non-medication therapies to be obtained, and symptom calls to be addressed.

In spite of her heavy work-load, Karla aspires to know how to help with the other specialty clinics so that she can help to manage when other nurses are in need. She assists with other nurses' clinics and message boxes when they are out. Her generosity is amazing when considered in the context of her own clinic's needs.