Working for a time in pediatrics showed Kathleen Thompson, RN, that nursing is the right career for her and that sometimes it's better that dreams don't come true. From her first days on the back of a half-Arabian horse as a 12-year-old in Arizona, she grew up wanting to be a veterinarian.

"I found that when I was in pediatrics working with children, they can't tell you what's wrong. It drove me crazy," Thompson said. "And it's the same thing with the animals. I don't know if I really would have been able to do that long term."

Thompson, 41, now works at the other end of the spectrum from pediatrics in a cardiac stepdown unit at St. John's Regional Health Center in Springfield, Mo. Besides the adult patients, a bank of telemetry monitors tells her exactly what's going on.

The 31-bed unit often runs at full capacity, which Thompson attributes to growth in the Ozarks. "For three months," she said, "we've been sending patients home, stat cleaning the beds and bringing patients up from the ER or CCU who have been waiting for six to eight hours for a bed."

The cardiac unit also is where Thompson can practice patient education, one of the things she likes best and the reason she plans to pursue a BSN degree and, eventually, a position as a patient educator. "I spend a lot of time sitting with patients and doing education," she said. "The BSN would be enough to get me where I want to be. I don't see myself going into management because, frankly, I like direct patient care."

Thompson said it took as long as 10 years-more than half of her 19-year career-to internalize that she couldn't fix everything and everyone. "Up until then, I would come home and worry about Mrs. Smith or Mr. Doe," she said. "Being able to leave [patients] at work was probably the hardest thing I had to learn-and the most important."

Nursing skills still go home with Thompson, however, to 40 picturesque acres in Buffalo, Mo. There, besides three children, she cares for three Arabian horses, 18 Nubian goats (the ones with long ears) that she milks and breeds, and four fox terriers she shows in national competitions. "We call them fox terrors," Thompson said of her "old lady dog," 15-year-old champion Patches and the others that include Patches' great-grandson, Harley.

Except for sutures and major veterinary issues, Thompson said she rarely needs a vet because of her nursing experience. She does her own vaccinating, worming, hoof trimming and most other medical care.

"In March, I had a baby goat born during a really bad cold spell," Thompson said. "He had gotten chilled to the point he was limp and barely breathing. Without my nursing background, I would've lost the kid."

She knew to bathe the newborn in hot water to raise its body temperature. Then she sat with him in a heating blanket, tube feeding him by the ounce through the night. In late April, the kid was 5 weeks old with a hearty appetite, so much so that he jerks a feed bottle out of her hand, Thompson said.

"I have lost kids, unfortunately, but I probably save more than I lose," she said. "The same with baby horses when I've had problems with them."

The acreage and animals are her refuge. "My front yard looks out over my big old red barn and a pasture and then up into a woods on a hill," Thompson said. "It's fairly private. I sit down and pick up a book or pick up my guitar or the computer after I've taken care of the animals and done my playing with them and shut myself away from the world."

But by the time her days off are over, Thompson said she looks forward to the next eight-hour shift at St. John's, much the same as she looks forward to home at the end of the workday.

At home, the phone-equipped with an answering machine-usually isn't allowed to intrude because, as Thompson said, "If work calls and asks me to go in, I'm a soft touch. If the machine picks up, I don't have to tell somebody 'No.' I know a lot of people who handle it that way."

Contact Phil McPeck at getpjm@aol.com.