Find Comfort with this Creamy Pumpkin Soup

November 6, 2024

As we adjust to the outcomes of yesterday’s tense election and embrace the shorter days of fall, there’s nothing more comforting than nourishing your body with a warm bowl of pumpkin soup! This creamy and delicious soup is tasty and packed with nutrients. Here’s how to make it:

Creamy Pumpkin Soup Recipe

Ingredients:

  • 2 tablespoons olive oil
  • 1 onion, diced
  • 2 cloves garlic, minced
  • 1 teaspoon ground ginger (or fresh ginger)
  • 4 cups pumpkin puree (canned or fresh)
  • 4 cups vegetable broth (low sodium)
  • 1 teaspoon ground cinnamon
  • 1/2 teaspoon nutmeg
  • Salt and pepper to taste
  • 1 cup coconut milk (or heavy cream for a richer soup)
  • Optional toppings: roasted pumpkin seeds, a swirl of cream, or fresh herbs

Instructions:

  1. Sauté the Aromatics: In a large pot, heat the olive oil over medium heat. Add the diced onion and garlic, and sauté until softened.
  2. Add Pumpkin and Spices: Stir in the pumpkin puree, ground ginger, cinnamon, nutmeg, salt, and pepper. Cook for a few minutes to enhance the flavors.
  3. Pour in the Broth: Add the vegetable broth and bring to a boil. Reduce heat and let it simmer for about 15 minutes.
  4. Blend Until Smooth: Use an immersion blender to blend the soup until smooth. Alternatively, carefully transfer to a blender in batches.
  5. Add Coconut Milk: Stir in the coconut milk and heat through. Adjust seasoning if needed.
  6. Serve: Ladle the soup into bowls and top with roasted pumpkin seeds, a swirl of cream, or fresh herbs if desired.

Nutritional Benefits:
Pumpkin is rich in vitamins A and C, fiber, and antioxidants, making this soup a perfect choice to nourish your body as we head into winter.

In these times of change and uncertainty, let’s prioritize nourishing ourselves.

Stay warm and healthy this season! 🍲💛

#WellnessWednesday

We’re hiring a Full-Time Medical Receptionist!

April 10, 2024

The Manette Clinic is growing!

We are seeking a Medical Office Receptionist to add to our amazing team.

The position will assist in answering phone calls, scheduling patients, triaging clinical questions to clinical staff, adding and updating patient information, and helping patients enjoy their experience by providing a friendly and engaging demeanor.

Essential Duties and Responsibilities

  • Greeting patients professionally, both in person and on the phone
  • Schedule and confirm patient’s appointments
  • Manage inbound calls, chat sessions, and patient voicemail, and appropriately receive and direct patients and vendors.
  • Collecting patient information, including medical history, payments, and insurance information, to enter into clinical databases (Charm, HINT & Spruce)
  • Educate patients on our communication between patients and staff
  • Ensure confidentiality of patient information
  • Cross-train into other support positions and functions, as directed by the program supervisor.
  • Other duties as assigned

Qualifications

Our ideal candidate has customer service experience or medical receptionist experience. For this position, fast learners and highly motivated applicants are expected. They must also be reliable and friendly, have excellent organizational skills, and be able to multitask.

Hours are 30-40 per week;

Must be available to work in both clinics, Bremerton and Poulsbo, Monday – Friday, 8 am -5:30 pm

Benefits are available for full-time employees 40 per week (probation period of 4 months) including, in-house primary care, Health Spending Card, Retirement plan, etc.

Please send a resume to [email protected], ATTN: Danielle Lopeman, Office Manager

Road Closure near Manette Bridge

February 6, 2024

Please be advised that starting February 12th, there will be a street closure near downtown Bremerton for work on the Manette Bridge roundabout.

“A stretch of 11th Street and Washington Avenue from Pacific Avenue to the Manette Bridge in Bremerton will be closed for approximately three months as the project to install a new roundabout at the bridge’s west end nears completion.”

We ask that you plan accordingly for your future appointments; construction may cause delays or require new routes to the clinic.

Read more here: https://www.kitsapsun.com/story/news/2024/01/23/bremerton-project-brings-closures-detours-near-downtown/72285008007/

How to use the Provider Line

December 5, 2023

The provider line has been developed for our patients to feel they are constantly cared for night and day, 7 days a week. This is a voicemail and text line only. This line is to help ease phone calls to the front desk and eliminate the middleman to ensure more accurate communication. What this means is that there are many things that we can assist you with using this line that will help the phone lines stay open to schedule appointments, answer new patient questions, and navigate issues that you may be unsure of or need more information about.

The best way to think of the provider line is quick access to your provider to request medication refills, provide quick updates on an ongoing issue, ask questions, and, of course, communicate how we can help with acute issues when you are unable to be seen in clinic or over the weekend.

The provider line is for quick updates and conversations; anything needing more than a 3-5 minute response should prompt us to offer a phone, virtual, or in-person appointment as soon as possible. This is often how the providers determine this based on your conversation, in which they will either offer to have the front desk reach out to schedule or ask you to schedule. 

Each provider checks these messages throughout each clinic day. Not all messages require a response from your provider, as they are information updates. Our nurse will triage some of these messages to offer help when your provider is out of the clinic or seeing patients. If it is a matter that needs to be seen right away, she will offer a time or reach out to the front desk to help get you scheduled promptly. Each provider will set their guidelines and schedule for responding to their patients. Remember, they are actively working in a clinic, so they may not respond if it’s not urgent, but always within 24 hours (business). Sometimes, you may get a quick text stating the information is noted, or medication has been sent.

Also, please DO NOT call us if you are experiencing something EMERGENT. Call 911 for immediate response.

For messages left after business hours or over the weekend, your provider or the provider on call will respond on their next scheduled clinic day unless it is an Acute or Urgent matter. They will respond within a few hours.

If you message over the weekend or a holiday, we always have someone on call checking these, and they will reach out to offer help unless it is not an urgent matter. Then, they will leave for your provider to address when back in the clinic, such as medication refills or updates on an ongoing issue. 

Our providers go above and beyond to provide the best one-on-one patient care possible. 

Here are a few helpful things to ensure we can respond promptly with the best response.

  • Always leave detailed messages if you are sick or have a new Acute issue.
    • For example, you want to leave these details: WHEN did this happen? WHEN did you start feeling this way? WHAT are your symptoms currently? WHAT have you done or tried at home?
  • If you are calling about a spouse, partner, parent, or child, please specify whom you are calling about so the doctor knows how to advise
  • If this is something you can take a picture of and send it to us so it can be accessed to see if it requires an in-person visit.
    • Often, we can see a picture and offer a home solution to try to help before being seen in the clinic.
    • Things to take pictures of are rashes, burns, cuts, and swollen areas (in which we may ask you to take a picture of both ankles, wrists, legs, and eyes). This way, we can see a comparison to other body parts in question.
  • Medication Refills 
    • Please allow 48 business hours (Monday – Friday) for medication refills
      • Our providers are not in the clinic every day, so notifying your pharmacy then us when you are down to your last 5-7 days will reduce the possibility of you running out of medications.
      • Controlled substances will only be filled by your provider. These can only be filled every 30 days at a time with no automatic refills; however, we request the same 48 business hours minimum notice of this, but 5-7 days’ notice will ensure there is no delay.

With supply shortages with many medications Nationwide, the more notice, the better to ensure no lapse in your refills.

  • Please call your pharmacy first for a refill. Most of the medications we will have already been sent with multiple refills. The pharmacy will send the provider the refill request if you are out of refills with that medication with the exact information we need, such as Medication name (Generic if applicable), dosing, and quantity. 
    • After you request a refill with your pharmacy, please allow 48 hours for us to respond and then contact the “Provider Line” with a quick message to check the status.
  • If you call/text the provider line with your medication request, specify the Medication Name and Pharmacy.
    • For example: Atenolol 25 mg, one tablet daily to Walgreens Kitsap Way

This will ensure we fill the correct medication dose and send it to the correct pharmacy.

Spring Newsletter 2023

April 24, 2023

Whether you are new to the clinic or have been with us from the beginning, we are glad you are here!

We had humble beginnings, and now we seem to be growing exponentially. With growth comes change. As the Greek philosopher Heraclitus said, “There is nothing permanent except change.”

We have new faces in the clinic, a clinic in Poulsbo and Manette, so many new patients, and a much busier practice.

Here are some ways we can improve your experience:

Communications

BUSY PHONES

Most days, we have two people answering phones and still can not get to each of you personally as you call in. This is why when you call, you need to leave a message. All front desk messages are handled by the end of the day. When you call and do not leave a message, we do not know you need us.

PROVIDER PHONE

Medication refills and specific needs from your provider- please do this on the provider line. It is a message phone and a text line 360-621-1104.

You can also reach this line by hitting option 2 when calling the main front desk line.

Price Changes

We had an increase in our membership price this year. This is our 4th increase since we opened our doors nearly 9 years ago. Our goal is never to price people out of our services, so if you are having a hardship, please let us know. We can work with you on payment plans or scholarships if needed.
With this, we will have some new charges for clinic add-on services starting in May (member prices; not for billable Medicare patients):

  • B-12  Injections: $10
  • Toradol Injections: $15
  • Joint Injections:$20 per body part
  • Tetanus shots: $47
  • CDL Physicals (starting in August)
    •  Member: $50
    •  Non Members: $150 (not Medicare)
  • Acupuncture
    • Members/Medicare: $40-$70
    • Non-Members:$100 (not Medicare)

Clinic Staff & Schedule

VACATION SCHEDULE

We are approaching warmer months which brings vacations for our staff. We strive for work-life balance; taking good care of ourselves helps us take good care of ourselves. We appreciate your patience if staffing is down when you want an appointment. It’s okay to see a different provider if yours is away.

URGENT CARE

We piloted an Urgent Care Clinic in our Manette location for February and March, hoping to help with the lack of community urgent care clinics on the weekends. We did this as a service to the community.  We were able to help about 6 patients during this time and may do another pilot of this idea in the Fall. For now, we will not be open on Saturdays.

STAFF CHANGES

Tammy will be moving back to South Carolina this summer to be closer to family. We will miss her terribly.

Appointments & Refills

MEDICATION REFILLS

Please allow 2-3  business days for all refills, especially controlled refills. Best requested directly thru your pharmacy or the provider line.

WELLNESS EXAMS

Plan for your yearly wellness exam; then, we can ensure you get in with your provider of choice at a time that suits you and us.

SAME DAY APPOINTMENTS

We do our best to get urgent exams (illness or injury) on the same day. This may not be with your provider if they do not have openings. Our providers communicate reguarly, so do not worry about seeing someone different.

TMC Limited Urgent Care

February 1, 2023

Effective February 4, 2023 we will be open for Limited Urgent Care needs to anyone in our community.  

The Manette Clinic will be open in our Bremerton office Saturdays from 10am-3pm for walk ins.

This will be on a first come first serve basis during these hours, last appointment will be given at 2:30pm. All services will be cash-pay at the time of visit. Our current members of the clinic will pay a copay to be seen on this day and non members of the clinic will pay the cash price based on services performed on the date of service.

For updates about this and more information please call the main office at 360-621-2696

COVID VACCINE UPDATE

October 2, 2021

Our clinic is no longer providing vaccines nor will we be providing 3rd booster shots. If you are looking for a COVID-19 vaccine please contact Ktisap Health Department to find a location near you.

If you lost or never recieved your Covid Vaccine card you can go to the website listed below to access your vaccine information through Washington State: https://wa.myir.net/login/

Please DO NOT CALL the front office and be advised that inbound phone calls regarding the COVID-19 vaccine will NOT be returned due to clinic capacity. Instead, feel free to check back via email. We will update the auto response for [email protected]. 

We appreciate your patience and understanding.

Stay safe and have a great day!

The Manette Clinic

 

Additional information regarding COVID vaccines may be found at:

 

The Manette Clinic Provider Spotlight With Deborah Tillman, Msn, ARNP-A-GNP-C

September 11, 2020

The Manette Clinic is fortunate to have some of the most knowledgeable and dedicated medical staff and administrators. Each one brings with them a wealth of experience. This spotlight is a chance to go beyond the bio and learn a little bit more about our very own Deborah Tillman, MSN, ARNP, A-GNP-C.

How did you come to work at The Manette Clinic?

Tillman: “I was assigned to The Manette Clinic for my first clinical placement as a nurse practitioner graduate student. After meeting with Tanya Spoon, touring the clinic, and setting up a student schedule, the university contacted me to say I’d been reassigned to another clinic instead. I told the university this was not possible as Tanya’s commitment had already been made with time and effort spent. I’d had such a good feel during my initial meeting that I didn’t want to give up the opportunity. My initial Manette Clinic experiences as a student set a high bar for the remainder of my training  and a year later when the opportunity presented itself to work at The Manette Clinic I didn’t hesitate.”

What drew you to The Manette Clinic?

Tillman: “From the first time I walked into the clinic, I felt welcome and part of a supportive team who had similar patient care goals.  Almost every patient I met as a student told me how much they appreciated the care they received at The Manette Clinic.”

What made you go into medicine?

Tillman: “Since I was in high school I’ve been drawn to medicine. Reflecting on my habit of buying anatomy books over the years, I decided to do something about it in my early 30’s by becoming a volunteer EMT. My first time riding in the back of an ambulance I felt like I’d found my place. Fifteen years later my heart didn’t want to give it up being a firefighter paramedic, however my body was telling me otherwise.  Becoming a nurse practitioner seemed like a great next step in helping folks with their medical needs.  I still feel at home in medical care settings and can’t imagine any other line of work.”

What do you want your patients to know about your medical style or approach?

Tillman: “It’s their life and their body, they get to decide how to go forward as best fits their preferences for life and how they wish to live it.  I need to know what their preferences are to best help them reach their goals.  I’m there to act as a guide who has some knowledge they may not have, some resources they may not have access to, and help work through with them the options’ benefits and risks.”

You also work in the community for The Manette Clinic, what is the most rewarding part of your time spent doing home care?

Tillman: “Over the years I’ve become comfortable being in folks’ homes as I work. I recognize the great trust placed in me as I’m welcomed into a home with family photos, favorite possessions, beloved pets, and all the mess that comes with day to day living that most casual visitors are not allowed to see.”

What is one of your passions outside of work?

Tillman: “I love to get outside and work hard, it doesn’t really matter the activity.  There hasn’t been much time for outside activities in the past 3-4 year. I hope to restart the habit and make new memories.  One summer I was part of a group of family and friends who hiked from Lake Quinault over the High Divide and to the Elwha River over several many days. Everyday was more beautiful than the last.”

Who is a living inspiration for you?

Tillman: “I’m inspired by anyone who gets knocked down and gets back up to keep trying to reach their goal.  No one is perfect, we all make mistakes, all unintentionally hurt loved ones along the bumpy road of life.  I appreciate when someone tries to do better next time, and keeps up the effort they can offer.”

What is your favorite thing about living in PNW/Kitsap?

Tillman: “The variety of activities available within a few hours’ travel time in any direction.”

Safety around our homes.

June 25, 2020

By Deborah Tillman, MSN, ARNP, A-GNP-C

Most of us have been spending the majority of our time at home these days along with the whole family.  Now might be a great time to create or update your home’s safety plan. If you don’t already have such a plan, putting one together and adding needed safety features may be welcome activities, especially if you’ve run out of fresh ideas after watching Frozen 2 for the tenth time.

Falls:

Trips and falls can happen to anyone of any age around the home. Risk of these can be substantially reduced with a few simple activities and additions to the home:

  • Clear your floors of small and loose items such as pet bowls, toys, electrical cords, throw rugs; anything that might slip away when stepped on or someone could catch with their foot and lose balance.
  • Arrange or remove furniture so there’s a wide walking path in all rooms, especially those leading towards exits to the outside.
  • Essential items should be placed where they can be easily reached by family members that may need them.
  • Add grab bars inside and outside of your bathtub or shower, and next to the toilet.
  • Add railings on both sides of stairs, and make sure stairs, hallways and any transitions in floor height have good lighting.
  • Outdoors areas should be well lit, with walkways smooth and free of puddles so mud and ice can not form.

Fire: 

Nine in 10 structure fires occur in the home and more than 8 in 10 fire-related deaths resulting from home fires.  Only 1 in 5 parents regularly practice fire escape plans at home, and only half of parents report their children know what to do in the event of a fire.  When a fire does happen at home, children can become frightened and hide. By educating and practicing with our children for these types of emergencies, we can save lives and even have a little fun while doing it.  Kids of all ages may find this a fun diversion and it can be as simple or as elaborate as you wish:

  • Have family members draw out on a sheet of paper your house with outside exits anyone can use clearly marked.
  • Pick a family safety spot that’s near your home, yet a safe distance away, for everyone to meet up in the event of an emergency.
  • Press the smoke alarm test button with all family members present so they know what the beep sounds like.
  • Then press the smoke alarm test button again, this time everyone walks to the safety spot in two minutes or less (use a timer). Two minutes is how much time a family has to safely exit the house in the event of a fire.  
  • For children under six, assign an adult to help them during the beeping sound and reaching the family safety spot activities.
  • Consider posting your house plan (with exits and family safety spot clearly marked) for everyone to see, like any good work of art.

(Sources:  National Safety Council, 2020; IAFF, 2018)

COVID-19, the Bully

March 19, 2020

By Nita Baer MA Lifespan Integration Therapist/Consultant Spiritual Director 

Surreal times! I’ve entertained a host of emotions this week as our community shuts down and the stock market flails. COVID-19 feels like a bully and the fall out chaotic. I’ve known bullies since day one. No fun!! 

This bully put our world into a steep, disorienting learning curve. Super uncomfortable! As humans we prefer comfortable because at a subconscious level our animal (reptilian) brain equates “sameness” with safety. Our first, subconscious question, in every situation is … “Am I safe?” This need for safety is found in your amygdala that was formed 80% in uterus and the last 20% in the first couple months of your life. Your amygdala houses your fight, flight, freeze, and collapse responses. All information comes in through your bodies five senses for screening by the amygdala before moving into conscious thought. 

If you were born into a home were your parent responded with warmth and kindness when you cried your outlook on life is much more likely to be, “Yes, I am safe. All will be well, and all manner of things will be well.” Thank your parent! 

If your parent was unpredictable for any reason, or unable to soothe you because you were sick, your matrix was wired much, much, differently. Your brain tells you, “If I am uncomfortable, I am in trouble. Nothing that causes me to feel uncomfortable ends well for me. We are going to die!” 

This anxiety does not improve by telling yourself to get a grip! In fact, dismissal will ramp up your emotions big time. Think of your amygdala like a young child. If a child thinks the adult in charge is not going to watch out for them, they freak out. If the child knows the adult in charge will be kind, stay with them even if they have big emotions, the child will calm down. 

This is because the worst thing a human can experience is a felt sense of abandonment. Abandonment to an infant (remember the forming age of your amygdala) means we die. A felt sense of abandonment verses physically being left is what matters. If a child cries or reaches out to their caregiver who is preoccupied with their phone or too busy, the child becomes anxious. Right now, in our community there are many people feeling anxious. Not uncomfortable, not restless, but perched on the edge of a panic attack, or well into a panic attack. They struggle moment by moment to ride the wave of emotion. They may startle more easily, anger may have a shorter fuse, they may withdraw or become really clingy. 

And these can be normally really high functioning folks! Like you and me! For those of you who believe, “All will be well,” the dysregulated emotions of the anxious may seem uncalled for, overreacting, a waste of energy, foolish, etc. How very privileged you are! Be thankful your amygdala is working well for you! 

This is a time for you to offer empathy (Brene Brown has a great free online animation regarding empathy) and offer constructive alternatives. Somewhat like a kind parent who validates a child’s emotion and then helps the child reorganize. Reorganizing an infant may be all about changing a diaper. Helping an adult reorganize may look like taking a walk, doing yoga, telling a funny story, offering art supplies, helping them consider what is true about the present moment. 

You who feel anxious… for God’s sake stay off the news!!! You all know the drill by now. Social-distancing, wash your hand, quarantine if you feel sick. All the details are too much and unnecessary! 

If you are reading, this the truth is, you have many more resources then when you were a child. The uncomfortableness of this moment is not the same as when you were an infant. Now you have many, many more options. You can call a friend, take a walk, a bike ride, weed, (our yards may look amazing this year!) read a funny story, do Qi-Gong, yoga, Sudoku, read something inspirational, do art, cook good food. (Yes, there is food. People in China are not starving, I checked!) The vast majority of you are not stuck in a blanket needing someone to pick you up! 

Make a choice to breathe deeply many times a day. Breathe in to the count of eight, hold it, exhale deeply and pause. Repeat ten times. If anxiety is increasing, count anything and everything. Count backwards by three or seven. Counting drives you into your left brain that will help your right brain (where your emotions hang out) calm down. Smell something yummy, feel the seam of your jeans, notice the colors around you. And breathe some more! 

To be human is amazing!! We all grew our own heart and lungs, we are tenacious, resourceful and strong! Remember vast majority of folks want to help you! 

Be well! 

Resources:

Lee Holden Qi-Gong, online classes and he is offering free wellness routines. 

Oak App for breathing.

Luminosity is a brain training app. A constructive place to put your mind to work.

Down Dog App offering free routines right now.