Rural Health's Specialty Lies in the Special Care
It was my first time back to a rural hospital. Though I had practically grown-up in rural health – both with frequent visits as a volunteer and as a support services employee – I had not been within the walls of a rural hospital in many years. And never had I been in one as a healthcare executive.
I arrived early, intending to look around and meet a few staff to better prepare me for a meeting with the Critical Access Hospital’s Board of Directors.
One of my first interactions was with a nurse coming out of a patient room. She was clearly emotional. Practically crying. I had seen the impact of caring for patients over the years. But this was not that. No, it was not simply a nurse and patient, but something much more. Even with my many years of experience, I didn’t yet know what I didn’t know – or regrettably, perhaps had forgotten.
After college, I found my way into the city. The first health system I worked for had more employees within one of its hospitals – not including patients and families – than the population of my entire hometown.
My healthcare career had been spent in ever increasing administrative roles. In addition to obtaining my Master of Healthcare Administration, I had gone from media relations to communications, marketing, business development and strategic operations. My roles enabled me to travel throughout the various components of entire health systems – emergency rooms, therapies, home health, inpatient, outpatient and ancillary services.
I had become accustomed to specialties from pediatrics to geriatrics. And within those, sub-specialties of therapy, diabetes, pulmonology, cardiology and more.
For many years I had worked with some of the finest administrative staff, nurses, doctors, researchers, countless specialist, support staff and of course patients and families. My focus was geared towards thousands of patients and millions of dollars in revenue versus operations cost for any given service line.
Having personally worked with and been a patient (or parent) utilizing various specialist, I appreciate their expertise. More than I could possibly express here!
But speaking with that tearful nurse in the hallway, quickly brought me back to my origins within rural health ...
I will forever be amazed and grateful for the skills to be found within the staff of these rural health systems. Often, their training enables a staffing model that has them serving a spectrum of patients. A single day can be spent treating a colicky baby in the clinic, handling a trauma case in the emergency room, a pneumonia patient in acute care and residents within the long-term care unit. So general in fact - from pediatrics to geriatrics and everything in between - that rural community health is, essentially, a specialty in and of itself.
“I have long been an advocate of psychosocial healthcare. Addressing mind, body and spirit of the patient and family is a primary focus of my role as a healthcare leader. Satisfied patients and families mean engaged patients and families, making for more compliant patients. Improving health outcomes and quality scores at lowered cost with fewer re-admissions.”
That nurse was not simply caring for another patient. It turns out, the woman in that room was on hospice. As her favorite 8th grade science teacher, she was the one that first suggested nursing, and happened to also teach both of her parents.
That is why, perhaps there is no greater psychosocial care to be found than that within the specialty of rural health. Those we care for are not only patients, but the local librarian that read to children for generations of families, the basketball coach who was a high school classmate of his squad's parents, or the pastor of the local church that did the memorial services for the grandmother, officiated the marriage service for the parents and baptized their children. They are not simply patients, they are neighbors, friends and family.
Likewise, as a rural health executive, the focus is not on thousands of patients for a particular service line, but rather the comprehensive care for an entire community. And instead of millions in revenue versus cost, we must optimize operations expenses with reimbursement, ensuring sustainability for our community's healthcare.
Caring for our shared community is what makes rural health so special. The spectrum of care provided by staff is what makes rural health a specialty all its own.