 Did physical therapy work with you this morning? Yes, they did. They did. How's your arm and your leg? It's getting better. It is. Yes. Good. Are you having any pain right now, Jane? No. Good. Do you feel like your pain is pretty well managed here? Yeah. Pretty much. I was just going to check your vital signs. Is that okay? Before you go to bed? Can you take a deep breath for me? One more? Great. Still ticking, huh? Still ticking. Just the most fulfilling thing is to know that at the end of the day you've helped somebody. They just love having the nurses come right to their home. They become like family members to you. You get to see the impact that you have in people's lives. Then more than I could have imagined it would be from my past experience in the nursing world. This is the greatest generation. I like taking care of the greatest generation. It's important to me that they know that they're in secure hands. They're here knowing I'm going to be taking care of everything's going to be okay. That's good. So another day of physical therapy. One more day closer to home. That's right. How are you today? Are you okay? Did you get a chance to go outside today? Here at the hospital in our rural setting we're responsible for all kinds of nursing. We do a lot of geriatric nursing because that's our clientele in this community. We have a large percentage of elderly in our community. A lot of things in your smaller community nursing home that might be diverged out in a larger community we take care of everything here. So yes you're going to need a lot of different skills to take care of everyone at once. The skills that you need to do home care it's like you have to be a jack of all trades because you might have a patient that needs wound care so there might be some wound back, some different equipment that you have to work with. You might be doing IV therapy teaching. A lot of teaching is we do in home care. We can take care of pediatric patients. We take care of people. We have some that are 100 years old. There's just a whole realm of a lot of different things you have to know. Life here is very interesting. It's very challenging. It changes from day to day. You use everything, every aspect of nursing that I learned about in college way back when is implemented here. We do have a lot of emergency situations where we get to actually use our skills and use our knowledge to do what's appropriate and best for the residents. They are outstanding. I've admired the nurses how friendly they are and how they get along with each other in relation to different little tasks that they do. I think it's just a very ideal place to be. There are always very conscientious of any health change we had. When I first came in they spotted the beginning of pneumonia and they jumped right on that and I got medication and I feel very safe here. We need these homes. We need the care we're getting. It's always important to be made no matter where you live or who you are. You need that extra care. I've seen some of my friends and classmates. Their parents come in here and they're near the end stages of life and their whole family is going through that together. I feel very honored and privileged to be a part of that, to be there when they're feeling most of honorable in their lives to help them prepare for what life is going to be like after this stage. Through the hugs and thank yous I think that we're doing a wonderful job here in our community making people feel that I can count on my local medical facility. They're there for me. Glad to help you out Ivan. Thank you very much. I think we have probably the most wonderful doctors to work with of any place I've ever worked where we have such a collegial working atmosphere and they respect what I as a nurse bring to the table and they learn, you know, it's a two-way street. We learn to trust each other. That's one of the really fun things about it is as an INR nurse in a clinic managed and nurse managed setting I have a lot of independence but yet I still have the providers here so that if I feel there's something that needs to be addressed it can be addressed. This gives me a good excuse to hold hands to it. When I was in college the buzz word was biopsychosocial and spiritual and long-term nursing encompasses all of that. You get to use all of those aspects of your nursing because people are here, they're here for longer periods of time, you get to know them, you get to know their families and I just think it's the best of the nursing world because of the population we're working with because of what we deal with with them and every aspect of nursing is covered here so for someone to think it might not be challenging or interesting here that's just not true it's a great place to work, a great environment. I'm so satisfied with what I'm doing. The reason is I think the elderly people they are valuable part of our society and in their past life they have worked so hard they have sacrificed their lives for us to get what we are getting today whatever we are enjoying today that is because of all the hard work they have put in. Another great thing about nursing homes is we get residents here that come in for therapy and we have a wonderful therapy program and we get to actually send them home. We can make a warm welcome inviting home that our residents want to share with their families. We can smile, we can laugh, it doesn't have to be like a hospital. Fun to come to work and see them smiling and happy knowing that you're there. I love the stories, I love the patients, I love the richness that they bring to my life that I wouldn't necessarily have thought they become your friends and they'll say to me I always feel so much better after I come here and talk to you or they'll give me a hug and they'll cry and they'll say thank you for listening to me and so I feel that's something that I'm able to do in my job here that some of the nurses that work with the providers don't have the time to do because they're on to the next one you know in order to keep everything flowing smoothly. I think the thing that helps me keep going the most is the satisfaction you get from the interaction with the people, getting to know the residents as compared to a short-term hospital stay. You get to actually know them and know their families and the interesting things that make them who they are. We have some pretty lively conversations and I have found nicknames for quite a few of the people after I ask a few questions I know a few things about them and I can pick out a nickname. They're very nice to me, they really care about us and not here we miss them. I know people care, I know they treat me well, they help me with anything I ask them to. I think they're good. You know it is very rewarding when you're going you know you've talked to somebody or you have a family member call you and say wow you know I'm so glad you were there to help take care of mom or you're sometimes it's even out of funeral service or you know a family service and they're saying you know gee I want to thank Doreen for you know helping us out so much and it's like wow we really did make a difference in that person's life and it really is rewarding to hear that. You'll often times get thank you cards after a resident has passed from their families just letting you know that they really appreciated everything that you did for their loved one. You do become friends, you do fall in love with these people and they're just amazing and they do bring joy to our lives and they do have very much have a purpose. They teach me dignity, they teach me humility, they teach me gratitude. You know a lot of times they say you know I wonder why I'm still here I'm not good for anything I don't do any good and I just tell them you know maybe your purpose is for me to get to know you. While interacting with the residents I get to know them their personalities what kind of lives they have they would have led what kind of families they would have raised how much hardship they would have gone through the ups and downs in their life all the depression period here in America you know which I can only read in books and these residents to me are open live books that can bring all those experiences to me and I think that makes me grow that's my bonus. They're just a joy they have taught us so many things they're they're the ones that have shaped the lives and how we live today. I know many of them I'd say over 95 percent of the clientele that comes through the hospital I know I'm related to I'm the best friend of their their children so it's important to me that they know that they're in secure hands. Especially in the end times of life you need to have your self-esteem built up and to know that your life is important and it was important and that there's always going to be someone who will remember you and so you know that's an important gift to be able to give to them and it's important gift that they when they allow to share that with you. They teach me something every day I've been doing this like I said for 37 years and every day I still learn something new from them. When you work with people that's the great thing is that it can change day to day hour to hour. When I worked with students I always said you know the patient doesn't need to necessarily know that you're assessing them but from the moment you see them you know are they smiling today are they saying they're having a good day what is their skin color you know are they breathing faster than normal there's just so many things that you just are absorbing and that's one of the things in this job that I love is because I see them so often that I kind of know and it's even things that I'm not always conscious of but when I'm walking them back from the waiting room and if I notice that one seems to be more having more labor breathing you know and I'll say you sound a little short of breath today is it worse than usual? I think when you when you work with the elderly and you get to know them so well it's like knowing a family member you you can anticipate their needs more as opposed to an acute setting so being able to read your patients in that way from that relationship you develop is an important skill set in and of itself. They come in with a complex usual list of diagnoses they have not just one or two they have multiple diagnoses that they've obtained throughout their whole lives some that provide a very difficult way of life for them breathing mobility they may be on lots of medications and the timing of those medications is very difficult for them to manage on their own so here we try to help them how can we make it so that you're still independent in your home yet you're following what your doctor has ordered. Can you take a deep breath for me? It offers a very wide experience anything can come through that door and we have to be prepared to handle any crisis that comes in and that can be heart attacks accidents someone with a common cold persistent cough but we're there to handle all of those as a team here at the hospital. We're here today as quiet, quiet today. I feel they'll always be a need for home care you know continuing on and on and on and growing because people don't want to be in the hospital they don't want to keep them there but they do need help and being taught how to do take care of themselves at home so I just see it being a very good field to be in and to help patients. For me I always felt that I was called to be a nurse and one of the things that I've learned is there's room in nursing for everybody. Don't just tie yourself into one area in the beginning you know get some experience to see which area it is you really really do have a passion for. Everybody is not cut out to be a geriatric nurse either but it is really a wonderful field to help people. Yeah it's vital that young people are getting into this profession and coming in with the newest information and the newest skills because you're going to be utilizing those and that's what people are going to need. I would tell them just to examine their relationship with their grandparents you know that when I think of my grandparents or family I just get that warm feeling and I think most people do with your grandparents it's a warm feeling you like to be around them why not work somewhere where you're going to have that warm feeling and you're gonna like it I just think everybody should come try it or even volunteer in the nursing home see if they like it there's been so many people that come and say I cannot believe how happy I am here and that's what we want it's accommodating for my family because I can go out and see patients well my children at school and I can just be out and about doing my job and you know I have the flexible hours not where you don't have to work a shift but when I got into home care I've taken care of so many different kinds of patients like little babies all the way up to my oldest patient was a hundred and six yeah my oldest patient was a hundred and six over 60 very good I enjoy working in a small town or a rural area because of getting to know your clients or your patients really well and it just seems like you know you can see them in church a month later and they're like oh that was my nurse she took care of me and they can come up and tell you I'm doing so much better now and you know seeing those people all in the community after you've taken care of miss a really good thing a reason that I really like working in a small community I like dealing with the people that I know I've grown up with all these people I was born and raised here in this community and my husband and I live just in a smaller community just 15 miles away and it's just wonderful knowing all these people and that I'm here to help take care of them I don't want people to feel scared when they come here I'm dealing with them sometimes when it's a life altering or changing time in their lives and I want to be able to make it as painless as I possibly can I love small towns you you know who lives here and everyone cares about each other here you know it's just like a family a small town is like a family I plan on raising a family here I actually have a five-year-old she'll be six in November and I love sending her to school in a small town where I know all the teachers and I know all of her classmates and it's wonderful I came back to meville so we could live in a smaller community we want our children to go to a smaller school and you have the added benefit of being able to be an integral part of the community getting to work with several generations of people you get to work with someone's parents and grandparents and you get to know all of the different generations of the family together so it's kind of fun it's like a being part of the community working in a small area like this I'm a gerontological nurse in North Dakota I make a difference in people's lives I'm a geriatric nurse in the state of North Dakota and these patients make a difference in my life I'm a gerontological nursing North Dakota and I make a difference in people's lives I am a nurse in North Dakota working in a long-term care facility and I know that I can make a difference in my residents lives I'm a gerontological nurse in North Dakota I make a difference in people's lives I am a home care nurse in North Dakota and I love doing my job I love being a home care nurse I work in long-term care and I make a difference in people's lives I'm a long-term care nurse in North Dakota and I make a difference in people's lives I'm a nurse who works in long-term care in North Dakota and I make a difference in people's lives I'm a nurse in North Dakota that takes care of older patients and it's been one of the best parts of my nursing career.