EIGHT - Heppner Gazette-Times, Heppner, Oregon Wednesday, April 26, 2023 In your community: Nurses provide care and compassion -Continued from PAGE ONE and night shifts. Greenup says larger hospitals have day, mid and night shifts, but 12 hours is the industry standard. Greenup mostly works the day shift at PMH, but she says everyone is re- quired to cover sick calls, so she occasionally works the night shift when another nurse has to call in sick. The entire Morrow County Health District has 15 full-time nurses on staff, including one nurse each at the Heppner and Boardman clinics and four nurses in home health and hospice. At the hospital, two nurses are on duty at once, along with two aides. Greenup says a lot of the nursing schedule is also comprised of PRN nurses. PRN is an acronym for the Latin term “pro re nata,” which means “as the situ- ation demands,” or simply, “as needed.” So, a PRN is a registered nurse who works as a temporary or short-term employee, often traveling to other areas to work. Right now, Greenup says, PMH has nurses that travel in from Boise and The Dalles, among other places. “And a lot of nurses pick up shifts at other hos- pitals,” she adds. “It’s just the way we’re wired.” And nurses definitely have to be wired a certain way to do what they do. “We see all walks of life, all stages of life,” Gree- nup says. “There’s so many avenues you can go in nurs- ing, and each one is fitting for some personality type, but you definitely have to be a people person.” She does add that she hasn’t always been such a people person. “Nursing school chang- Registered nurse Kathleen Greenup pauses for a moment at the Pioneer Memorial Hospital nurses’ station. -Photo by Andrea Di Salvo es you,” she says. “You train your mind to think a certain way. You’d almost have to resist the change to not be intrigued by people after nursing school.” Greenup says she thinks people generally have a good idea of what nurses do—everyone, at some point in their lives, has had contact with a nurse. How- ever, they may not realize what it’s like to be a nurse at a critical access hospital like Pioneer Memorial. “Because we’re such a small hospital, people may think we’re not that busy,” she says. “We don’t see the number of patients that larger hospitals see, but the diversity of patients is so much broader.” “It’s definitely more than giving shots,” she adds. Some of the tools of the nursing trade or well- known, while others aren’t as noticeable. Along with the trademark stethoscope, Greenup carries trauma shears, pen, radio, flushes, alcohol wipes, tape and her cell phone, which has nursing apps to help her with things like drug cal- culations. Saline flushes have multiple uses, everything from cleaning spills to rins- ing eyes to flushing out IVs. Trauma shears, she says, are extremely sharp scissors that are used to cut dressings, or even clothing if needed. “When an emergent patient comes in, we don’t waste time trying to gen- tly undress them,” she explains. “We cut their clothes.” Another difference working in a rural critical access hospital, she says, is that the doctor is not necessarily in the hospital when an emergency hap- pens. Doctors are nearby and can—and are—on the scene quickly, but there are moments when the nurs- es need to act even more quickly. “We have to work well together and know our doc- tors, and our doctors have to know the nurses,” she says, adding that the hospital has protocols the nurses can work from for common emergency situations such as heart attack, stroke or ab- dominal pain. “That allows us to work quickly before the doctor even arrives.” She also says that fron- tier hospitals like PMH lack some of the resources that larger organizations have, such as entire departments with dedicated respiratory consultants, IV experts and on-site pharmacists. “We do it all,” she says. “We don’t have people we can call in. We’re the people.” That makes teamwork an important part of life at Pioneer Memorial. “Medicine is a team sport. It wasn’t always like that,” she says, adding that it used to be more doc- tor-drive with a “captain of the ship” kind of atmo- sphere. Here, she says, the doctors are phenomenal and are good at asking for nurse input. “Patients are getting much better care, because nurses are the ones spending 12 hours a day with them. They know ev- erything about them—they know about their fami- lies, they know if someone doesn’t like ice in their water.” “It’s nice to be included in the big picture,” she says. When asked if the job is stressful, Greenup pauses and then says, “I think that depends on who you ask. For me it’s not.” She does say that man- aging stress is important, which means having coping skills, good family support and being able to rely on the medical team. “It’s all super import- ant,” she says. “One of the things the health district does really well is that, any time we have an event that’s high stress, there’s always a de- brief,” she adds. Everyone is included, and MCHD has a mental health professional on staff who is always avail- able to help. “Debrief is super im- portant with those stressors so you don’t carry them around with you,” she says. “You can move on with your life and be a wife, a mom, a friend.” Greenup says that, in nursing, it’s often the small things that make the biggest impact, both for the nurses and for the patients. She remembers family members of patients who took the time to thank her on what was likely the worst day of their lives. “You don’t get that ev- erywhere, but you definitely get that here at home. The littlest things make the big- gest difference when you’re a nurse,” says Greenup. She also shares that she owns a pair of yellow scrubs, which are among her favorites. She recalls a day she was wearing those scrubs when she walked into a patient’s room and asked how she was. “She (the patient) said, ‘I knew today was going to be a terrible day, but then you walked in with those yellow scrubs,’” says Gree- nup. “It’s the little things that add up to be the big things.” “Nursing is a pretty blessed field. We just need more of us,” she concludes. “There hasn’t been a single day in my entire life that I haven’t wanted to come to work.”