Communities across the midwest feel the impact of recent snowfall and below-zero temperatures, but that weather didn’t stop Iowa hospice nurse Tiffany McArdle.
McArdle, a hospice nurse for St. Croix Hospice, says that in her seven years of working as a hospice nurse, she never imagined she would be walking through a blizzard to reach a patient, but never doubted she would find a way to make it to the family in need.
“I walked through a lot of snow to get to the door,” McArdle says. “Got to the door, and the wife answered, and she started crying.”
They shared an emotional moment, made possible by McArdle’s determination to reach her patient.
“A patient’s wife had called in saying that her husband had had a change in condition,” McArdle says. “We were experiencing a blizzard at the same time.”
Still, McArdle said she knew she had to get to the house.
“I knew they lived alone,” McArdle says. “No, no other family nearby. They were in the countryside, so I knew I needed to get there. You get very close to these families and the patients, and we go to wherever our patients call home. That’s where we go.”
The patient’s house was situated off a gravel road atop a hill. “I got out of my car and walked up to see how bad it was,” McArdle says. “I could see the house from the hill and knew I couldn’t make it.”
McArdle says she called a friend with a truck who drove her to the end of the family’s driveway, but with snow still falling and a drifted-over driveway. McArdle had to make a quick decision.
“We found a spot through the yard that was not as much snow,” McArdle says.
She walked the rest of the way to the front door.
McArdle says walking through the snow and the drifts were so bad. “The snow was up to my knees, walking through it to get to her door.”
McArdle says it took her nearly an hour to reach the house after the call came through. It was shocking to her patient’s wife when she arrived.
“She was very overwhelmed with everything that was going on,” McArdle said. “She didn’t think anybody would be able to make it to her.”
After ensuring her patient was comfortable, McArdle said she called the Page County Sheriff’s Department.
“I realized we need to get a plow on this road just in case the funeral home was going to have to make it,” McArdle says. “And I wanted her kids to be able to be with her as well at this time.”
McArdle says the sheriff and the county’s plow had cleared the family’s road and driveway within an hour.
Daily Nurse proudly names hospice nurse Tiffany McArdle as the Nurse of the Week. McArdle showed great strength and determination during extreme conditions and displayed unwavering dedication to providing compassionate care to her patients.
McArdle says it was just a very heartwarming experience. “It was a very emotional experience. I mean, I was very proud. And to represent St. Croix Hospice like that, you know, meant the world.”
McArdle is thankful for the help of the sheriff’s office and the county plow to let her patient’s family say their final goodbyes in person.
“The patient’s wife didn’t have to say anything,” McArdle says. “I felt it. She was happy we could be there, and getting him comfortable meant the world to her.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
During the most challenging time of year for patients and their families in the University of Iowa Hospital’s Pediatric Emergency Department, ED nurse Joe Schmuecker, RN, has gone above and beyond to spread a little holiday cheer over the last five years.
Every Christmas, Schmuecker sets up a homemade red mailbox for children in the pediatric department to send letters to the North Pole. Then, Schmuecker and a team of his colleagues answer every letter.
For Schmuecker, it’s a chance to connect with patients and bring a little joy within the stress of a hospital visit.
Daily Nurse is proud to name Joe Schmuecker our Nurse of the Week for his dedication to positively impacting his young patients and helping to spread joy throughout the holiday season.
Schmuecker says he wants to give kids a sense of normalcy in the hospital.
“This whole project started to bring out the holiday spirit in our department and to create some positive moments with patients and their families,” he says.
He expects 75-100 letters to be stuffed in the mailbox each year. The letters ask for the child’s name, age, what presents are on their wish list, and – most importantly – if they should be on the naughty or the nice list.
Schmuecker says the team has gotten the replies down to about five minutes each, but when they fill out a full page, it’s not just a quick response. It’s a very thoughtful letter responding to what the kids said. And then, if he got to work with that patient, they throw some things in there that would make it more personal and believable for them.
“The letters that stand out to me the most are the ones where the child checks the ‘I’ve been naughty’ box, though the kids do have a chance to explain why they think they’ve been naughty,” says Schmuecker. “There are also the letters that ask for selfless acts, like having their sibling not be sick. Those messages stay with you.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
Poring over historical pictures at the Good Samaritan Society long-term care facility in Algona, Iowa, is a person who’s been pivotal. “It opened in March of 1966 and I began employment in the summer of that year,” says Nurse of the Week Mary Hannover, LPN.
Do the math and Hannover’s service at the Society, still ongoing, adds up to an unheard of 55 years. “Half of my life. Half of my life has been living and working in a nursing home and supporting of,” Hannover says.
Administrator Joe Bartolo says 55 years in one place is “crazy” to think about. “Good Sam is in her heart,” Bartolo says. “She knows the ins and outs of everything from day one in Algona.” Retired administrator John E. Kern adds, “When people in Algona think of Good Samaritan, they immediately think of Mary.”
“We would not be here” without her
When the current long-term care facility opened in ‘66, Hannover split time as a CNA between the new building and the old home down the street.
“We had three levels of residents. The guts of the operation was still in the basement. So, the washers and that. If you walked up the stairs from the basement and did not carry a basket of laundry, you were not well thought of,” Hannover says.
It’s hard not to see similarities to how the Society got its start nearly 100 years ago in a little house in Arthur, North Dakota.
“They didn’t have any elevators or lifts at that time. They’d have to carry food from the basement all the way up to the first, second, third floor. Same with residents – if you had to get a resident to the first or second floor, you had to carry them up the steps,” Bartolo says.
Lifting others up through care is the 73-year-old’s passion. After she grew up on a farm west of Algona, her career got off to a slow start.
“I applied at three different community colleges to go into nursing. I was rejected by all of them,” Hannover says with a laugh. “So I came to town, I got a job and I kept my job.”
First as a CNA, then a licensed practical nurse and finally a fundraiser in resource development.
“If we didn’t have someone like her in our facility for the last 55 years helping get funding and things like that, and being a member of the community and church, getting people to come live here, work here, we would not be here in Algona without Mary Hannover,” Bartolo says.
Proud of Society’s development in Algona
Hannover’s personal mission is to spread the Good Samaritan message and raise funds to support its mission. “I remember going around in the community selling our point of view. ‘Why would you need that? We’ve never had that before,’” Hannover says about the responses she would hear. “I’m kind of proud about the fact that we’ve raised some wonderful buildings here. I always said it’s well worth every dollar that you’ve had to ask for.”
From independent living apartments to a rehabilitation center, she didn’t shy away from promoting the cause.
“Mary would often remind me to ‘never be afraid to apologize.’ She was always about service to others. She was very loyal and committed to the residents, their families and to the staff. She loved talking about the history of Good Samaritan and specifically Algona,” Kern says.
Looking back on all the additions to the campus, she says it’s incredible to imagine the number of lives touched by the Society.
“You talk about someone who is here for the center, here for the residents and not concerned about her time, that’s someone who lives out the mission,” Bartolo says.
“She’d do her Monday-Friday, resource development, and then she would come in on Saturdays and Sundays and feed breakfast. Every Saturday and Sunday, every holiday, she never missed any time unless she was really sick.”
‘Everybody is equal and the same’
Hannover admits her body is showing some wear and tear these days as she nears retirement. Her mind, however, is sharp and her focus the same.
“In Christ’s love, everyone is someone. You can’t help but think that the smallest resident, the largest resident, the most active resident, the inactive resident, everybody is equal and the same. If you don’t have that squared in your thought process, life becomes more complicated,” Hannover says.
“It’s a great organization. It’s served me well. I’ve enjoyed my time. Have I enjoyed every day? No. Nobody does. I’ve had some bad days and I’ve had some very, very good days. Your emphasis is always on life and where you can make life better.”
To see a video interview with Mary Hannover, click here.
Access to simulation training could be a game-changer for nurses and other healthcare workers in rural Iowa, where training and continuing education (CE) has long been an ordeal. A nurse in the Iowa heartland may have to drive hundreds of miles to learn new techniques at a distant city hospital. Fortunately, healthcare workers in the state’s more thinly populated areas will soon be able to hone their skills thanks to a new $8 million dollar grant through the University of Iowa College of Nursing.
The grant money is coming from the rural healthcare program at the Helmsley Charitable Trust, which has donated millions to underserved rural areas since 2009. The program covers eight states: South Dakota, North Dakota, Nebraska, Wyoming, Minnesota, Montana, Nevada, and now Iowa. Walter Panzirer, a trust representative, said their aim is to build a sustainable, long-term simulation program to support health care providers’ continuing education in these states: “We hope to improve quality outcomes because the more you can train on something, the better the outcomes will be.”
According to the Daily Iowan, the grant will help launch the Simulation in Motion (SIM) project in Iowa. The SIM project, founded seven years ago by a group of South Dakota healthcare providers, spearheads the development of simulation training programs in midwestern states to help rural HCPs keep their skills fresh and learn how to implement new techniques and treatments for unusual conditions. The U Iowa College of Nursing is using the funds to invest in three mobile training units designed to look like emergency departments and ambulances. The ED/ambulance units will be equipped with patient simulators, medical equipment, and educators to conduct the training. Inside the trucks, educators will train students and local HCPs on the simulators, which have human-like anatomies that can mimic a range of conditions and complications.
Jacinda Bunch, the co-director of SIM – Iowa, notes that “Some emergency situations are not seen very often, and it’s hard to keep up on those skills and remember everything you should do.” Bringing the simulations to these areas helps rural health care providers train closer to home so they do not have to engage in lengthy, expensive commutes to city hospitals to develop these skills. Bunch remarked that for rural HCPs months or even years can pass without encountering certain medical situations, and when such situations do arise, rusty or outdated skills can result in worse outcomes.
The opportunity to work with simulations is a boon for nurses and other practitioners in Iowa’s remote parts, says Cormac O’Sullivan, clinical associate professor of nursing and co-director of SIM – Iowa. “Health care providers really remember what to do when they do simulations. As the students and providers practice, they become more comfortable in the scenario and more open to learning and retaining it better.”
As Covid-19 cases spike all over the country, many healthcare systems are in desperate straits. States that proudly saw thousands of their nurses fly out this spring to “frontline” hotspots like New York City, Seattle, New Orleans, and Boston are now starved for resources themselves. With the latest stage of the pandemic coursing through 48 states, the frontlines are often in smaller cities and rural states that tend to lack the amenities common at metropolitian hospitals. Local and state health care systems are struggling to treat patients amid dire shortages of staff, beds, and equipment.
Under the strain of the present surge, healthcare systems are assigning non-Covid patients to beds in convention centers, hospitals are canceling elective surgeries, ICU nurses are working 60-hour weeks, and nurses who sped to New York in April are now working overtime to treat Covid patients in their hometowns. Areas that are especially overwhelmed, such as El Paso, store their dead in mobile cooling units staffed by jail inmates, and airlift non-Covid patients to hospitals in cities that for the present have escaped the new surge. In addition to seeking aid from National Guard medics, the American Hospital Association’s vice president of quality and patient safety, Nancy Fosterome, told Stat News that some hospitals are even turning to local dentists, Red Cross volunteers, and people with basic health experience to help with tasks that require less training.
In North Dakota, the weight of the Covid caseload—currently the worst in the country and, per capita, one of the worst in the world—has effectively broken the state’s contact tracing system. Kailee Lingang, a University of North Dakota nursing student now helping with contact tracing in the state, told the Washington Post that “Test and trace went by the wayside. Even if we had enough staff to call up everyone’s workplace and contact, there are so many new infections that it wouldn’t be as effective. At this point, the government has given up on following the virus’s path through the state. All we can do is notify people, as quickly as we can, that they have the virus.”
In Indiana, the state and local healthcare systems are sputtering in the wake of a 60% increase in hospitalizations. One doctor in the state, Timothy Mullinder, told MedPage Today that patients “who need to go to the ICU have been stuck in the ER for 24 hours because there are no beds available. Post-operative patients are stuck in the PACU recovery area well over 24 hours because there are no beds available.”
With the entire state out of staffed hospital beds, Iowa’s healthcare system is also overwhelmed. Whitney Neville, an Iowa nurse, told the Atlantic on November 13, “Last Monday we had 25 patients waiting in the emergency department. They had been admitted but there was no one to take care of them.” The strain on the system, combined with the state’s relaxed social distancing policies, prompted one infectious disease doctor to speak in near-apocalyptic tones: “The wave hasn’t even crashed down on us yet. It keeps rising and rising, and we’re all running on fear. The health-care system in Iowa is going to collapse, no question.” The problem, however, extends well beyond North Dakota, Texas, and Iowa. A November 17 Atlantic article found that 22% of all US hospitals are facing staffing shortages, and added, “More than 35 percent of hospitals in Arkansas, Missouri, North Dakota, New Mexico, Oklahoma, South Carolina, Virginia, and Wisconsin are anticipating a staffing shortage this week.”
At the center of the system, nurses and other healthcare workers are working as many shifts as they can, while doing their best to attend to waves of incoming patients. The latest surge, however, has driven a growing number of nurses to express their frustration with incoherent policies and public intransigence on the matter of masking, social distancing, and incredulity over the very existence of the virus. Michelle Cavanaugh, a nurse at the Nebraska Medicine Medical Center, spoke for many when she told a Utah reporter, “We’re seeing the worst of the worst and these patients are dying, and you go home at the end of the night and you drive by bars and you drive by restaurants and they’re packed full and people aren’t wearing masks. I wish that I could get people to see COVID through my eyes.”
