I never really thought about that, I knew at some point I would probably transition into an NP practice, whether that would be emergency medicine, urgent care, or family practice. I never really had a thought that this is what I was going to do when I started the program.

We are both in our fifties so we kind of started thinking about making the move sooner rather than later. So I went home and kind of just did an online search, just out of curiosity, and this particular job was posted 2 hours prior to me looking. I was working here less than 2 months later. But I never had a vision of, okay, I’m going to go out and practice in a rural setting, in the middle of nowhere, and be the provider that people looked to.

The hospital is a not-for-profit, I don’t believe they have grant funding, but we have a very high Medicare population, and this is something I learned about here, with CAHs, Medicare is actually a better payer source than private insurance.

I didn’t really think about how closely or how intimate you get into somebody’s life with their health care. It’s more than just seeing patients every day, it’s that we see people continually, we get to know them a little bit more. It’s a little more personal than it would be if you were working in a larger place.

That was one of things I started looking at because in my prior job I was chief flight nurse for 5 years and part of that job was call every fourth week.

I was on call 24/7 for 7 days and got minimal pay, something like $2 per hour.

Even though 99% of the time it was just phone stuff, it still limited what you could do. I didn’t want to ever be on call again but the system here makes it much more palatable. I take call one night per week and one weekend per month.

The transition to frontier life has been easy, I mean quite easy. At this point, I don’t see us doing anything different. As long as things stay the way they are now, here, you know the working relationship that we all have, and if this hospital stays solvent, yeah. There’s always things that can change, but yeah.

There is an adolescent in our community who had recently undergone a lot of family trauma and grief. About 3 months later I started seeing him for depression. So, I went through the whole process, started him on anti-depressants, started having him in frequently, had him see a psychiatrist through tele-health, who kind of helped me manage the medications for the patient. I saw him again 4 to 5 months ago in the clinic and could tell he was really depressed. I said, if you ever decide to hurt yourself or do anything, you need to call me. I gave him my cell phone number along with my home number. I also gave him the number of the crisis counselor and suicide prevention hotline. I said, I don’t do this often for people but I want you to call me. I was on call one weekend, I was driving from my house to the clinic, and I get this phone call and it’s an 800 number I’ve never seen. This lady gets on the phone and said, are you . . . and I said yes, and she said I’m . . . from the suicide hotline and I’ve got . . . on the line. I was like, wow, okay. So she puts . . . on the phone and I convinced him to come into the hospital. The patient was at home, alone in a room, contemplating suicide. I said, please tell me you’ll come in to see me and he said, yes I will and he came in. The patient had made a plan to take every pill in the house. He had made a definitive plan, not only had he thought about it, but decided, this is what I am going to do. So, I got him admitted to a pediatric mental health facility. The patient completed both an in-patient and out-patient program. I sent him a card saying hang in there, and he replied with a letter essentially telling me that if it weren’t for me he wouldn’t be alive. You know that’s kind of the unique position that you’re in, working in a frontier community, it’s not real often that you get to be that directly involved with, especially someone that age, who probably would have taken all those pills and killed himself.