Rangely hospital getting back to a full healthy staff

RANGELY I In the coming weeks and months, Rangely District Hospital hopes to offer what it’s been short on for the better part of a year: continuity.
In December, Dr. Mercedes Cameron took leave to be treated for breast cancer. Then, after extended absences beginning in February, Dr. Chris Adams resigned from the hospital in June, citing medical reasons and going on the hospital’s long-term disability program.
The hospital dealt with the loss of half of its regular physicians by coordinating the schedules of remaining doctors Karyl Ting, Tim Hsu and several locum tenens (fill-in) doctors. Still, in the last year, the hospital has had weeks in which just one doctor cared for patients in the clinic and emergency rooms. It has also had to cancel appointments, some of them long-standing.
“It’s unfortunate, but there’s no way we could have planned for what happened with Dr. Adams,” Rangely District Hospital CEO Nick Goshe said. “There’s no way we could have planned for what happened with Dr. Cameron … It’s been rough and we know that we’ve had a lot of cancellations. But I think it’s short-term.”
Goshe has reason to think so. Last week, family practice physician Katy Rieves arrived to familiarize herself with Rangely’s hospital, her new coworkers and future patients. Rieves, who began seeking a rural situation last year after running a Grand Junction private practice for 12 years, heard from friend and former coworker Mercedes Cameron that Rangely might be a good fit. After an interview and a visit, she was inclined to agree.
“The hospital’s gorgeous,” Rieves said. “To have a small town with such a great facility is a blessing.
“But more importantly, every single person … knew every other single person and seemed so nice and kind,” she said.
The hospital staff’s “learning-conducive” approach to dealing with challenges — among them federally-mandated Electronic Medical Records (EMR) requirements — was another draw, Rieves said. So was working at a facility that, while remote, still has relatively close driving and flight access to cities, at least compared to the Alaskan hospitals Rieves also considered.
Of the three health care providers who will begin scheduling patients between now and March, one is already familiar with the hospital’s inner workings. Registered nurse Shelby Lindsay, who contracted with RDH as a travel nurse in April 2012 and signed on as a full-time employee last November, will earn his nurse practitioner license and begin seeing patients early next year.
“I’ve always had a desire to help people,” he said. “That was why I got into health care to begin with. This just gives me the opportunity to take it to another level and be able to do more for my patients.”
Although Lindsay will consult regularly with physicians, he will see patients under his own license. Although the new position comes with a certain amount of anticipation, it’s a challenge Lindsay said he is ready for.
“When I started out in health care as a paramedic, that was anxiety-provoking — the fact that people were trusting me to make decisions for them,” Lindsay said. “And then when I moved on to become a nurse, that had its own extra level of anxiety for the same reason. And this will, as well. But you do your best to keep your patients’ best interests at the forefront.”
A second physician, D.O. Casey Aguirre, will arrive in Rangely after completing his residency in Pueblo this March. Aguirre, a Salt Lake City native, has been looking to practice on the Western Slope, Goshe said.
The picture, once complete, should result in locum doctors working only on weekends or when regular doctors are on vacation or ill, Goshe said.
Dr. Cameron also spent time in Rangely last week, visiting staff and learning about the new Electronic Medical Records system implemented since she left. Although she’s not yet ready to come back to work, citing “chemo brain” as stifling her mental acuity, she said it is still possible she’ll return.
“Physically, I’m great,” she said. “I can do everything I always did. I’m fabulously strong, all of that. It’s just the mental part. And we’ll just have to see what happens with all of that.
“There’s a big pull, a huge pull to come back here,” Cameron said. “You walk in the door and everybody’s thrilled to see you. But more importantly, it’s a really fabulous place to work.”
Whatever her future with RDH, Cameron believes that Rieves, Lindsay and Aguirre will provide the consistency the community needs.
“It’s a difficult thing in a very small town to not have continuity,” Cameron said. “We have that with the staff, but not the care providers. We’ve gotten close a few times and then things blow up. I get cancer, et cetera… Things happen.
“Now here we are again,” she said. “Shelby, Katy, Dr. Hsu, Dr. Ting are people who are going to be there. That’s what we all want for our care providers, someone who knows us and cares about us. We’re going to have that now.”
Rieves, who has a strong background in women’s health, said she is looking forward to expanding her “breadth of care” in Rangely, spending more time treating patients and their illnesses and less time dealing with patient management tasks.
One of her strengths, she said, is to look at illnesses from a variety of angles, then work with patients on an approach they’re comfortable with. For some individuals, that teamwork approach can result in what Rieves most loves about medicine: seeing people make consistently positive choices.
“If people change their habits, then their need for me is much less,” Rieves said. “It feels a lot better to someone when they’re facing death or illness if they’ve done the best they can versus shaming someone because this is a behavior they’ve wanted to change but they couldn’t.”
Lindsay’s motivation for moving to the next level of care is twofold: the people he’ll be working to help and those he works with every day.
“Most of the people who work here are really invested in the community and … seeing us fulfill our mission rather than just trying to get a paycheck,” he said. “That was one of the things that attracted me to want to stay.”
Rieves will work every other week in Rangely while Dr. Ting will see patients on Rieves’ off weeks. Lindsay will fill appointments Mondays through Fridays, while Dr. Aguirre will work Mondays through Thursdays each week.
Goshe plans to have two care providers in the clinic during the week and one provider covering the hospital size to minimize future cancellations.