Desperately seeking nurses
RHCB struggles to find Nurse Administrator, address changing rules for nurses
by Annie O’Brien

At the November 8 Rural Health Care Board (RHCB) meeting, the Board listened to suggestions from practicing and retired nurses on ways to improve nurse recruiting, retention and administration in the county’s Rural Health Care District (RHCD). The presentation transformed into a discussion over nurses’roles and protocols for treating patients.

Marilyn Huffman, a nurse at the Pinedale Clinic, who has experience overseeing shift schedules, said she has been helping the nurses at Marbleton Clinic manage their staff calendars. She asked Cindy Van, a retired nurse with administrative experience, and asked her to help her tackle some of the organizational tasks.

At the November 8 meeting, Van presented a proposal to the Board, asking for permission to work part time on nurse staffing and establishing medical protocols.

Huffman addressed RHCB Chairman Bill Budd, saying, “It is my hope you will approve this, Mr. Budd.”

But Budd expressed confusion over Huffman’s role. He said was under the impression that Huffman would take on the administrator position and work to bring more nurses to the southern end of the county.

He asked, “How do you see your position in regard to getting nurses into the Marbleton Clinic?”

Huffman, a self-described “bedside nurse,” said she did not want the permanent position of Nurse Administrator. However, she claimed she had forwarded several applications from nurses who wanted to work at the Pinedale Clinic, which has an adequate nursing staff, to Marbleton.

Huffman also said, while she was willing to help staff the clinics, she was hesitant to accept the position of county Nurse Administrator because she did not want to intrude on a Marbleton nurse’s job.

Bill Budd responded, “We don’t have any RNs. I don’t know whose job you’d be taking.” He referenced a complaint by Mary Jo Carlson, who claimed she had been turned away when she applied to work at the Marbleton Clinic, stating, “We do need them and we don’t have any. We’ve had some who have applied and been turned away.”

Huffman reiterated her aversion to assuming the administrative role full-time, but said she would work with Van and explore options for recruiting nurses.

Board member Jud Faler sought a different solution to the administrative problem. He asked Johnson if the Clinic Administrator position, which the District is actively looking to fill, would be responsible for all staffing concerns. Faler also asked Van to contact someone from Sweetwater or Douglas counties to help draft nursing procedures.

Van said while she was currently studying policies from the Jackson medical community, Sublette County lacks a medical protocol for nurses who are faced with certain situations. For instance, she said, if a patient presented with chest pain when there is no doctor at hand, nurses at some hospitals and clinics automatically administer the MONA procedure (they give the patient morphine, oxygen, nitroglycerin and aspirin).

Board members questioned why there was no medical treatment protocol for nurses. Huffman replied that the small, private-practice nature of medicine in Sublette County prior to the founding of the RHCD meant nurses were used to working in intimate settings with a single doctor who knew what they were capable of. But with unfamiliar locums and new permanent doctors coming to the county, as well as the fact that the clinics are now publicly funded and administered, nurses need written rules of conduct.

Before, Huffman said, “We’ve had protocols and procedures – it just hasn’t been written in a book.”

After the RHCB approved her proposal to consult with Huffman part time, Van said she would try to present her suggestions on staffing and protocols in January.