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Essentially the Reason We’re Here

Sharma Vaughn, RN, MPA
Executive Director, Community Care Alliance
Western Healthcare Alliance
April 1, 2020


Dear rural community,

In case you were wondering, you are essential. Any nurse will tell you. And right now, the world will agree that nurses are in the know.

A month ago, they were not. Doctors were not. Hospitals were not. We were being told that these shady characters were taking advantage of Coloradans at their worst moments in life, scalping the vulnerable. Hospitals were charging outrageous prices over illness and laughing all the way to the bank.

Lately our hospitals’ and clinics’ trips to the bank have been for lines of credit to float them through the pandemic. They do this knowing they are all that stands between plague and their people. People are valuable.

Big profit margins have never been the story coming from the rural hospitals I know. Newspaper articles about outrageous hospital profit came out in print the same day our hospital had staff meetings about which essential community medical service we might have to cut. Those hospitals in the newspaper, were definitely NOT the same hospital as us.

The stories of rural hospitals are simpler. People need help and hospitals exist for their people. People are valuable. Often, it’s the simple things that matter, like compassion, integrity, or giving someone flowers.

I learned this as a young nurse entering rural health for the first time. Coming from an urban ICU, I thought I had a handle on compassion. Compassion, that thing my teachers said, “you can’t teach, but MUST prioritize.”

I had a few lessons coming.

It started when I realized that my new rural coworkers had often lost family members in the very trauma room we worked in. Sometimes they had been the staff on shift, doing chest compressions. Here, healthcare was personal. Those lessons sank in as I began to care for my own neighbors, friends, that guy at church, or lady in my book club.

They became indelibly etched in my core when one day I met a sweet baby, safe in his first car seat carrier, a beautiful addition to a sweet family I had worked with for years. Months later I pressed that baby’s last handprint (and first handprint) in play dough. It was an inadequate memorial – my only offering to a mom whose heart broke the same day mine did.

It matters how we treat people. The hospital exists because of the community. I learned indelibly what that meant.

For me, it was the first time working in a hospital that was a small government entity. Literally, the hospital existed because the people chose to have a hospital. It had been a door-to-door campaign back in the 60’s to pass a mill levy because there was a need to have healthcare for a community otherwise isolated and vulnerable. It was a choice to build up infrastructure. It was as important as the highway and the water treatment plant. It was essential.

More essential was that the community said it was essential. We are the same, the community and the hospital. One would not have come into existence without the other; one would not continue to exist without the other. In the birth-death cycle of this world, I’ll let you sort out which is which. I’ve never been able to.

For that community, and for many other rural communities, this story repeats: The people need the hospital; the hospital needs its people.

There’s been a lot of talk over what makes an essential service these days. Local restaurants don’t make the list. That’s interesting because if the kitchen is the heart of that home, wouldn’t the local cafe be the heart of the town? Pastors, hairdressers, and bartenders don’t make the list; and suddenly, the town’s entire counseling services are shut down. We laugh about that because we know it’s true. The flower shop, the rec center, the museum, and the kids’ concerts, all deemed “nonessential,” are essentially our art, beauty, culture, heritage, and future.

The dichotomy is mind-blowing because we know. We know as nurses who put our scrubs on each day. We know as the maintenance department putting on our boots on at 0400. We know as the purchasing department heading to a dwindling supply of personal protective equipment. We know for whom we exist: the essential community that has always surrounded us and held us up. We don’t just know this in a philosophical kind of way, either. We know it in a small town, know your neighbor’s kids well enough to yell at them for chasing a ball into the street kind of way.

They say in rural, we may argue with one another, but when it comes down to brass tacks, nobody else better mess with us. Yeah, we have our rumblings, and there’s some growling from time to time, but when push comes to shove, communities come together. They sure have these days, too!

We hear the stories of sewing groups making surgical masks by hand for rural hospitals, low on the priority list for PPE, but among the first to field the Coronavirus in Colorado. We know the local distilleries have started making hand sanitizer, answering their community’s need with resourcefulness and generosity. (Let’s be honest, we always have loved rumrunners and moonshiners!)

Finally, we have been indelibly marked by flowers. The florists reinforcing the foundations and pillars of their community with petals and stems. This gesture was simple and powerful. Flowers carried gratitude to a hospital broiling in pandemic. One could call it an inadequate memorial, “nonessential.” This “only offering” reminds us that the community we’re doing this for knows too, that you are our own; you are essentially the reason we’re here.

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