The Red Lake Margaret Cochenour Memorial Hospital: Nursing and delivering care in a remote rural hospital

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When you were in nursing school you tried to decide which clinical area of practice you would most want to practice in upon graduation. As you did your maternity experience you pondered if this was for you. You enjoyed the excitement of the emergency department and the critical care areas. It would be a difficult decision, but what if you chose to work in a small rural remote hospital? You could have the opportunity to do it all, or most of it.

Red Lake is a small community of approximately 6,000 people in Northwestern Ontario, approximately 2,000 km north of Toronto, 170 km north of the Transcanada Highway, between Dryden and Kenora. The Red Lake Margaret Cochenour Memorial Hospital has 22 acute care beds and six chronic care beds. The entire hospital is smaller than most wards in a city hospital. We do not have a doctor in the hospital at all times so the nurses must make thorough assessments and then contact the physician on call.

Our nurses are skilled in providing all aspects of care. Because there are usually only two or three registered nurses working in the hospital at any one time, they must be able to meet the challenge of what might present. When there is a maternity patient, it is that nurse on shift who is responsible for assisting with the safe delivery of the newborn. If a cardiac arrest arrives via ambulance, she must go to assist with the resuscitation. She might be the one assessing the cardiac patient, doing the EKG and preparing the Tenecteplase upon the diagnosis of AMI.

Nurses at Red Lake all maintain certification in ACLS and NRP with the majority of them also having their TNCC. Our nurses have the opportunity to work on committees and provide valuable input into policies or clinical pathways. They have also assisted with the accreditation process. There are opportunities to do flight nursing with patients on medevacs, participate in education, or medical consults via videoconferencing within our Telehealth suite, or upon further training, administer chemotherapy to our oncology patients.

Our nurses often look at the specialty nurses in the city with awe, wishing they could be similarly skilled, but I think if you placed one of those specialty nurses into a rural remote hospital ward, they would be the ones looking with admiration at what our nurses are capable of doing.

Because of our distance from larger centers, and our geographic location in Northwestern Ontario, recruitment can be difficult at times – however when staff leaves our facility the reason is often because their spouse relocates to another community or because they wish to further their education on a full-time basis. It is often with tears when they do leave because of the relationships they have developed with their coworkers. When they do go to hospitals elsewhere, they are usually able to go to almost any clinical area because of the diverse experience they have had while working in Red Lake.