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Just before the blacktop country road turns to dirt, a nursing home rests discreetly on the outskirts of Moutain View, in rural, south-central Missouri.
This is where a doctor’s rounds still include the occasional house call, when a patient in a very remote area can’t make it in to the clinic.
A city of about 3,000, Mountain View serves as a medical hub to the tiny towns surrounding it: Summersville, Hutton Valley, Peace Valley, and Birch Tree.
In rural areas across the United States, a greater proportion of the population is uninsured…many people here work for small firms with no benefits, or they’re self-employed as loggers, farmers, or truckers.
For this morning’s Sense of Community feature, we’re getting a glimpse at what it’s like to be a nurse in such a rural part of the Ozarks. Meet Heather Goolsby.
“You know, when you get out of school, you have aspirations of living in the big city, and working in a hospital. And I tried that, and I didn’t like it. This is the place that I want to be. This is home,” she said.
She’s an RN, and the assistant director of nursing here at the Mountain View Healthcare nursing home.
She went to Nursing School at MSU-West Plains and graduated seven years ago. She worked at a Springfield hospital before returning to Mountain View to be closer to her family.
On this day, she’s walking the halls, and stops by the room where residents are listening to a musical group perform. The banjo player is actually Goolsby’s mother-in-law, herself a retired nurse, and a person Goolsby says she admires greatly.
“I always had the desire to help people. It’s what I do. Family members, friends, people on the street…if they needed a helping hand, I wanted to be there to do it,” she said.
Moore: “I noticed that when you’re walking through here greeting the residents, you almost always stopped and you whispered in their ear. What are you telling them, exactly?”
Goolsby: “The residents here are my family, and you get to know them and they’re here so long, you get to know them, and they become your grandparents. They become your loved ones. You stop, and you say hi, or you say ‘I love you’ and give them a hug or hold their hand. And that’s a reward for being here: being able to be with them at the end of their life to be able to touch them and make their lives better.”
She says in a rural area, the community is extremely tight-knit. They have to be, because there are fewer resources. Whenever there’s a need, even among staff members, someone steps up to meet it. For example, right now, there’s a box at the front where the doctors and nurses are pitching in money for the nursing aides and attendants, so they can get their children holiday toys. Also, she says, the levels of hierarchy in medicine—between doctors, nurses, and other staff members—are more relaxed here than in urban areas.
“We work with some of the most fantastic doctors here. And you can call them friends. You see them out on the street, and they’ll say ‘Hi.’ And you can just say their first name. And it’s not ‘Dr. so-and-so.’ We have a physician, and his name is Dr. Roberts. And you can just say, ‘Hi Jon, how’s your mom doing?’” she said.
In addition to working at the nursing home, Goolsby works part time as a hospice nurse, and she also volunteers her skills at the free clinic here for the uninsured: the Good Samaritan Care Clinic.
That’s where people often stand in line for three hours before the clinic opens, hoping to see a doctor. There's also a free dental clinic there. About one thousand people are on the waiting list to get their teeth pulled--and the criteria for that waiting list are that you have to have a broken tooth, or a very painful one. That clinic operates every Monday night, and its medical staff is 100% volunteers.
One night, between taking vital signs and going over medications, she noticed a woman crying quietly.
“She lost her job, had lost it recently before coming in, and had no way to pay for anything. There are the ones who are truly grateful, and they’ll sit there and cry because they’re so happy that you’re here to help them when nobody else was.
In the rural Ozarks, churches play a huge role in health care: they do smaller tasks, like providing the entertainment at nursing homes, as well as more monumental tasks of donating the land and parsonage for the free clinic, as the First Baptist Church here did. And as for the pace here? It’s culturally slower, she says, even on a busy day.
“You see more of a friendship in close-knit communities, and people are a lot kinder to each other, usually. It’s not the hustle and bustle, it’s take your time and see things and experience what there is to offer,” she said.
In her job as a nurse for Riverways Hospice, Goolsby is often on call on the weekends. In a place this rural, that can mean a lot of time in the car.
“And in fact, I drove to Isabella last weekend from Birch Tree, which is over a two hour drive. It was a long trip. And I got called out to check on a dressing that the family member was concerned about. And you just get in your car and go,” she said.
The night before our interview, she was called out to another hospice patient.
“I really had become quite attached to this family, and they meant a lot. They’re like my own grandparents. And you know, my patient was terminally ill. And his wife and I were talking, and he passed away. I hadn’t expected to still be there when it happened. His wife just hugged me and said, ‘I love you, and I’m so appreciative of everything you’ve done for us. God sent us an angel tonight.’…So, it’s moments like that. That’s why you become a nurse,” she said.
Heather Goolsby is also the mother of two young boys. This young Clara Barton of rural Howell County says she intends to live out her days serving people in the only place she could ever call home.
For KSMU’s Sense of Community series, I’m Jennifer Moore.