SATURDAY, FEBRUARY 26, 2022 | COURAGE | PROGRESS 2022 | PAGE 11
Hospice workers in the area share dedication to both their profession and their patients By Alex Guerrero
alex.guerrero@albertleatribune.com
Growing up, some people arenât sure what they want to do. For others, their dream job turns out to be something completely different than what they went to school for. For Andrea Madrigal, her career path was inspired by her mother, Patty, who herself is a nurse. Madrigal started nursing in 2015 as a personal care assistant. She then worked up to a licensed practical nurse and finally to her current job at Embrace Home Care LLC as a registered nurse. âI love helping people,â she said. âI actually went to school to become an occupational therapist, and when my mom started this company I started out as a PCA and I found that I loved working with the clients.â Being a health care nurse isnât just drawing blood and administering shots either. âEvery day is different,â she said. âFor the most part we try to help out with things needing to be done with patients such as paperwork, phone calls, schedules, handling employees,â she said. During one of her nursing shifts, she may have to take an evening shift from 3 to 10 p.m., though on occasion sheâs worked 14-hour days with nothing more than a 30-minute or hour break. One shift constitutes seven hours with one client, and sheâs currently alternating between three clients. Because Embrace is an in-home service, she also has to travel to patientsâ homes. All of her patients are ventilator dependent, and some require gastrointestinal tubes. âMost of the time we are just caring for them, getting their hygiene cares done, their oral cares done,â she said. âAny patient appointments that they need to go to, we are there with them at the hospitals.â She also administers medications and treatments. Patients may also have diseases. âWe take little ones out of St. Marys,â Patty Madrigal said. âWeâre in the process of taking one now where we have a baby that was born with a disease or they were born prematurely, and we take them and we put them in the home and then we staff them with nurses.â Another challenge is staffing, and if theyâre short-staffed or other agencies are, that means
Erin Brandenburg, a registered nurse, has worked at Mayo Hospice since 2008. ALEX GUERRERO/ALBERT LEA TRIBUNE
Jacqueline Carstens is a medical social worker at Mayo Hospice. someone in the community in need of care wonât have it. And like everything else, COVID-19 made Andrea Madrigal alter the way she works, whether it was being more mindful of things happening around her or washing her hands more frequently. Sheâs also wearing masks in patientsâ homes at all times. âWeâre just mindful of them and being more cautious,â she said. Embrace currently has around 60 clients and 10 employees covering seven counties, with most of their base in Steele, Freeborn and Mower counties. Madrigal is working on her masterâs degree as a family nurse practitioner, and she also serves as a case manager at Embrace.
âEvery patient is differentâ One circumstance can alter a personâs life trajectory forever. This was the case for Erin Brandenburg, a BSN/RN at Mayo Hospice. âMy dad had multiple sclerosis for many years,â she said. âHe was diagnosed a year before I was born.â That meant she helped care for him at home while
in school, and her work drew her to the field. âWhen I worked in [a] rural hospital in Emmetsburg, we had a hospice room at the end of the hall and nobody wanted to take the hospice patients,â she said. âI kind of volunteered and enjoyed it and liked it, so then I kind of became the hospice nurse who would take the hospice patients when they were at the hospital.â So when she moved to Lake Mills and saw a hospice position open, she applied and was hired. As a hospice case manager, she and her team deal with six to eight patients. âI schedule visits throughout the week,â she said. âThe thing with hospice patients is every patient is different. Some might be seen several times a week, some may be seen once a week, some maybe three to four times a week or daily depending on their needs and how theyâre doing overall.â Typically, Brandenburg tries to see four patients daily within the 45-minute hospital radius. âI go into the patientâs home, the nursing home or wherever the patient resides, and Iâm assessing the patientâs symptoms,â she said. That can mean figuring
out whatâs bothering the patient, as well as prescribing treatment. Sheâll also educate the family or facility staff depending on who is caring for the patient. She also tries to save one day for admissions. âIf thereâs a new patient to take on, I like to have room for that,â she said. âAdmission to hospice can pretty much take up your whole day.â Originally, unless absolutely necessary, COVID19 put a pause on patient visits and made her adapt. âWe would do Zoom visits, video visits of any way, telehealth, all of that â phone visits sometimes if they didnât have the technology for telehealth,â she said. âWe were doing a lot of that when the pandemic started.â Sheâs also wearing personal protective equipment and goggles. âFacemasks obviously are a must, but it kind of hinders being able to see your patients and them being able to see you and ⌠you miss that kind of connection you had with your patients prior to the pandemic.â Another challenge she has faced is not knowing how many staff sheâll have. âYou may have to take on extra because somebody is sick or somebody is out or you pick up extra work because you just donât know what the dayâs going to bring or if you need it you might pick up an extra day here or there just to help out and get through.â During the pandemic, Brandenburg has learned the value of teamwork. âHaving people there to support you as well as you supporting the patients, and just being able to work together to get through,â she said. âYou just never know. âSome days youâre
working fine, everybodyâs working. Next day somebody is out because we all have families outside of this.â Sheâs also spending less time at the physical hospital because she starts and ends her day at home. âI have my laptop, and so I just go from my patients to home to patientâs houses to back home,â she said. âMost of our meetings here in the office are all via Zoom now, so we donât have to physically see each other in person very much.â And thatâs something she was very appreciative about: easier access to patients. Brandenburg grew up in Buffalo Center, Iowa, and received her two-year nursing degree through Iowa Lakes Community College, and earned her Bachelor of Science in nursing through the University of Iowa. She has been a nurse since 2001 and has been with Mayo Hospice since 2008.
Supporting patients and families in new ways Knowing what you want can make life easier. That was the case with Jacqueline Carstens, a medical social worker with Mayo Hospice. âI started at [Naeve Hospital] as a discharge planner where I helped people get placed into facilities or health services at home,â Carstens said. âThen they started the Hospice program around 1985 and they were looking for social workers. So I was able to help with that when it started.â Besides that, she went to the nursing home that Naeve owned in Wells, so being in health care was always in her plans. âItâs a philosophy of caring for people at the end of life, and working as a team and just having that support to help people when a lot of times people are not wanting to be with people at the end of life,â she said. âI just thought it was a very rewarding experience, and Iâve stayed with it ever since.â As the social worker on her team, she tries to help people with social and emotional concerns. âA lot of times the nurse is focusing more on the symptom management of the patient,â she said. âA lot of what I do is try to help with the family.â That could mean making a phone call or taking a home visit, where she wants to support the
family with information on what to expect as their loved one progresses through a disease. âWe work not only with the patientâs physical needs, itâs the social/emotional,â she said. âAnd then we have a chaplain on our team that helps with the spiritual. So we really work as a team of professionals.â Because of changes made during the pandemic, Carstens is able to work from home. âWe all have laptops with all of the patient information in, and so we kind of look at what Iâm going to be doing for the day, setting up my scheduling,â she said. âI usually try to see people at least once a month, but it may be every two weeks.â After organizing her data, sheâll make her visits or phone calls to some of her 23 patients. She said the pandemic hasnât stopped their visits, but at the beginning it did change how she operated. âSome of the facilities where we had our patients reside in, the families werenât always allowed to be there with them,â she said. âAnd so I remember being outside a window of a facility because they could only look at their loved one through a window. âSo supporting them that way, that was a big change.â The emergence of telehealth has also interfered with any personal touches to one-on-one support. Thatâs not to say everything has been harder. âSometimes things can be more efficient if youâre able to do things by telehealth,â she said. âWe do a lot of Zoom meetings and connections.â But the current crisis has also taught her to not be afraid. Instead, she tries to do the best she can while still being careful. âLife is precious,â she said. She also admires her colleagues on the front lines of the crisis who arenât afraid to go in with their personal protective equipment. âIt is a tough time but we still have to be there to take care of the people that need us,â she said. âI think that made us stronger as a team, too.â Visits typically include assessing how patients are coping and answering any questions But make no mistake, not every day is the same. Carstens grew up in Blue Earth and graduated from St. Benedictâs with a major in social work and has worked in hospice for 26 years.
âThis has been such a fun and exciting experience to be a part ofâ MANAGER AT MERCYONE CLINIC IN ALBERT LEA HAPPY TO BE A PART OF NEW ENDEAVOR By Alex Guerrero
alex.guerrero@albertleatribune.com
Life often takes you on unexpected twists, and the road to the goal is almost never straightforward. Take Kristin Flatness, a registered nurse and the manager at MercyOne Albert Lea Family Medicine and Specialty Care, for example. âI was actually working in another health care administration position at a senior living facility,â she said via email. âOne of my tenants was a member of the Save Our Healthcare organization (that is what Albert Lea Healthcare Coalition was called at the time) and convinced me that I would be a great candidate for the new MercyOne Clinic director.â So she decided to apply after she found the ad circled in red and placed in the middle of her desk. âI didnât want to let my tenant down, so I decided to give it a shot and apply,â she said. âLow and behold, that got me where I am today and I couldnât
be happier.â But being a nurse wasnât her original goal. Flatness, who was always interested in the medical field, had previously worked for about nine years in a hospital in-patient pharmacy. âI wanted to go back to school to be a pharmacist,â she said. âBut without any pharmacy schools in the area, that wasnât an option for me. Nursing was the next best choice.â And despite not pursuing pharmacy, sheâs happy where sheâs at. âThis has been such a fun and exciting experience to be a part of and I could not be more proud of the citizens of Albert Lea and thankful for the ALHC,â she said. âI am also grateful for being able to work with such a fantastic group of providers and staff here at the MercyOne clinic.â But like everything else, the pandemic changed how she and her team at MercyOne operate. âWith COVID in full swing, we had to adapt
Kristin Flatness works as a registered nurse and the manager at MercyOne Albert Lea Family Medicine and Specialty Care. ALEX GUERRERO/ALBERT LEA TRIBUNE our increasing acute visit demand to meet the needs of our sick patients,â she said. âWeâve created new safety protocols so that we are able to reduce exposure between our patients who are here for a well
visit and patients who are coming in because they are sick.â Those new protocols include specialty visits along with âwellâ visits such as regular child visits, physicians, Medicare wellness
checks, chronic disease management visits and pre-op physicals. But those procedures arenât all. âWe then clear the clinic following cleaning protocols, and start seeing those
with upper respiratory illness, possible influenza, strep, COVID-19 and other contagious illness,â she said. Before seeing them, she asks those patients to wait in their cars rather than the waiting room before being called into an exam room. She said she anticipated that process to change once COVID becomes more manageable. Above all, sheâs learned to never predict what could happen. âThings can literally change minute-by-minute,â she said. âWith COVID there were so many unknowns and policies and procedures changed hourby-hour some days.â Staffing was also a concern. âYou have to learn to take everything in stride and be flexible,â she said. She encouraged anyone looking to join the health care field to visit mercyone.org/northiowa/ careers. Flatness graduated from Blue Earth Area High School and graduated with a bachelorâs degree in education from the University of Minnesota-Twin Cities. She also earned a masterâs degree in health care administration.