Ellen Rabideau is Health Services Director of Prestige Senior Care of East Wenatchee, an assisted living community recently purchased by a company that owns several buildings.
In addition to the traditional role of the RN to assess and manage medical issues, the role requires a good amount of social work and case management. Critical thinking skills are essential for day-to-day symptom management as is an understanding of the developmental needs of the older population in order to provide age-appropriate care.
The role also requires providing ongoing instruction to the care team and residents, delegation of tasks to team members when the RN is not there and providing ongoing communication, documentation and coordination of services both in-house and out-of-community.
Ellen’s philosophy: Provide holistic care #
Ellen is guided by the holistic care model and endeavors to meet every person’s goal of living happy, healthy and well. She addresses their physical, mental and spiritual/emotional needs in close personal relationships.
“Being involved in the direct care of the residents allows us to build trusting relationships,” Ellen said. “Getting to know the residents and their family members well, advocating for the residents when their conditions change, listening to the residents and helping them meet their needs and being available in times of need are invaluable to our work. Overseeing the entire care team allows us to offer continuity of care throughout all of the shifts.”
Getting to know patients over time also gives Ellen and her colleagues the ability to see their needs clearly and advocate for interventions and treatment changes that can make a meaningful difference. She tells the story of a long-term care resident who suffered from a neurological condition that caused pain and tremors that were uncontrolled. “We were able to advocate for a supplement and appropriate medication changes that made an actual difference. The resident was relieved of these troubling symptoms through the end of his life.”
How she got into long-term care nursing #
Ellen’s career in long-term care started a decade before she became an RN with a position doing activities in a small memory care community of about 20 residents. Later, she moved to Montana, where she worked at a small skilled nursing facility, first as a cook, then as dietary manager. She cross-trained as a CNA.
Ellen completed her associate’s degree at Kankakee Community College in Illinois, one of the top accredited nursing programs in the state. Ellen was unsure which career path to take, and so when she was offered a position in an ICU upon licensure, she took it. She felt very fortunate to be mentored by her colleagues to develop the knowledge base and excellent assessment skills to manage current complex medical care.
Ellen was moved to return to working with older adults after caring for a patient in ICU who was given aggressive end-of-life treatments while the family supported and advocated for their loved one’s end-of-life wishes. She decided to be an advocate for and learn more about working with older adults. Within a year, Ellen and her husband had moved back to Montana where she began working in a small facility and quickly advanced to Assistant Health Director. She and her husband have been in Wenatchee two years and she is now the sole nurse in her assisted living community. She oversees and coordinates the care of 42 older adults and roughly a dozen front-line team members.
What makes it hard #
“Time is one big factor. As the RN, routine assessments of the residents must be completed as required by our assisted living contracts. But many of our residents experience changes of condition or hospitalizations between scheduled re-assessments. It’s a day-to-day endeavor of keeping caught up with each individual’s changing needs and keeping required documentation current. Plus having the time to support and train care team members, from continuing education to immunizations.”
What makes it rewarding #
Relationship building. “In this setting, the care team and residents get to know each other on a familiar level,” Ellen said. “The families trust us to steward the care of their loved ones in their absence; this is an immense and joyful responsibility. There are lessons to be learned through inter-generational connectivity.”