Ellen Ribidau 1

Ellen Rabideau, RN

This content origi­nally appeared in the Spring/​Summer 2020 issue (PDF) of The Washington Nurse magazine. See the full set of stories on long-term care.

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.

“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.”

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.”