Montana Nurse Describes How Coronavirus Pushes Rural Health Care To Its Limits

Published December 4, 2020 at 12:40 PM CST

A patient is connected to a ventilator and other medical devices in a COVID-19 intensive care unit. (Go Nakamura/Getty Images)

In rural America, treating COVID-19 patients can be especially difficult.

People live far from limited medical facilities, and communities are small and isolated. Often, there’s a stigma around just getting tested for the virus.

Joey Traywick, a nurse working in the coronavirus unit at St. Vincent Healthcare in Billings, Montana, says he walks into work every morning with an “ominous feeling.”

“You start realizing you’re kind of going into the heart of the beast, if you will,” he says.

As a nurse, he mentally prepares for a demanding 12 or more hour shift where he has to hit the ground running as soon as he clocks in. Multiple patients typically need assistance right away, he says.

In a rural hospital, there are only so many intensive care unit beds, he explains, which often means the ICU and COVID-19 units are bargaining with each other.

“We do the best we can,” he says. “We’re rural medicine — 500 miles for any direction, we’re it. We have more cows than people in Montana, we like to say.”

But with so few resources and a current coronavirus surge underway, Traywick expects patients will have to be taken to cities with larger facilities, such as Denver or Salt Lake City.

Traywick is recovering from COVID-19 himself. He didn’t need to be hospitalized but says he’s still not back to 100% health. With the coronavirus, even taking a hot shower gave him the chills, he says.

While fellow health care workers told him to take his time coming back, Traywick knew as soon as he tested negative for the virus, he had to get back to nursing and his patients. It’s something he knows others in the field have experienced during the pandemic and predicts it’s a feeling that will “define us as a generation of caregivers and nurses.”

During the pandemic, Traywick cared for 53-year-old J.D. Old Mouse, a member of the Northern Cheyenne tribe. He was the last flute maker for the Northern Cheyenne people.

At first, the two didn’t get along, he says. Old Mouse expected doctors and nurses to be on time, a nearly impossible feat with nurses stretched thin with a multitude of patients.

During a series of long shifts — Traywick recalls being on day 14 or 15 in a row — the nurse cared for Old Mouse every day. After several weeks of interacting, the pair ended up sparking a friendship.

But Old Mouse’s health deteriorated. Still, they kept the conversation light with Traywick reminding Old Mouse about making him a flute and teaching him how to play. Their chat about flutes happened two days before Old Mouse died in the ICU.

Traywick recalls getting a call from Old Mouse’s family, who said they wanted to thank him for taking care of their beloved husband, father and grandfather.

Sure enough, about 40 friends and family members of the Northern Cheyenne tribe were in the hospital parking lot waiting to share their gratitude with Traywick. They “encircled me and prayed for me in the dark at nine o’clock at night to thank me,” he recalls through tears.

Shortly after, they dispersed. They said Old Mouse’s body was being brought from the hospital to the funeral home.

A little while later, Traywick received a handmade Native American flute, called the Sparrow Hawk, in the mail. The instrument was from a stranger in Arizona who heard of Traywick and Old Mouse’s story and wanted the nurse to have it.

The entire experience — caring for Old Mouse, the family’s thankfulness and a stranger’s gift — touched Traywick. He says if others don’t have empathy and compassion in their hearts during these unprecedented times, then he’ll have twice as much to make up for it.

“My job is to have twice as much compassion and twice as much empathy for the people that don’t have it,” he says, “and for the people that don’t think about wearing a mask for my friend J.D. Old Mouse.”

Knowing the virus is random and unjust, he says it’s everyone’s responsibility on the front lines to act tenderly and respectfully to those they care for.

As Traywick reflects on the experience, he says he’s been writing thank you cards to the folks who have recently sent him kind words and gifts.

One 80-year-old woman from California couldn’t go out to buy a card so she painted a watercolor picture. It depicts a nurse holding the hand of a patient.

“And the last responders,” she wrote.

This article was originally published on WBUR.org.