After working as an ER nurse, I was done. Then I discovered the magic of a small town practice

This is a First Person column by Christie Brulhart, who lives in Consort, Alta. For more information about CBC’s First Person stories, see the FAQ.

When people ask me what it was like to work as an ER nurse during the pandemic, I always lie. 

I tell them the worst part was being mandated to work by my employer, the isolation or the masks. I don’t think they want to know the truth.

Because the truth is that the hardest part about the pandemic was listening to someone who was struggling to breathe, say their last clipped sentence: “Can you tell my daughter I love her?” 

Perhaps I didn’t fully appreciate how fractured our health-care system was until March 2020. 

My breaking point

I was working a night shift in a rural emergency room caring for a COVID-positive patient — an elderly woman who had suffered from polio as a child and was bed-bound as a result. 

She had a violent cough that shook her slight frame. When she wasn’t coughing, she would be gasping for air. Her vital signs were looking more unstable by the minute.  Every time we asked her about her pain, she gestured, “10/10.”

Due to her chronic illness, she had chosen to receive comfort care rather than life-sustaining interventions like intubation. 

 As a registered nurse, I knew the patient should have been offered a pump that would deliver pain medications at a steady state and the patient could hit a button and receive “breakthrough” doses. But it wasn’t within my scope of practice to administer medications without a doctor’s or a nurse practitioner’s order. 

Unfortunately, the doctor on shift did not feel that the patient needed further pain medications, despite my insistence and documentation. 

Another nurse and I spent the rest of the night in and out of her room, each holding one of her hands. We both cried behind our masks and goggles as she struggled to breathe. Watching that woman dying in pain in an emergency department is one of the most heart-breaking things I’ve ever seen. 

That was the moment I decided to become a nurse practitioner. As an Albertan, you can see a nurse practitioner for most things you’d see a family doctor for. They have more training and experience than a regular nurse. 

The next day, I started working on my application for the master of nursing program at the University of Alberta (U of A).

Receiving my acceptance letter from the U of A was like jumping into a crisp lake first thing on a Sunday morning — it was so refreshing to feel empowered. I started the program in fall 2022.

Many of my colleagues at the U of A had worked in critical care environments related to my experience. It was healing being surrounded by intelligent and driven women who wanted to make a difference, despite the burnout, divisiveness and pain they experienced during the pandemic.

Passion reignited

Rural emergency care became a passion of mine after working as a registered nurse in the emergency department in Bonnyville, an Alberta town with fewer than 7,000 people. Returning to school reignited my passion to provide equitable and accessible care to rural communities. 

A nurse I met through the program suggested that if I wanted to have a big impact in a rural community and advocate for NPs to work in rural ERs, then I should look at the job posting for the Consort Medical Clinic.

The clinic served a village of about 670 residents in east-central Alberta. The posting had closed four weeks earlier but I figured I had nothing to lose. Within a day, I received a call and by December 2023, I signed my contract. 

The town has been traditionally under the care of medical doctors. I was the first nurse practitioner it had ever hired.

That Christmas, to the surprise of my husband and I, we were featured in the local newspaper announcing that I had been hired. We received dozens of Christmas cards from the community members and elementary students welcoming us to Consort before we had even moved. 

The town has restored my faith in humanity and reignited my passion for holistic care.

The thing I’ve learned and love about rural communities is that they can seem dainty and cold if you’re just passing through, but if you spend a little time there, you’ll quickly understand why people never leave.

My husband and I had been on the waiting list to adopt a baby for a few years. Shortly after our arrival in Consort, we had an unexpected surprise — we had been chosen by a birth family to adopt their baby girl. 

We had less than 24 hours to prepare for her arrival. I feared that there would be outrage from the community because I had just started seeing patients, and suddenly I was taking time off.

I was obviously very wrong. Consort welcomed her arrival with open arms.

When I first arrived in the quaint town, my initial thought was that this would be a stepping stone in my career. In a few short months, I had a much clearer understanding of what this town means to me. 

Before I knew it, I was calling it home.

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