If you end up injured or ill in the West Chilcotin, it’s Ruth Kuehl-Venn you want to see.
With over 48 years of nursing experience, most of it working as an outpost nurse in remote and rural regions across Canada, Kuehl-Venn loves what she does.
“Doing this job has given me the most satisfaction I think I could ever want in terms of a job,” she says.
Ruth works as the nurse manager alongside a small handful of other health professionals at the West Chilcotin Health Centre in Tatla Lake, a small unincorporated community on the western edge of the Chilcotin Plateau and a place Ruth has worked in and called home since 1992.
“I was born and raised on a farm in eastern Ontario,” Ruth says. “So moving to Tatla Lake in many ways was very similar. Ranching, logging, and tourism were the main industries, and the people were similar to what I grew up with. So yeah, I’ve been here for 32 years.”
The clinic is one of three in the West Chilcotin area—Anahim Lake and Alexis Creek have clinics as well—and serves around 250 residents, and more during the summer tourist season.
Without outpost clinics or nurses here, patients would have to travel by road for three hours (more in the winter) east to Williams Lake or west to Bella Coola to receive treatment.
The clinic has a doctor who comes in two days a week, but the remote nature of this work means outpost nurses in B.C. are required to do extra training to become ‘certified nurses.’
“You do a little bit of everything,” Ruth says. “Whether we’re stabilizing somebody and sending them to the hospital or actually dealing with it here locally. In some ways, we call ourselves a jack-of-all-trades.”
Being a certified nurse allows Ruth to use her training and judgment to assess and treat a patient, slightly beyond the scope of a registered nurse.
“We have decision support tools that allow us to treat common problems,” Ruth explains. “Obviously, I’m not a doctor, but I can go ahead and dispense antibiotics with the supply we have here in the clinic. I can treat the very common stuff like sore throats, ear infections, and infectious wounds. Before, I needed to call the doctor in an emergency and talk to them.”
The West Chilcotin Health Centre staff can also access a 24/7 virtual program called RUDi (Rural Urgent Doctors in-aid), a program available across the province where rural nurses and physicians can access doctors and bring patients in as well to discuss their case.
“I can call up whoever’s on call for that time period and talk to a doctor about our problems,” Ruth says. “It’s a two-way thing so they can actually see my patient, and the patient can ask questions as well. It helps us out in emergency situations and in situations where I do need to have a doctor’s order for medication. That works really well.”
While technology has made the work of remote outpost nurses like her easier in some ways, Ruth also admits that her line of work has its challenges.
“We’re really cramped for space,” Ruth says. “We’ve had to convert our garage into storage space, and if we get an emergency in and I’m already using the one stretcher bed, we have to move things around.”
The clinic is the size of a double wide trailer. It has one exam room and a lab room. The small emergency room in the back has a few stretchers separated by curtains which in a major city might not be a big deal, but in a region where everyone knows each other, Ruth says that “having a bigger space would also improve privacy for people.”
Being able to relay important information, especially during an emergency can also be tricky.
“I have seen it take literally almost a whole day to get a trauma patient to the hospital,” Ruth says. “We have satellite phones, but I have been in a situation where I needed to use my satellite phone and it didn't work because we couldn’t access the satellite. We do have cell service right now within Tatla Lake, but it only works within a few kilometers, and we have some radios because of the SARS (Search and Rescue Service). We figure out ways to make things work, but you know, it’s not always easy. Communication has been a real issue for us.”
Kuehl-Venn loves where she lives and what she does, but she is nearing retirement after 48 years of working, and she also feels a pull to help out and reconnect to her eastern Ontario roots.
“I have family back in Ontario who’d I’d like to go back and spend time with because I miss them,” she says.
But before then she hopes she’ll have the opportunity to train other nurses interested in coming to Tatla Lake.
“One of the things I like about what I do is the time that I have to spend with my patients to deal with whatever it is that their concerns are. It makes me feel good and happy that I’m able to offer that,” Ruth says. “If someone’s interested in doing this job, we would be delighted. I’d like to train people and work with them.”