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What distinguishes a rural setting is arequirement to work seamlessly as a teamand be a jack of all trades – or a “Pat ofall trades” if you will. Pat mentions acase where a patient came in on a C-spinefollowing an accident. After being sent toMedicine Hat for emergency treatment,the ongoing care provided in Oyen meansPat now has experience with halo care. “Ina rural hospital, your job is like workingin all wards of an urban hospital at once,”Pat says.A rural environment means workingwith what you have…and don’t have.Big Country Hospital’s ER is like aregional triage. The hospital doesn’thave equipment like CT/MRI/Scopes,and there are no surgical procedures(sent to Medicine Hat two hours away).Conscious sedation/setting of brokenbones, dislocations, biopsies, and theusual coughs and colds are managedlocally. Those sent away for surgeryare typically sent back to Big CountryHospital to recuperate. Home care ismanaged through the facility.But it’s not a quiet ER. Oyen’s locationat the intersection of a busy highwayintersection generates many car accidents.A location midway between Calgary andSaskatoon generates stops for those whohave health issues while driving. Somestop at the hospital because the ER waitis 15 to 30 minutes as opposed to a typicalseveral hour wait in urban centres. Pattalks about really busy recent years, wherethe presence of 1000 person oil and gasconstruction camps generates injuriesfrom broken bones to burns.The Big Country Hospital’s 10 acutecare beds, 30 long term care beds, and 24hour ER generates a day in the work lifethat feels like those oatmeal variety packboxes in the grocery store. For Pat thattranslates to a 12 hour shift (one LPN andone RN), report first thing in the morningto cover patient needs, breakfast and medsat 8 am, assessment and treatment of 8-10outpatients in the ER (shared with RN),all inpatient care including assessments,vitals, charting, meds, injections, orderingof lab work if required – and answeringthe phone and doing all departmentpaperwork when the office staff goeshome at 4 pm. The LPN role has comea long way since 1990 when Pat started,describing her role at that time as a “washand transfer caregiver.” “We had to locatean RN to even take a doctor’s order,” Patsays.Nurses play a coordinating role within asmall collaborative team consisting of aphysician, RN manager, physiotherapist,and dietary technician. An occupationaltherapist, dietitian, and respiratorytechnician visit once a month fromMedicine Hat. “The team shares thewhole hospital together,” Pat says. “In10 care | volume 27 issue 1