By Jen Rinaldi

Dear Reader

First off, this is not a hit piece, and it is not intended to be an unfair assessment of the healthcare we have here on the mountain. It is based only on the experiences we have accumulated during our years here, along with the lessons we have learned about how to set yourself up for success if you have a procedure scheduled or must visit the emergency room because of complications.

Healthcare in a rural community can be complicated. Providers and staff are often working under constraints: limited specialty coverage, transfer challenges, weather, distance, staffing shortages, and systems that do not always communicate smoothly with one another. Plus, many of the doctors, nurses, and support staff are on a rotation schedule from other states.

That does not mean residents are powerless or that our medical services are lacking. It only means we need to be prepared, organized, and willing to advocate for ourselves and our loved ones in a calm, clear, and respectful way.

Before a Planned Procedure

If you have a procedure scheduled, do not assume someone will automatically handle or communicate every detail. If you are approaching a weekend, you will not be able to reach your doctor or his office, so ask questions early, write down the answers, and make sure you know who is responsible for each part of your care after the procedure. Ask them what you should do if you feel sick over a weekend, or what complications are typical. If your doctor is visiting, can the ER easily reach him/or her. Is any of the support staff or a PA available to answer questions or give advice if problems arise when the offices are closed?

The Main Lesson: Preparation Matters

One of the biggest lessons we have learned is that preparation matters!

Whether you are heading in for a scheduled procedure or making an unexpected trip to the ER, the more organized you are before you walk through the door, the better chance you have of understanding what is happening, asking the right questions, and making sure nothing important gets missed. Online searches can be useful, but they cannot replace guidance from your care team, so put them to work! When in doubt, ask them, not Dr. Google, before making self-care decisions that could affect your recovery.

Case in point: My husband had a procedure on a Wednesday. By Thursday night, complications had developed. We went to the ER, where he was fitted with a new device and sent home without further instructions.

What happened next: On Friday morning, we called the provider who performed the surgery to ask what we should do next. Staff told us it was safe to remove the device. By 6:00 p.m. that same day, we were back in the ER.

The lesson: It was frustrating because we had followed the discharge instructions, called the provider’s office, and tried to confirm the right next step. Days later, when we could finally see the doctor, we learned the device should not have been removed. Much of that time, stress, and confusion might have been avoided if we had asked more detailed questions before leaving after the original procedure on Wednesday.

Before going to the emergency room (ER)

Emergency visits are stressful by nature, and they are even harder when you are sick, in pain, frightened, or trying to explain a complicated medical history from memory. If possible, take a few minutes to gather the basics before you leave. If it is a true emergency, call for help and do not delay care. Keep in mind that at our ER, five to six hours is the normal wait time for service, depending on the urgency of your condition. Intake and discharge each take about an hour, then there are tests and doctor consults.

“The ER’s job is not to provide follow-up care; it is there to address urgent problems and stabilize the situation until you can follow up with the appropriate provider.”

• Bring a current medication list, including dosages and when each medication was last taken.

• Bring personal items such as a toothbrush, comb, water, energy bars, and phone chargers in case they admit you.

• Bring a list of allergies and past reactions, including reactions to medications, contrast dye, latex, adhesives, or anesthesia.

• Write down the symptoms, when they started, what changed, and what makes them better or worse.

• Bring insurance cards, identification, and contact information for your primary care provider and specialists.

• If possible, bring someone who can listen, take notes, ask questions, and help remember instructions.

• Ask what has been ruled out, what still needs follow-up, and what warning signs should bring you back.

What Every Resident Should Keep Ready

A simple one-page medical summary can make a difficult visit easier. Keep a printed copy at home, keep a digital copy on your phone and a printed one in your car glove box, and update it whenever something changes.

• Full name, date of birth, and emergency contact.

• Current medications, dosages, and how often they are taken.

• Allergies and the specific reaction each allergy causes.

• Major diagnoses, chronic conditions, surgeries, and hospitalizations.

• Names and phone numbers of doctors, specialists, pharmacies, and preferred hospitals.

• Insurance information and prescription coverage details.

• Medical devices, implants, pacemakers, or other important equipment.

• Recent test results or imaging reports, if you have them.

• A short list of questions you want answered before leaving.

How to Advocate Without Being Combative

Advocacy does not have to mean confrontation, and when you are tired and upset, this seems almost impossible to manage. In our experience, the most effective approach is to be calm, specific, and persistent. The goal is to help the care team understand the situation clearly and to make sure you understand the plan before decisions are made or before you leave.

• Ask clear questions: “What are we looking for?” “What supplies do I need until Monday?” “Who should I follow up with?” “Can bandages, catheters, or packing be removed, or do we wait for a PA or Doctor?”

• Take notes or ask your advocate to take notes for you; timelines become hazy when you are under stress at 3AM in the morning!

• Make sure if medications are involved that you have them sent to a pharmacy that is open on the weekend, such as CVS, Walgreen, or Walmart. (We had to set up an account in a rush and had to wait hours; pick a pharmacy with weekend hours for emergencies!)

• If something does not make sense, ask for clarification before agreeing or leaving.

• Stay respectful, but do not be afraid to speak up when something feels incomplete or unclear.

Before You Leave: Discharge Questions

Discharge is one of the most important parts of the visit, whether it’s from the ER or from the procedure itself. Before you leave, make sure you understand the diagnosis or working explanation, the treatment plan, medication changes, follow-up steps, and the warning signs that could send you back for care.

• What symptoms would mean that we should come back immediately?

• Who do we follow up with, and how soon?

• What happens if I have complications? Who do I contact?

• Do we need copies of records, labs, imaging, or discharge notes for another doctor?

A Closing Thought

The point of sharing this is not to discourage or frighten anyone from seeking care here. The point is to help you be better prepared. On the mountain, preparation can make the difference between confusion and clarity, between feeling helpless and knowing what to ask, and between leaving with a stack of papers most of us never consult or leaving with a true plan of action that will lead you to recovery.

We can appreciate the people working in local healthcare while still being honest about the challenges residents face. We can be grateful for the care available while also pushing for clearer communication, better coordination, and stronger systems. Most of all, we can help one another become better-prepared patients, caregivers, neighbors, and advocates.