Nursing a labor of love for Jackie Bischoff

Working in her hometown hospital and clinic has been a labor of love for 49-year veteran

It has often been said that a good nurse is worth his or her weight in gold, or words to that effect, and that they have a love of patients in their heart that is unparalleled.

Certainly, both superlatives could be said about longtime Lovell nurse Jackie Bischoff, who has worked for North Big Horn Hospital for 49 years full-time and after recovering from some back surgery is actually back at work on a part-time basis.

The daughter of Herb and Melva Fink, Jackie had her eyes set on nursing from a young age.

“I just always knew I wanted to be a nurse,” she said. “I dressed up my Barbie dolls. I would cut off the tops of socks and make dresses and then make little caps out of pieces of paper. It was always something I knew I wanted to do.”

In high school, Jackie was a member of the Future Nurses Club and worked as a candy-striper.

After her graduation from LHS in 1974, she attended St. Patrick’s School of Nursing in Missoula and earned her degree as a “diploma nurse” in 1977. She attended school year-around, with no summer break, her first year, then had working summer breaks during years two and three.

“I actually started at the hospital in 1970 in the kitchen, and I worked there clear through high school, and then on my summer breaks (during college) I worked as a nurse’s aide until I graduated in ‘77 and then started as an RN,” she said. “You didn’t have to have a certificate then, just the fact that I was in nursing school gave me enough background.”

Jackie married husband Dave Bischoff in 1978 and added ranching to her resume of skills. The pair made a good combination, because while Dave knew cows and ranching, he wasn’t a farmer, whereas Jackie had experience on her parents’ farm. Dave was working construction when his father-in-law, Herb, needed some help.

Hack Jolley had asked Herb to farm his place just east of Lovell, and Herb already had a lot on his plate with his own operation, so he asked Dave to help him with farming. Dave did so and eventually bought that farm from Jolley, the place where Dave and Jackie raised their family and live to this day.

Dave and Jackie raised three kids on that farm, now adults with families of their own: Brian (wife Kary), who works as a salesman at Fremont Motors in Powell; Lindsay Ruble (husband Marko) of Cody, a language and speech pathologist; and Betsy Piper (husband Jesse), a radiology tech at North Big Horn Hospital specializing in cardiovascular ultrasound. The Bischoffs have eight grandchildren.

Longtime career

Jackie was hired as a registered nurse at North Big Horn Hospital and worked in the facility on 10th Street that preceded the current hospital and care center on Lane 12. She said she worked as a general nurse, performing duties in a multitude of areas.

“They did surgery, (delivered) babies, the emergency room – you kind of did it all,” Jackie said, “and I knew the minute I stepped in the operating room as a student, that was going to be my love, so because I liked it so much, they made sure that I got to do a lot of it when I started here.”

Asked what she enjoyed about the operating room, she responded, “You learned about how things worked, but when you opened up a body you could actually see it, and you saw results really fast. You improved people immediately. … I like to make things better, solve problems.”

As a young nurse, Jackie had one special skill that came in extremely handy in the OR: the ability to scrub and disinfect.

“As a diploma nurse, we were actually taught how to scrub, and you won’t find a registered nurse that knows how to do that,” she said. “But it was part of my training, so that was really beneficial to them. They didn’t have scrub techs then, so they would train people with an interest. We had a couple LPNs that they trained to scrub, but mostly it was just a full RN staff.”

After she’d been at the hospital around four years, Jackie became the manager of the operating room and as such supervised the move to the newly constructed hospital on Lane 12 in 1984. That move came with a story.

“When we were ready to move to the new hospital, I worked all night packing up everything, and I went home to sleep for a couple hours, so I could unpack it in the new OR,” she said. “They had an emergency appendectomy come in in the midst of the transfer, so they found everything, thank heavens. I’d labeled everything. They found the stuff to open it and do the surgery and then transferred the patient over to the new hospital.”

Jackie said she worked as the OR manager until four or five years ago, when she shifted her primary duties to the clinic.

“Surgery had gotten so busy that I had to choose whether to do that full-time or the clinic, and age wise, I knew I was getting toward the end of my stamina,” she said. “I knew the clinic would be an easier route for me, but I continued to help them out, especially if they were short a scrub person.”

For decades, Jackie ran the OR, and her duties were many and important.

“The budget, that was a big one, and staffing, which was always a problem,” she said. “And then the day-to-day coordinating the surgeries, personnel and equipment, especially when we started doing orthopedics when Dr. (Jared) Lee came in. He felt strongly that it would be beneficial, especially to older people, not to have to travel and have their families out of town, and so he really pushed for that.

“And so we were suddenly dropped into orthopedics. It was a big investment for us, but it’s continued. He and Dr. (Mark) Ryzewicz would come from Cody and before that we had a doctor that would come from Billings, Dr. Robinson. They didn’t do any total joints or anything like that. They would just do scopes and minor things. Then they got more into total joints, so then people could stay in their hometown.”

Of all the different procedures she assisted with, Jackie said she enjoyed general surgery the most, and she saw techniques evolve over the years.

“I like general surgery the best, and we moved from all open cases to laparoscopic,” she said. “It’s called minimally invasive (surgery), so instead of a whole open incision, you had maybe four little cuts, and we would use scopes and work on the outside of the body with long instruments that could reach in, and now they’ve got the robotics that give you a 360 (degree) view of what you’re looking at, rather than the 180 that the laparoscopic gave.”

Jackie hasn’t had a chance to assist Dr. Michael Hill with his robotic surgery work, but as she returns to work part-time, she may have a chance to work with Dr. Hill.

“That’s what they would like me to do now, if my back surgery is successful for standing for periods of time,” she said. “Joann (Walker, OR manager) would really like the help in that department, so I will still get to learn something new. … I would be the scrub nurse, so I would do all the setting up and the passing of the instruments.

“They’re doing a lot of GYN (gynecological) surgeries now with Dr. (Brenda) Camp, so that’ll be kind of new for me. I’ve done a lot of GYN, but it was all open. And she does a lot of the robotics, too.”

Working with Ken

Except for helping now and then, Jackie stepped away from the OR about five years ago and moved full-time to the clinic. She had performed relief work in the clinic over the years and, in fact, worked with then clinic manager DeDe Wardell to implement the current system of a nurse being assigned to a particular doctor rather than rotating, which allowed the nurse to be familiar with cases and not have to get up to speed with each new doctor.

Jackie has worked with longtime hospital Physician Assistant Ken Ferbrache MPAS, PA-C for many years and has really enjoyed the work.

“It has been fantastic. I couldn’t have asked for a better person to work with,” she said. “He’s one of those where you are part of a team, never ‘I’m the boss. Do as I say’ type of thing.”

Ferbrache was equally effusive in his praise of Bischoff.

“We worked together for 27 years, and believe me, she’s the one that kept me focused on where I was supposed to be and what I was supposed to be doing,” he said. “My wife Ranee and I jokingly called Jackie my ‘work wife’ because she, for sure, kept me where I needed to be for a lot of years.

“She took great pride in working with student and less experienced nurses to help them perform their work duties in an efficient manner while using those values that Jackie always lived by of compassion, honesty, integrity and trust. She had a wonderful ability of deferring and assisting in quality care for each patient to keep me from burnout and feeling overwhelmed.

Ferbrache has great respect for his nurse’s character and spiritual nature.

“Even though we are not of the same religion, she has a deep abiding love of Jesus Christ, as I do, and that very much translated into her work as an RN. One of my favorite things to do was we’d share a meaningful quote almost every morning to lift each other and remember that every person deserves to be treated with love, caring, dignity and respect, as He treated those He met.”

Jackie had back surgery on April 6 after announcing her retirement and working what she thought was her last day on April 2. But after a few weeks on the mend, she started working some hours with Ferbrache’s new nurse, Haley Finton, to give her some transitional help. She realized she still enjoys the work and is willing to come back part-time in the clinic and the OR, whatever is needed.

She is currently cleared for working six hours in a shift, then hopes to move up to the full 10 hours, which would match a doctor’s typical workday. But she has no plans to return to full-time work.

“My husband has been saying for the last three years that, you know, Monday you were great, Tuesday you were OK but by Wednesday you were dragging,” she said.

Loving a community

Jackie said working as a nurse in her hometown has been extremely rewarding.

“Working in a small town, you’re going to know 99% of the people that walk through the door,” she said. “There’s going to be very few strangers, and it’s like one giant family. I’ve had people that knew that I was retiring, and there would be hugs on their last visit, or people will see me out in public and tell me how much they miss me, so I think caring for the people here has been the most rewarding and seeing our hospital doing as well as it is again.

“We went through some kind of rough patches, but we have a great variety of providers now. We’re kind of covering all the bases.”

She said the affiliation with the Billings Clinic has been especially valuable when it comes to the strength of the hospital.

“It’s nice that they don’t completely manage us, so we do get to make our own decisions, and adding on the different providers that we’ve been able to do has been great,” she said.

Many changes

Jackie said she has seen many changes at the hospital and care center over the years, especially in the area of technology.

“There were no computers when I started, and with the era of computer use, the technology just sped up,” she said. “Technology climbs and climbs, but then with the innovation of computers, it just really went (up). And then you had the laparoscopic procedures. And when I first started, the only way to get a blood gas was to do an arterial stick, and when they said that there was something coming out where you could put a thing on your finger and get your blood oxygen, I thought, ‘Oh, that can’t be possible.’

“And now people have them at home because they’re now affordable and it’s a good thing to check your oxygen. And I remember going on paper hunts because something was done and you had to track down the results because there wasn’t a computer system where you could pull it all up and say here it is.

“The hospital, the emergency room, the clinic, every bit of it’s on computer, and they use an app on their phone now when they go in to see a patient in the clinic. They take it back, it uploads, they read it to make sure that it says exactly what they want it to, sign it, and your note’s done, and then it can be billed for, because no billing can be done until that chart is signed. So financially it makes everything run smoother, too.”

Jackie said she truly appreciates the support the community has for the hospital, adding that one of the rewarding aspects of that relationship is how having a strong staff of providers allows people to feel comfortable moving to the community.

“That has made us what we are again, and our people around here are all coming back home, which is nice,” she said.