Pam Shilts has been a long-time nursing leader tenaciously shaping the direction of Volunteers of America healthcare services in rural Western Colorado over the better part of 40 years. Her story begins with an early involvement in long-term care for a loved one – her grandfather.
In the 1970s, Pam Shilts’ grandfather Raleigh Leroy (Red) Hindman was a resident at Valley Manor Care Center in Montrose, Colorado. This is the time-period when vast improvements in nursing home care were taking root across the country. Pam’s observations of the good care her grandfather received gave her the inspiration to become a nurse.
“My grandfather had a brain tumor,” she said. “He had been a very colorful man with language and inappropriate behaviors at times before he became ill. Because of the tumor, he lost his ability to filter his statements and would say inappropriate things to nurses. However, his nurses would look beyond his words and talk with him about his pain levels, what he might eat for the day (usually only ice cream), would sit with him listening to his stories and rub lotion on his head.”
Pam explained her grandfather once had a beautiful head of red hair before losing it all to chemotherapy. He worried about his lack of hair, and his scalp became itchy after the treatments.
“One of the nurses, Hazel McCall, would call my mom with any updates and meet us at the care center door when we arrived after school every day around 4:00 p.m. She would greet us with an ice cream cone and give us an update before we went inside to visit my grandfather,” Pam said.
Growing up with these positive and constructive interactions from caring nurses, it was not a surprise when Pam chose to pursue her first job in healthcare at Valley Manor Care Center as a nursing assistant in 1979. After graduating high school in 1981, she worked until completing her LPN education at the then named Vocational-Technical College in Delta, Colorado. She would soon branch out and leave the comforts of her childhood home behind.
Marrying a sailor, Pam was on her way across the country to Virginia, where her husband was assigned a duty station. As a young newlywed, she found work in a Presbyterian home for church members who needed assistance with daily activities. The model of care was much like today’s assisted living communities.
Searching for her next employer, Pam saw an advertisement for a medical-surgical nurse. She did not realize however that the position was at the state psychiatric hospital. Pam was eager to try new things and was not deterred by the challenges this post might provide.
When her husband was assigned to different ports of duty, Pam learned to adapt her skills to different care settings.
“After a year in Virginia, we were off to South Carolina, where I went to work in small rural nursing home in Monck’s Corner,” she said. “I also did part time work in the Children Hospital in Charleston with ventilator dependent children.”
Two years later, Pam found herself in Cocoa Beach, Florida, while her husband was assigned to a position working with NASA and the Air Force on a special missile project.
“In Florida, I worked at Humana Hospital while studying to complete my RN degree at the same time,” she said. “During this time period I saw many AIDS patients as the state of Florida offered experimental medications and chemotherapy with house supervision as needed.”
Pam’s deep concern for her patients led her to propose creating a class around teaching safe sex practices. The hospital administration approved her proposal. She began to teach patients during and after their AIDS treatments and distributed to-go bags stocked with supplies to support safe sex practices.
“This was a very tough time in my nursing career and I was still fairly new to nursing,” Pam said. “We put on our “space suits” to care for so many different individuals infected with AIDS. We took care of drug addicts, those with unsafe sexual activities, hemophiliacs, and those who had blood transfusions. These patients experienced anger and guilt while being critically ill. Most of the patients at that time did die and it was hard to see so many patients pass away. We had all the PPE to wear, just like now with Covid-19, and the same lack of physical touch hurt my heart for them.
“One young man told me adamantly, that if his girlfriend loved him, he would expect her to continue with unsafe sex practices,” Pam recalled. “But he attended my class anyway, and on his next hospital admission he told me they were practicing safe sex. That was such a proud moment for me as maybe it was a gift of life for someone else.”
Pam received the Nurse of the Year award in 1991 from Humana Hospital group for the work she did in creating, teaching and managing this vital program.
Always seeking a challenge, Pam next took a position at a larger hospital in Melbourne, Florida as a Surgical ICU manager. She also served on the code team (CPR ACLS) as well as the Joint Commission Task Force working on policy revisions, education plans and quality assurance projects.
“During this time I had an awesome opportunity working Hurricane Andrew clean-up,” she said. “This meant a trip to Miami staying in an auditorium, sleeping on a cot, working 12 hour shifts in an oncology unit. After this experience, I felt it was time to return to Montrose.”
Upon returning to the Western Slope in 1995, Pam immediately went back to work at Valley Manor Care Center as the night supervisor. Her desire for professional challenges moved her into various other nursing positions with Volunteers of America including rehab director. During this time, she studied for and received a Gerontology and Restorative Therapy Certification.
Approximately six years later, a local healthcare advocate and developer, John Fitzmaurice, approached Pam to lead in the creation of a Volunteers of America home health agency.
“I expressed to John that I had no business experience, just nursing, but John believed in me and we were off and running,” Pam said. “By December of 2001, we had our home health license approved and doors open. During this time, we had offices in Montrose, Delta and Grand Junction, as well as tele-health medicine.
“We collaborated with Midwestern Mental Health and Community Options and assisted them with on-call needs. We were leaders in home health telemedicine rural practices and we were honored in Las Vegas for decreasing Medicaid visits by seeing residents when there was the need, versus on a routine basis. The outcome of this type of care showed a marked decrease in emergency room visits and an improvement in overall health data of the patients.”
After successfully managing the home health program, Pam’s next big role was to become the Director of Nursing at Valley Manor Care Center. She had come full circle.
“John Fitzmaurice encouraged me to accept and so off I went,” she said. “It was fascinating for me to begin learning all the regulations in long term care that were very different from the hospital or home health requirements.”
Volunteers of America provided Pam a platform to pursue quality of care in a variety of care settings, she said. The ability to live the organization’s mission on a daily basis and being able to grow within the organization were other reasons she named for her loyalty to the faith-based, non profit organization for so many years.
Several individuals served as Pam’s mentors over the years and were critical to her development and ability to self-create her most current role — regional clinical consultant. She now works closely with the Volunteers of America National Services senior vice presidents and other corporate clinical leaders to develop best practices and policy for the entire healthcare division and trainings for nurse leaders in the individual programs, senior living communities and care centers.
“I have always had a deep passion about training and the potential it provides our teams and greater organization,” Pam said. “Volunteers of America allowed me to make that dream a reality and we now have a regional training center at the regional office in Montrose, which I oversee.”
The current training Pam oversees includes a Nursing Assistant program, Resident Care Assistant program, which incorporates the Feeding Assistant and Patient Care Assistant, Personal Care Assistant, CPI (Crisis Prevention Intervention), and CPR/First Aid. The regional training center has two SIMs manikins and two regular manikins, all of which are used in employee competency trainings.
Pam’s ability to fill gaps in services and develop new, impactful programs led to two nominations for the Nightingale Award. The Nightingale Awards were founded in 1985 to recognize excellence in human caring by Colorado registered nurses. The Colorado Area Health Education Centers (AHEC) administers the awards as part of their mission to improve the quality and quantity of education to healthcare providers in Colorado in order to enhance the delivery of healthcare services throughout the state, with special emphasis on frontier, rural and urban communities and minority populations.
Continuing education has always been on Pam’s agenda. She currently holds the following certifications: Certified Interact Champion, which is the program Volunteers of America uses to reduce re-hospitalizations and quickly identify changes in residents’ health status, and a Quality Assurance and Gerontology Certification.
Addressing the whole needs — physical, emotional and spiritual — of the residents and staff is also a top priority to Pam who became a Volunteers of America commissioned minister in 2015.
“My ministry is mostly used towards staff in crisis and in staff development. God gave me a talent in seeing the best in those around me and an ability to identify personal strengths,” she said. “Identifying strengths allows leaders to find the best position for staff to achieve long-term success. And if staff are using their strengths, it results in them feeling good about their role and overall contribution to the mission of the organization.
“My regional director of operations, Craig Ammermann, who is also a commissioned minister, taught me a great deal about crucial conversation,” Pam said. “He mentored me in practicing more patience with my nursing leaders and how to take time to be more proactive.”
Looking ahead to the future, there are many potential directions for the nursing industry. Pam feels developing ways to provide more direct care time with patients would be beneficial to all.
“We need to try to bring back bedside nursing and limit governmental reporting and charting requirement for reimbursement. So much time is needed to be in compliance that patients, clients, residents do not get enough hands on care,” she said. “More time with residents would also increase the nurses’ satisfaction with their role and keep them in the industry. Not once have I heard I’m leaving my job because I don’t like working with residents, patients and clients.”
Pam shared some advice for those thinking about beginning a career in healthcare.
“As you enter healthcare, life will be different at home, potentially less time on weekends or holidays and maybe you will be working odd shifts like nights, but the satisfaction you will get from working everyday with people who are vulnerable and need supportive services will be a reward that words can’t describe.”
Erin Berge is the Regional Marketing Director for Volunteers of America, a national, nonprofit, faith-based organization that provides a network of health care and aging options, housing and supportive services in Montrose and Delta Counties (voaseniorliving.org or 1-844-862-4968).