2023 Salute to Nurses — Honoring local nurses who make a difference

NURSING PROGRAM: Miles Community College

FOCUS: Hospice

YEARS OF SERVICE: 44

By Jennifer L. Mason

Brand Ave. Studios Contributing Writer

A nurse for nearly 44 years, Roxanne Allen has seen a lot. Today, she serves as the hospice director at RiverStone Health, where she coordinates care, guidance and training. Allen’s first encounter with hospice care was as a registered nurse case manager, but that’s not where her career began.

“When I was in high school, my dad started having significant health problems, which gave me some insight into a health career,” Allen said. “After I graduated from high school, I enrolled in a vocational program to become a licensed practical nurse (LPN) and did that for a couple of years.”

After receiving her RN, Allen worked in a hospital setting in orthopedics and oncology. She recalls a friend encouraging her to check out hospice care - so she did.

“My friend also worked in hospice care, and she kept at me,” Allen said. “I gave it a try by working part time in hospice and part time in oncology. I needed to be sure I could do it … go out into the community and visit with the patients in their homes.”

Allen quickly realized it was a completely different type of nursing; it was rewarding and difficult. While in the community, Allen enjoyed getting to know her patients and their families. She connected with them and provided supportive education for symptom management and general care as they became sicker and closer to the end of their life.

“They are difficult situations for sure,” Allen said. “When a patient is approaching the end of their life, there’s a lot of anticipatory grief – especially for the families. There’s certainly a lot of education and coaching, and relationships are formed – so, it’s hard on us too when a patient dies.”

It’s a continuum of health care that not everyone can do. Some people love to work in pediatrics or prefer another entity of health care. For Allen, her choice of hospice wins every time.

“We were blessed the day Roxanne joined RiverStone Health,” said Kandra Diefenderfer, home care and hospice senior director. “Roxanne’s commitment to delivering quality and compassionate care to hospice patients is unwavering and deserves the highest recognition. She’s not only a colleague, but a friend that’s taught me the value of serving others.”

A natural leader, Allen has what many would call a servant’s heart. She is judgment free and expects nothing in return.

“I respect people where they are,” Allen said. “Our staff may recommend something to a patient they don’t want – and that’s OK. I sit down in those situations with no agenda except to listen to their worries.”

Allen loves her people well, which includes her staff and family at home. She reflects after thinking of her decades of nursing and notes that a loving and understanding husband was crucial to her success. When asked how she comes alongside her staff, Allen said, “My job is to equip them to be successful in any field. I want my staff to feel heard, and I want them constantly learning.”

NURSING PROGRAM: Montana State University – Bozeman

FOCUS: Cardiac Telemetry Unit

YEARS OF SERVICE: 7

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

When Kate Brew first attended college, she was on a path to being a physician’s assistant (PA). After earning her first bachelor’s degree in exercise science, she applied for PA school, but there was a waiting list. During that time, Brew started working as a CNA, and she recalled her coworkers, including her mom, encouraging her to take the nursing route.

“I did go a rather nontraditional route, but I always knew I wanted to do something medical because of my physical ailments,” Brew said. “I’ve torn my ACL twice, and when I was a kid, I remember having several ear infections.”

Brew ultimately decided that nursing would suit her personality while serving others and interacting with patients. She didn’t know right away what field she wanted to pursue, but she knew the options were endless. When she did her preceptorship, which was during the last semester of nursing school, Brew was a float nurse.

“Being a float nurse had its challenges, but it exposed me to several medical floors, which in turn, introduced me to several fields or specialties,” Brew said. “I felt more drawn to some over others, but I liked the cardiac aspect. In the telemetry unit, we get a lot of patients that are still very critical but don’t quite meet the criteria of being in the ICU, and because they’re not ventilated, I can still interact with them.”

When Brew goes to work, her faith compels her to serve others. When she’s caring for her patients, Brew realizes they are in a vulnerable state. After all, they’re receiving new diagnoses that may have a lifelong effect on their lives.

“If I can impact their stay with me - whatever that looks like - then I feel like I’ve done right by them,” Brew said. “I show up to work for my patients and try to provide compassionate care in the most authentic way possible.”

Jena Huck, clinical nurse manager in the cardiac telemetry unit, confirmed this. “Kate is one of the humblest and most genuine individuals I’ve had the privilege of working with,” Huck said. “She puts her heart into her work and every interaction with her patients, families, or coworkers.”

Brew’s been told before that she’s patient and empathetic. In fact, her coworkers tell her she’s the best with confused patients or difficult situations. Brew states that she’s just doing her job … meeting patients where they are.

“No doubt, it can be difficult,” Brew said. “Sometimes, I’m celebrating with a family when the test results came back negative and other times, they’ve just received word that they need open-heart surgery.”

“Kate cares deeply and has a contagious personality ... people are drawn to her,” Huck said. “She’s the type of nurse that patients go home and talk about because she does the small things, anticipates needs, and knows the importance of human connection.”

Every family and patient is special to Brew. She puts herself in other people’s shoes and tries to think about what the patient or family member may need.

“While my role has developed over the years, and I’ve matured in my nursing – one thing remains the same … it still brings me great joy that I get to be a part of each patient’s story.”

NURSING PROGRAM: University of South Carolina - Upstate

FOCUS: Rehabilitation

YEARS OF SERVICE: 7

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

Kandace Estepp grew up nearby in Miles and later moved to South Carolina. While attending the University of South Carolina – Upstate, Estepp worked at an assisted living facility where her confidence grew and provided the next stepping stone to becoming a nurse.

“I didn’t have any family in the medical field, let alone anyone in my family that had graduated from college,” Estepp said. “But I knew that I wanted to grow academically and make a difference in the lives of others. Working with elderly patients during college allowed me to build relationships as I’ve never done before.”

When her father was diagnosed with lung cancer in 2020, she and her family moved back to Montana to be closer to him. She recalls applying for several jobs, but every sign told her to accept the offer at the Rehabilitation Hospital – so she did.

The Hospital has been open for four years, and Estepp has been there for three years. A state-of-the-art rehabilitation facility, the focus of the Hospital is to help patients recover from their injuries or illnesses. Estepp cares for patients recovering from strokes, brain injuries, neurological conditions, trauma, spinal cord injuries, amputations and orthopedic injuries.

“I enjoy building a rapport with my patients,” Estepp said. “They are often at their weakest and in a vulnerable predicament. On average, most patients only stay with us for about two weeks before they go home. It’s amazing to see what each patient overcomes.”

A busy mom of twin toddler boys, Estepp works the night shift so she can spend as much time as possible with them. She’s also busy working as a part-time cosmetic sales director.

“I promised my dad before he passed away that I would finish sales goal – and by the grace of God, I did it,” Estepp said. “Just like nursing, it’s all about caring for people, being personable, and making them feel important. Neither profession is a checklist for me. I take the time to get to know people.”

At the Rehabilitation Hospital, Estepp enjoys being a positive example to others and while it’s sometimes stressful, she prefers to be a light to other people in such a dark world. She also realizes that you can’t please everyone, but she can always be as kind as possible.

“I try to be an advocate for my patients and just be there to hold their hands through everything they’re going through – the highs and the lows – just being a good listener,” Estepp said.

“Kandace is a lovely human being, which makes her a great nurse,” said Jennifer Graves, CEO. “She’s kind, caring, and compassionate and always helpful to patients and coworkers. She has excellent clinical skills and is very thorough with our patients who have had devastating life events.”

NURSING PROGRAM: Montana State University – Bozeman and Stanford University

FOCUS: Division of Health Promotion

YEARS OF SERVICE: 35

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

As a child, Karen Graf knew she wanted to be a nurse. Her aunts and grandmas were also nurses, so there was no doubt. Her great-aunt was a Baptist missionary to the Crow people and later retired in Billings. When Graf was a young girl, her great-aunt would visit people in the hospital previously under her care, and Graf would tag along.

“Back in the day, it was called a candy striper … it was a volunteer program,” Graf said. “I was probably age 12 or so when I started doing that, and then I worked as a CNA during high school. I continued as a CNA through nursing school.”

Graf’s nursing career spans 35 years. She’s worked in cardiovascular, the ICU and the emergency department. She also worked in ophthalmology surgery for seven years, two days a week.

“When I had a child born with Down syndrome, my life changed,” Graf said. “Working in ophthalmology allowed me to spend more time at home. When my son started attending school, I noticed different things and alerted the principal … that’s when he told me I needed to be a school nurse.”

Today, Graf splits her time as a nurse manager in the public health school-based nursing program at RiverStone, and she’s also a school nurse on Fridays. Most of her time at RiverStone is spent in administrative work doing evidence-based practice policies and procedures.

“I like the combination of administrative work and boots on the ground with the kids,” Graf said. “With my nurses, I can provide a good foundation so they can carry out evidence-based practices. With my K-12 students, I love when the lightbulb goes off, and they understand something about their bodies or how they can stay healthy or how to make better choices.”

Connecting people to health and wellness expands outside of the U.S. for Graf. She had the opportunity to love on other patients while on a mission trip in Kenya. For a year, she worked at Tenwek Hospital, a ministry of Africa Gospel Church. The hospital’s motto is, ‘We treat, Jesus heals.’

“The local tribe I worked with always asked a traditional greeting: Kasserian Ingera,” Graf said. “It means, ‘And how are the children?’ “Monitoring the well-being of children is the best way to determine the health and prosperity of the whole town or society at large.”

It applies to her nursing students too. Graf truly wants to know how you are and cares about others. In the tribes, when life is good, the villagers respond that - ‘all the children are well.’

When asked about her accomplishments, she mentions being able to connect her RiverStone nursing students to health and wellness so they can be successful in their learning. Her other passion is for children with special needs who don’t always have the best health outcomes. She recognized as her son went through adolescence that some schools often fail to deliver comprehensive health education that includes healthy relationships and growth and development.

“Karen is an expert on special education,” said Dr. Claire Oakley, Ph.D., retired director of health promotion, public health division. “She assists the rural schools with the intersection of nursing during a school day along with advocacy for student support. Our county schools are lucky.”

At the end of the day, Graf treats her students or patients like you would treat your grandmother or mom. An excellent and thoughtful listener, she’s not one to jump in abruptly and pepper someone with questions. “I’m empathetic and allow others to have some space,” Graf said. “I find they tell me more when I just listen.”

She credited her mentorships along the way and knew she wanted to embody their philosophy and treat people well. And – that she does.

NURSING PROGRAM: Montana State University – Bozeman

FOCUS: Intensive Care Unit (ICU)

YEARS OF SERVICE: 6

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

For Sarah Hawkaluk, her grandmother’s wisdom sent her on a journey into the health care field. Previously a nurse, her grandmother recommended she get a job as a CNA to garner some exposure.

“My grandma was absolutely right,” Hawkaluk said. “She knew I’d be exposed to different areas. I worked as a CNA during college, and that’s when I decided health care was for me and to become a nurse.”

Fast forward to her early career, Hawkaluk’s previous experience in a step-down unit paved the way for her to become an ICU nurse. During the pandemic, she was one of the nurses who stepped up to take what she thought would be low-level ICU care patients. While an unfortunate time, Hawkaluk was thrust into the middle of it and became an ICU nurse in everything but the title.

“It was during this time I discovered that aspect of critical care was fascinating to me,” Hawkaluk said. “I could see big differences in patients based on their treatment and responses in a single shift. It was also a time when I had many great conversations with patients and families who are often at the hardest times in their lives. I decided there was something to it and pursued additional training and ended up in the ICU.”

The ICU brings quick thinking and rapid responses. Sometimes patients are awake and able to talk, and sometimes, they can’t breathe on their own. A schedule for the day is ideal, but in the ICU, a patient can have an emergent change in the blink of an eye.

“Significant changes impact the rest of our day,” Hawkaluk said. “If the focus needs to change, then we make that happen. My goal is to help these patients progress through what may be the sickest time in their lives. If successful, then I’m helping prepare these patients for the transition to a medical bed in the hospital, a step-down unit, or medical-surgical floor.”

ICU nurse manager Samantha Merrill shared how Hawkaluk consistently goes above and beyond expectations and truly puts her patients first.

Working in the ICU requires flexibility but also requires mental toughness. Hawkaluk references two frames of mind in which she relies on.

“In the ICU, we take one hour at a time,” Hawkaluk said. “If that’s all we can handle, then one hour at a time is all we worry about. The second mindset is simple: it’s OK to ask. It’s always OK to ask questions if you don’t know something. It helps everyone involved.”

Merrill shares, “Her compassion, kindhearted spirit, and willingness to help others make her an invaluable asset to the nursing profession. Sarah is an exemplary model of nursing standards and a beloved member of our ICU team.”

Hawkaluk finds joy in many things, but one of her greatest is helping a patient through something. For example, removing them from a ventilator and hearing the patient speak for the first time in days, or maybe a patient is finally medically stable, and they can get out of bed and start walking. “Those moments are some of my favorites.”

She elaborates how the ICU team works frequently and closely with many chaplains. A particular chaplain shared a question he often asks patients or families struggling with a hard case – what is your fear?

“I’ll never forget it,” Hawkaluk said. “He said when a patient or a family member is terrified and feels like they have no control – they either tend to shut down or sometimes become belligerent. That is true for so many of us. Being scared or angry or whatever it may be … almost always stems from fear.”

While much of nursing happens in the background, one thing for sure – nurses are there 24/7, 365 days a year. When reflecting on her grandmother’s wisdom, Hawkaluk remembers her saying that patients go to the hospital for nursing care … and she’s happy to be the one to provide it.

NURSING PROGRAM: University of Nevada, Las Vegas

FOCUS: Oncology and School Nurse

YEARS OF SERVICE: 16

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

When you think of a nurse, the phrase jack-of-all-trades may come to mind. That’s because nurses wear many hats, including a myriad of roles. Amy Hilliard is quite comfortable sporting such a title. “I love to be a resource for others,” Hilliard said.

She doesn’t have a typical background story where a family member is a nurse. Hilliard wanted to be a dentist. During her pre-med days at the University of Nevada, Las Vegas, her career path made a turn.

“I always knew I wanted to have a career where I worked with people,” Hilliard said. “I love people, including kids.”

While in nursing school, she didn’t have a clear direction in which area of nursing to pursue, which is not unusual among nursing students. Hilliard was a little concerned but was patient and trusted the process. She said it wasn’t long before oncology picked her.

Today, Hilliard works at the Billings Clinic as an inpatient oncology nurse and has many roles such as an admit discharge transfer nurse, a charge nurse, a floor nurse, a preceptor – wherever she can fill in and be the most helpful. But that’s not all she does! In addition to working at the Clinic, she’s also a school nurse at St. Francis Catholic School.

“When COVID started, the school needed some extra help, and so, I stepped in to provide some relief for them … and my daughter also attends school there, so that’s a bonus,” Hilliard said. “I love working with both spectrums. I get to work with patients and their families, doctors, coworkers … and at the school, I work with students K-8 where I’m able to be an advocate for them because healthy kids learn and perform better.”

The school principal commented how Hilliard’s presence is a blessing to the students and staff.

“Amy carefully assesses each situation with such care, professionalism and thoughtfulness,” said Debra Hayes, M.Ed., school principal. “When she’s not seeing patients (students), she’s helping in the office, in the classrooms and wherever needed. Amy’s always asking what she can do to help. We love her!”

In the Clinic, she considers herself to be a leader. She empowers other nurses and provides them with the confidence they need. Hilliard shared she’ll never be the ‘nurse that eats their young.’

“Amy has a way of encouraging nurses to grow in their skills, confidence and knowledge,” said Austin Bourassa, nurse manager of inpatient cancer care at Billings Clinic. “She brings a positive and encouraging attitude, and that positivity spills over to her teammates, often easing the stress of a difficult shift.”

Hilliard considers it an honor to be a nurse and to care for people in vulnerable or frightful situations. Enthralled by the human body and its capabilities, she gets excited to see how medicine and faith work together. She’s passionate and feels called to be a nurse.

“I love the profession, and I want to grow the profession,” Hilliard said. “It’s where my heart is, and I have no doubt it’s been calling. Whether in the Clinic, or the school, I feel like each place has such a team aspect. I love the relationships that we build together.”

NURSING PROGRAM: Montana State University – Bozeman

FOCUS: Intensive Care Unit (ICU)

YEARS OF SERVICE: 5

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

As a young girl, Cali Mailloux dreamed of moving to the big city of Billings. From a small town originally, she fulfilled that dream and came to Billings after graduating high school. She worked as a CNA throughout college and quipped that everyone thought it was funny at the time because she disliked anything gross or bloody – but she ended up loving it. Raised by loving parents, Mailloux attributes much of her love for nursing to her dad, who exudes unlimited patience and her mom, the ultimate giver.

“Their attributes resonated in me, and I was able to find a field I love where I can apply those,” Mailloux said.

Armed with her nursing degree, Mailloux began her career on the cardiac telemetry unit at St. Vincent. With her experience in post-cardiac care, she reflected on how she never dreamed she would be an ICU nurse. “I’m so glad I gave it a try,” Mailloux said. “I love working here.”

A challenging department … Mailloux comments on how she’s constantly learning. “For me, I never want to plateau,” Mailloux said. “If I do, I start to feel burned out. Montana doesn’t have specialized ICUs, so we’re continuously learning and on our toes.”

The ICU may be different every day, but the goal always stays the same – to care for patients. Mailloux takes pride in meeting her patients right where they are. “There’s no judgment with me,” Mailloux said. “I try to be empathetic and provide kindness – because I can, not because I’m receiving anything in return. It brings me joy.”

Most patients in the ICU are in a fragile state and sometimes are in a potentially life-threatening situation. Whether it’s a serious accident, major surgery, or a sudden decline in health, Mailloux treats each one as if they’re a family member.

“My ICU patients are in vulnerable situations and rely on me,” Mailloux said. “They’re usually intubated or sedated and can’t fight for themselves. I work so hard to do everything for them in their critical state. It’s an act of love … unconditional love. It’s compassion. It’s empathy. I love being a nurse.”

When asked about Cali’s character, ICU nurse manager Samantha Merrill said it was no surprise to her that Cali was nominated. “Cali is exceptionally compassionate, dedicated and intelligent,” Merrill said. “She’s always willing to help others in need.”

Helping others also includes her coworkers. Mailloux’s patients are only half of the equation as her coworkers make up the other half of her joy.

“Working in a critical care area like the ICU … you have to have a loving and supportive community around you, and oh, do we have it,” Mailloux said. “It’s a beautiful place to work. I have the best coworkers.”

Merrill spoke about said coworkers. “Cali is highly respected and admired amongst her peers and more importantly, her patients and their families,” Merrill said. “We’re blessed to call her a friend and honored to have her as a part of our ICU team.”

Some people see weeds. Some see flowers. Mailloux always sees the rainbow. She sees the best in everyone, thrives on creating a happy and kind environment, and is convinced it allows her to enjoy every aspect of her life. She’s also a firm believer that when you find a career you love and enjoy … consider it a gift.

“After my shift, I know I’ve provided the utmost care for someone,” Mailloux said. “I’ve helped the patient and the family, and at the end of the day - that’s a proud feeling. I love being a nurse!”

NURSING PROGRAM: Montana State University – Bozeman

FOCUS: Nurse Residency

YEARS OF SERVICE: 13

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

AJ Peterschick has worked as a registered nurse for 13 years in multiple settings; however, his current role serving as a nurse residency specialist is one of the most rewarding yet. Similarly to a physician residency program, new nurses with less than a year of experience attend a nurses residency program at Billings Clinic. A year-long program, the Clinic comes alongside new nurses and equips them to be successful.

“There was a statistic not too long ago that references how new nurses stop being nurses within a year,” Peterschick said. “We don’t want our nurses to become a statistic. While they’re going through orientation, we’re meeting with their preceptors and other leaders. We’re teaching them things they would typically have to do and expect them to do on the floor, but maybe they haven’t seen it yet on the floor.”

The data is significant. According to Nurse.com’s 2022 Nurse Salary Research Report, 29% of nurses across all license types considered leaving in 2021, compared to only 11% in 2020 - but not under Peterschick’s watch. A natural preceptor, he enjoys teaching new nurses the bigger picture of nursing.

“I want my nurses to be able to understand their value – the respect they deserve,” Peterschick said. “After all, we’re asking new nurses to be seasoned nurses faster than we’ve ever asked them to be before. We want them to take care of sicker patients while wanting and expecting them to know more than they ever have. I want them all to be successful. I’m one of those people that share my knowledge and will teach myself right out of a job to teach you everything I know.”

While nursing degrees are a dime a dozen in Peterschick’s family, he didn’t immediately know that nursing was his forever home. After high school, he enrolled in a car mechanic school and worked in various fields not related to health care.

“I was drawn to pursue something else and enrolled in college,” Peterschick said. “While taking general education courses, one of my professors asked me to help tutor students in classes like biology and chemistry. From there, I never looked back. I realized that nursing provided the perfect flexibility and endless opportunities.”

Peterschick started in the ICU and cross-trained in the emergency department. His nursing career includes working in the catheter lab, interventional radiology, vascular access, operating room coordinator, college professor, and travel nurse. He’s been in nurse residency for about two years or so.

“I’m not surprised AJ received a nomination for one of the outstanding nurses in 2023,” said Barb Sakahara, former director of perioperative services and surgery. “AJ is extremely well-versed and always made my job easier because he would do anything and everything to help the team.”

When you’re with Peterschick, you receive 110% of him. He’s passionate, helpful and giving. He pours everything into whatever problem or situation in which he’s working.

“Nobody wants to be in the hospital, and nobody in the hospital is healthy,” Peterschick said. “Patients typically aren’t themselves and can be scared and unsure. I understand their point of view, and I try to find that middle ground with everyone I encounter. It’s my job to help them.”

Sakahara went on to say that AJ makes everyone feel safe, appreciated and cared for as a patient or coworker. “He’s passionate about the profession, patient care, and education and is one of the most top-notch nurses I’ve ever had the pleasure of working with.”

NURSING PROGRAM: Montana State University – Billings

FOCUS: Assisted Living

YEARS OF SERVICE: 4

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

A nurse for a little more than four years, Kailee Noyes recalls wanting to be in the medical field as a young person. While she doesn’t have family in the health care industry, she knew that’s where she belonged.

When Noyes attended nursing school, she worked as a certified medical assistant at a local clinic. As she explored her options, she remembered hearing great things about St. John’s, specifically, their CNA program.

“After I completed the CNA courses at St. John’s, my decision to care for the elderly was solidified,” Noyes said. “I also think my grandma having dementia was a deciding factor. I love being able to care for my elders the way I’d want someone else to care for my grandparents.”

The Billings Heights - WyndStone campus offers independent living, assisted living and memory care services. Most of the residents at WyndStone are still pretty independent. They may need a little more assistance than someone living by themseleves – like helping with their medicine.

“WyndStone has a very homelike feeling,” Noyes said. “It’s a smaller community, and we all wear many hats – like a jack-of-all-trades. We may get pulled in to take a resident to an appointment or help a CNA on the floor.”

Not only does she get to form relationships with the residents but Noyes gets to know their families. She said they all become second families, considering she spends more time with them than with her family.

“Those bonds and relationships become even more special when a resident passes away,” Noyes said. “It’s normal to grieve as long as you remain respectful and professional at the same time. It takes a caring and loving person to be a nurse.”

Noyes has those attributes under her belt, along with being resilient and tenacious. Initially a single mom, she worked hard and long to get where she is today as the assisted living health director.

“Kailee truly has all of the characteristics of an amazing nurse: kindness, compassion, leadership, and advocacy, just to name a few,” said Carmen Cox, regional health director. “She makes a positive impact in the lives of our seniors and the team she leads every day. Kailee offers support, comfort, and reassurance to our families faced with difficult decisions about senior care.”

“It wasn’t easy being a single mom,” Noyes said. “I went to school, cared for my child and worked full-time. I’ve worked hard to get where I am today. My advice to others would be - to never give up because anyone can succeed with the right mindset.”

NURSING PROGRAM: Montana State University – Billings and Bozeman

FOCUS: Emergency Department

YEARS OF SERVICE: 33

By Jennifer L. Mason, Brand Ave. Studios Contributing Writer

Darcy Smith recalls wanting to be a nurse from a young age. However, it wasn’t until she graduated from high school and went to register for college classes that she put her calling into practice. Smith recalls one of the professors encouraging her to look into nursing since it’s known to have a work-life balance and different opportunities.

“I believe that nursing was a calling for me … it just felt natural,” Smith said. “During my junior year of college, I worked as a CNA at a nursing home, and the following year, I worked as a CNA in a cardiovascular step-down unit at a local hospital. Both opportunities provided me with a lot of experience and exposure.”

Smith always knew she wanted to be in critical care. Her first job as a registered nurse was in the intensive care unit (ICU) at the Billings Clinic. Smith felt at home with the pathophysiology and the critical thinking skills that come with the role. She was fortunate to have several nurses and critical care physicians who mentored and nurtured her in the ICU.

“I was an ICU nurse for seven years, and during my last four years in the ICU, I worked as a flight nurse, so I was splitting my role between flying and working in the ICU,” Smith said. “I developed skills for a lifetime.”

After working in the ICU, Smith transferred to the emergency department at the Clinic where she’s been ever since. With the city of Billings being the largest in Montana, the Clinic services many outlying smaller hospitals in Wyoming and the eastern part of the state. Smith loves the fast-paced environment of the emergency room, which provides plenty of adrenaline along with a wide variety of patients.

“One minute, I can be taking care of low acuity patients like a sprained ankle, a minor laceration up to gunshot wounds, stabbings, or critically ill patients that are unstable,” Smith said. “And within minutes, we’ll have back-to-back ambulances coming in or patients walking through the front door.”

A bedside nurse for 33 years, Smith takes pride that she’s still in the same role. She enjoys being able to make a difference in the lives of her patients. She also likes the teamwork aspect within the department, which she considers her work family. As a veteran nurse, she loves to come alongside younger nurses like others did with her.

“I try to inspire the teamwork aspect because we can’t do the work alone,” Smith said.

Tami Grewell, the clinical coordinator of the emergency department, said that Smith exemplifies the role of a nurse. “Darcy is committed to providing safe and exceptional care,” Grewell said. “She shows kindness and compassion to everyone she encounters and is a role model to those around her. In our department, you’ll often hear new and more experienced staff say that the goal is to ‘be like Darcy’ - she truly is one of a kind.”

For a patient in the emergency department, it’s sometimes the worst day of their lives. Smith acknowledges that she witnesses people’s lives suddenly change forever. Even after a long career, Smith shared how life-altering situations weigh heavy on her.

“So often, the patients may not know what we’re doing clinically, but they know how you made them feel,” Smith said. “Sometimes people just want to be heard and be validated. I love to care for others, and I feel like it’s what God called me to do.”