Decades of care

Editor’s Note: This is the second story in a series highlighting Adair County Health System in its 75th year.

Adair County Health System has provided its community with quality care close to home for more than seven decades.

Deb Tindle of Bridgewater and Jeff Howard of Stuart are among the many who devoted decades of their lives to the hospital — Tindle as a registered nurse and Howard in emergency medical services.

The growth of EMS

Howard’s career spanned from 1989 to 2004. He said the way EMS evolved locally serves as a microcosm of how the hospital as a whole has grown in meeting the community’s needs.

The county ambulance service was not always under the hospital’s umbrella. It was initially operated by Everett and Clella Booton of Greenfield, who ran a “load-and-go” ambulance service. The Bootons were active in CPR training and other outreach efforts. Their daughter, Polly, is a dispatcher with the Adair County Sheriff’s Office and remembers her grandmother living with them when she was a little girl so an adult was always home if her parents had to go on a call.

The ambualance service later became a county operation before ultimately transitioning to hospital oversight.

When Howard joined the service, Marvel Blazek supervised EMS. Shortly thereafter, Deb Tindle’s husband, Dan, became EMS supervisor. He would serve as a revolutionary leader for the agency.

“Marvel wanted me to take an instructor class, so then the whole department was a basic EMT-level service,” Howard recalled. “Then we all became EMT-I level, so you could start IVs. It advanced as it went, because then we were defibrillator trained.”

In those days, the ambulance was housed on the east side of the hospital near where the helipad is now. A second ambulance, added later, was stored in an empty garage off Highway 25 during the winter months and parked outside during nicer weather.

Howard described the significant changes that came after Dan Tindle became supervisor.

“We went from ‘load and go’ to pre-hospital care — doing things out in the field, starting IVs and getting the patient ready so when we got to the emergency room, Deb and the nurses and doctors could take over,” Howard said. That shift required a medical director, a role filled by Dr. Glen Hanson.

“As time went on, we had a great crew,” Howard said. “These were advanced EMTs, before we got our paramedics.”

As EMS demand increased, Adair County Ambulance began using tiered responses and was dispatched simultaneously with volunteer fire departments and rescue squads throughout the county. EMS staff also provided training for those agencies and employed some of those volunteers on a part-time basis.

“We depended on our volunteers,” Howard said. “They were part-time on our staff and helped tremendously. If Unit 1 was in Des Moines, we’d call and see who could staff a second unit. If we got a call here, they’d come get that second ambulance and respond with whatever fire department it was, and it worked well.”

In the mid-1990s, Howard, Dan Tindle and Jan Beach completed a yearlong paramedic course through Indian Hills Community College.

“Once we became state-certified paramedics, we wanted to be able to use our skills,” Howard said. “Dan and I did all the paperwork. We had to have a pharmacist, a medical director, and our ambulance had to be inspected. This was all new for us.”

He said the transition required close coordination with hospital nurses, who became designees under new protocols.

“If we had a patient who needed medication, we’d call our report into the nurses,” Howard said. “They followed protocols and gave us permission to administer it or not.”

‘So many areas’

Deb Tindle’s career at the hospital spanned from 1986 to 2017. She said one of the most significant advancements she witnessed was the ambulance service reaching the paramedic level, a change that also required nurses to complete additional training and certifications.

Tindle also saw many other changes during her career. She earned $7 an hour when she started and received a 30-cent raise shortly thereafter. That same year, hospital administrator Joe Rivera ensured employees had access to health insurance for the first time and that EMS staff were paid wages commensurate with their training.

One of the biggest contrasts Tindle recalls is the shift from paper charting to electronic records.

“We had one big ER with a curtain, and that was it,” she added. “You didn’t have much privacy. We didn’t have much lifting equipment, either.”

She said the hospital auxiliary later helped purchase lifting devices after staff demonstrated how they would prevent injuries.

“Starting out, we didn’t have a lot of those things,” she said.

Tindle credits longtime nurses as a key component of the hospital’s success. She also witnessed multiple remodels and expansions over the years. While parts of the hospital have been added on, a large portion of the structure — deemed sound after being struck by an EF-4 tornado in 2024 — dates back to 1950, with subsequent remodels.

Tindle recalls when the surgery department was added and when the hospital stopped delivering babies. She still encounters people around town whom she helped deliver.

She said working at a rural hospital had advantages, particularly the breadth of experience required.

“You were trained in so many areas,” Tindle said. “Nurses in metro hospitals, at that time anyway, didn’t have to be that way.”

Over her career, Tindle handled medication delivery, nebulizer treatments, bathing patients, emergency care, IV starts, IV medications and IV antibiotics.

“Your day depended on what the patient needed,” she said. “We had to do it all because you were working everywhere.”

She recalled Mercy student nurses being surprised by the pace and variety of care.

“I had a patient in special care, then I went to the ER, then I went to OB,” she said. “This is a 20-some-bed hospital. You have to do all that.”

Patient education was one of the most rewarding parts of her job, Tindle said. She remembers carefully teaching a patient how to use a nebulizer machine and later receiving a letter thanking her for taking the time.

In recent years, staff morale has continued to improve, something Tindle has observed closely since retiring. She remains involved through the Adair County Hospital Auxiliary and the hospital’s board of trustees, where she serves alongside Chairman Jimmy Freeland, Vice Chair Willard Olesen, Secretary-Treasurer Barb Kalbach, Bo Geidel, Mark Schildberg and Connie Hohertz.

She has also served on a patient and family advocacy team that brings diverse perspectives to help the hospital stay connected to patient experiences and outcomes.

“Seeing the nursing side and then the board of trustees side has been an eye-opener,” Tindle said. “We help manage the money and see where it goes and what it’s for. We get all the reports every month.”

In the beginning

According to local newspapers, more than 2,400 people visited the hospital during its open house in September 1950. Sixty hostesses representing Adair County churches escorted group tours as staff explained each department. The hospital cost $366,882.63 and was funded through a $100,000 county bond issue, a government grant and individual donations. A nursing staff of 27 assumed responsibility when the hospital opened.

Tindle said she has been impressed with the leadership of current CEO Catherine Hillestad, who began her role in 2021.

“It wasn’t even half a day after the tornado and she had secured the school so we could continue caring for patients,” Tindle said. “EMS was there, then we started doing labs and X-rays. I got a call from her at 10 o’clock that night explaining what had happened and what we were doing. Catherine and her executive team were wonderful.”