Author Archives: Jennifer Kellner

Women’s Health & Mental Health Month

Everyone who has ever flown on an airplane has heard these instructions: “Secure your own oxygen mask before trying to help others.” It’s also true when it comes to your health. You can’t take care of your loved ones if you haven’t cared for yourself first. Women have traditionally filled the roles of caregivers for their families, which makes it even more important to attend to their own health. 

Erin Leonard, ARNP

As women move through the different stages of life, there are screenings and routine exams based on age that can potentially be lifesaving. Erin Leonard, ARNP at the Mount Ayr Medical Clinic, encourages the basics, “A healthy diet and exercise is so important for women of all ages.” Erin recommends a wellness exam every year. Wellness visits can include breast exams, pelvic exams, lab work, and immunizations. The healthcare providers at the Mount Ayr Medical Clinic encourage younger women and girls to discuss what’s happening with their bodies during well child and well adolescent visits. Beginning at age 21, a pap smear is recommended every three years until the age of 30. “After 30, we do a Pap smear with HPV testing.  This can be done every 5 years, as long as previous testing has been normal,” says Erin. Screening intervals can change depending on previous results. “One size does not fit all. The best approach is shared decision making between a woman and her primary care provider. As women age, they need to add mammograms and colonoscopies to the list, too!” 

Top of mind this year is how the COVID-19 pandemic has affected everyone, especially women who are pregnant, or may be trying to get pregnant.  “There have been a lot of questions surrounding the COVID-19 vaccine, and whether or not women should get it,” said Erin.  The CDC, World Health Organization, and American College of Obstetrics and Gynecology recommend vaccinating pregnant women against COVID-19 due to the increased risk of complications should they contract the virus.  Additionally, the vaccine has not been tied to adverse outcomes related to pregnancy or fertility.  Recent studies have shown immunity passed on to babies in moms who have been vaccinated during pregnancy and lactating mothers.  Erin added, “If you have any concerns, you should discuss these with your healthcare provider.”

No matter your age, particularly in stressful times like a pandemic, mental health is as important as physical health. “We screen for depression and anxiety in all our annual visits,” said Erin. “Mental health concerns can span across our entire lifetime. We’re here to help when it’s needed.” 

According to Morgan Drake, Director of Ringgold County Hospital’s Senior Life Solutions, women are twice as likely as men to experience symptoms of depression. “There are a variety of reasons,” said Morgan. “But often it’s related to hormones. Women’s hormones change at the onset of menstruation, with pregnancy, if they’re experiencing infertility, or going through menopause.”

Although these hormonal changes may be inevitable, they don’t have to lead to depression. “Physically taking care of ourselves with a healthy diet and some exercise is a great place to start,” she said. “Studies show that even 30 minutes of walking each day can be as effective as taking anti-depression medication.” Morgan added that the walks can be broken up into 10-minute bursts and be equally beneficial.

Along with basic diet and exercise, it’s important to get adequate sleep and practice keeping stress in check. “We suggest learning relaxing techniques and making time to do things you enjoy. Even caring for a pet can relieve stress,” said Morgan.

Morgan invites the entire community to participate in Wear Green Day on May 21 to bring attention to Mental Health Awareness.

Print the Full May 2021 Story

Longest Tenured Employee at RCH

Kathi Schuster, CNO

Ringgold County Hospital’s longest tenured employee is Chief Nursing Officer, Kathi Schuster. Like many people with a passion for helping others, she knew from the time she was a freshman in high school that nursing was going to be her career. “My mother died of a heart attack when I was 12,” said Kathi. “It’s why I got into nursing.” In fact, she began working as a Certified Nursing Assistant at RCH before she even went to college.

She was accepted into the Methodist School of Nursing in Des Moines when she was a junior in high school. She decided to finish high school and enjoy her senior year before entering the program. “It was a three-year program that ran year-round,” she explained. “We only had three weeks off every August. When I graduated, I was a Registered Nurse. I chose nursing because of my experience with the nurses at Ringgold County Hospital. They obviously knew what they were doing, and I wanted to be like them. I wanted to be the best.” She added that she eventually did get into management and got another degree in business administration.

Her first nursing job was at Iowa Methodist Medical Center in pediatrics, where she had done her clinical training. Then she met her husband, who is from Mount Ayr, so she started looking at area hospitals. “I interviewed at other places, but I thought this was a better fit for me. I liked the direction this hospital was going. I liked the people. It was clear that everyone respected the nurses and worked as a team. Some other hospitals had a little more ‘stuff’ but the people weren’t as friendly.” It certainly has proven to be a good fit since she started at RCH in April 1982 and has never left!

According to Kathi, back then when she worked as a full-time RN, they did everything, “Emergency Room, Operating Room, Medical/Surgical, Obstetrics, we did it all! I loved it! My favorite was Obstetrics and the ER.” At the time, RCH was considered a Sole Community Provider Hospital and had 46 beds. “When I started, it was nothing to have both halls completely full. The rules have since changed significantly. We used to admit patients for things that are outpatient procedures now.”

After two years, Kathi was selected to help develop an entire program for the new Harold Hughes Center, a Chemical Dependency Unit. “I developed all the policies and procedures and assisted the Director of Nursing with a hospital-wide nursing standards and procedure manual.”

In 1988, Kathi was urged to apply for the Director of Nursing position at RCH. “There had been several people in the position, and it was clear we needed some stability,” she said. Again, Kathi made a career move that was a good fit. She remained Director of Nursing until 2005 when she was promoted to Chief Nursing Officer. “I’ve been responsible for all the nursing units: acute care, ER, surgical, out-patient,” she said. Over the years, she acquired additional departments including physical therapy, laboratory, radiology and the Mount Ayr Medical Clinic. “I’ve got very good managers!” Now her job is less clinical and more administrative, so she was pleased to pitch in and help during the Covid-19 pandemic. “It’s been kind of fun to get back to my roots!”

Kathi is proud of the orientation she’s developed for nurses new to RCH. “When I first started, we were expected to just jump in anywhere on the first day. I wanted to be sure that all of our nurses have advanced cardiac life support training. I implemented a policy that nurses have to work a year on the floor before working in the ER. I’m very proud of that.”

Technology has made the biggest changes at the hospital since Kathi started almost 40 years ago. “I actually think that having Electronic Health Records has helped,” she said. “It has standardized orders. In the past we had to go from memory. Things are now at our fingertips.”

Having such a long history in one place, Kathi has seen it all. One of the most significant milestones was helping design the current facility, which was built in 2009. “Our CEO Gordon Winkler really shined when we were building the new hospital,” said Kathi. “He allowed everyone to have a voice and it showed a lot of teamwork.”

After such a long and illustrious career, Kathi’s compassion and empathy are demonstrated when asked about the highlights. “Seeing other nurses grow, be successful, and move up in their own careers is my favorite part of the job.”

Celebrating 70 Years of Service

Caring Is Our Calling!

In 1949, a small group of committed citizens had the vision and the wherewithal to build a hospital in Ringgold County, and raised $26,453 in just two weeks. Exceeding the original goal of $21,000, the fundraising proved to the hospitals’ Board of Trustees that the people were sincere and enthusiastic in their determination to provide hospital facilities in the county.  

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” – Margaret Mead 

In April 1951, their dream became a reality when Ringgold County Hospital was completed and opened its doors for the first time with 21 employees. The timing was excellent, as seven babies, one girl and six boys, were born in the first week of operation. The first adult patient arrived via the Emergency Room and received a “five-dollar bouquet” presented by the Mount Ayr Post Office. The cash was courtesy of Rhodes Funeral Home which had promised the award to the first hospital patient.

Much has changed over 70 years. The hospital facility itself was expanded and renovated multiple times to accommodate new technology and new services. Under the leadership of CEO Gordon Winkler, the current hospital was completed in 2009. The state-of-the-art facility was designed to accommodate departments ranging from physical therapy to medical imaging, visiting physician’s clinics, a lab and pharmacy. The Mount Ayr Medical Clinic is now located within the hospital, allowing clinic patients easy access to all hospital services.

The committed team of medical professionals keeps up to date with today’s technologies, from 3-D imaging to electronic medical records. But the hands-on commitment to quality care for all patients is the same as it was in 1951. Ringgold County Hospital may not have changed the entire world, but it certainly has had a positive impact on the residents of southwest Iowa for the past 70 years.

Noble Nurses: Wheeler and Johnson

We are celebrating the hard work, compassion, and dedication of nurses everywhere. Here at Ringgold County Hospital and Mt. Ayr Medical Clinic, our thanks go out to all the nurses in our hospital and clinic who care for our community every day. Each month, we’re profiling two more outstanding nurses for their contributions.

Kelsey Wheeler, LPN


Jayla Johnson, RN

Kelsey Wheeler was an athlete growing up in Gravity, IA. “My hometown is so small that you’ll miss it if you blink!” she said. She and her three siblings went to Bedford schools, where she played softball, volleyball and ran track. She headed to Nebraska Wesleyan for college, intending to become an athletic trainer. “I tried softball for a little bit in college. I wanted to follow the sports thing through. I really don’t know what inspired me, since science wasn’t my thing in school.”

Kelsey learned about nursing through personal experience. “My mom has MS, and she was receiving treatment in a hospital. I started talking to the nurses there and realized that appealed to me more than athletic training.” So, she switched schools and career paths and headed to North Central Missouri College to get a nursing degree. She graduated with her LPN in 2014.

Following graduation, she moved back in with her mother to care for her, which led to a job with a home health agency. She cared for her mother as well as other patients. “It was a great introduction into a nursing career,” said Kelsey.

When she learned about an opening at the Mount Ayr Medical Clinic, she applied. “I liked the idea of the routine, and the Monday-to-Friday schedule.”

Kelsey loves the day-to-day interaction with the clinic patients. “I feel as if they’re my patients. I’ve been able to learn the whole community. Growing up in Bedford, there was such a strong sports rivalry. It’s been great to see that everyone here in Mount Ayr is so caring. It’s a nurturing and loving community.”

With a five-month-old daughter, she is planning to stay at the Clinic for the foreseeable future. “The Mount Ayr Medical Clinic is my second family!”


Jayla Johnson got some practical advice from her mother which set her on a nursing career path. “I was leaning towards becoming a beautician,” she said. “My mom reminded me that were at least 10 beauticians in the county, and that I needed a profession that would guarantee a job. So, I took a health occupations class while I was in high school. At the same time, I started a job as a Certified Nursing Assistant at the nursing home. I realized that I liked taking care of people!”

She didn’t waste any time. Two days after high school graduation, she began her studies at Southwestern Community College and earned her LPN in 1998. She continued to work at the Clearview Nursing Home and oversaw a walking program and did wound care. “I really liked wound care and taking care of the elderly,” said Jayla. “It has always been my favorite. They have all kinds of stories to tell.”

Although she loved her job, she realized that she wasn’t going to move up any further until she got her degree as a registered nurse. So, she “took a leap of faith”, quit her job, cashed out her 401K, and went back to school full time. “I leaned on my significant other and my family for support. I wanted to focus on school.” It took her about 14 months, and she became an RN.

After graduation, she started at the hospice in Mount Ayr. “They taught me a lot. I enjoyed building the bonds with the entire family, not just the patients.” When a friend recommended she apply for an opening at the Ringgold County Hospital Visiting Physicians Clinic, she hesitated, thinking she wouldn’t be good at it. But eventually, she was convinced and is so happy in her job. “I love the variety of all the clinics,” she said. “I still trim nails, and I love that.” She does all the clinic prep work, pulling labs and notes for the doctors. She does the scheduling and assists the physicians during the actual clinics. And, she’s backup for cardiac rehab and stress testing.

The favorite part of her job is seeing all the people and caring for them. “I like knowing they can count on me.” And like her work in hospice, she cares for the entire family helping them navigate through the patient’s healthcare. “I create a game plan and make the necessary referrals and schedule appointments.”

Jayla enjoys the variety of work in the Clinic. “Going back to school and getting my RN has really paid off,” she said. “I only wish I had done it sooner!”

Early pediatric intervention improves outcomes

Pediatrician Tabitha Wilson, M.D.

Parents gazing into the face of a baby often only see perfection. As the babies grow into toddlers, they can amaze and amuse their caregivers with their antics. But alongside all the cuteness, children’s development needs to be monitored to make sure they’re on track. “Well-child checkups are so important,” says pediatrician Tabitha Wilson, MD. “If a developmental issue is discovered, the earlier the intervention, the better the outcome.”

Dr. Wilson recommends well checks starting at 3-5 days, and then regularly until the child is two years old. After that, annual checkups are important. “Every child is different. But the key is early intervention. If we can catch a speech difficulty when they’re age two, we can have it fixed before they even start school.” She added that the most common cause of language issues is hearing loss which parents may not be aware of, but that can be discovered by a doctor.

“We can check a child’s vision as early as age three,” said Dr. Wilson. “It seems young, but we can make a big difference if we find a problem early.” Along with hearing and vision, it’s important to keep an eye on dental health as well. “Babies should see a dentist as soon as they have their first tooth! Believe it or not, some preschoolers have dental issues.”

Most parents are aware of the need for immunizations along with developmental screenings. “Babies need some immunization during every visit for their first 18 months,” she said. “If the immunizations get off schedule, it is a problem. There needs to be a certain amount of time between doses to be effective. Some vaccines, like for Rota virus, can’t be given after eight months.”

Iowa has some of the highest lead levels of any state in the US. So Iowa Public Health recommends all children be tested for lead. “It’s a simple finger prick to get enough blood for a test. But if high lead levels are found, it can cause brain damage and lower the child’s IQ if not treated. So, here in Iowa, it’s important.”

Obesity is a nationwide problem, and increasingly children have high cholesterol and high lipid levels. “The American Academy of Pediatrics recommends screening children for high cholesterol. If it’s elevated, we start with diet and exercise changes before putting them on medication. Over the past year, kids have gained weight. They’re getting less exercise than normal due to Covid restrictions.”

It’s not just weight Dr. Wilson checks on. She makes sure that weight and growth are appropriate. Neither overweight nor underweight are healthy. “Kids should grow around two inches a year. The right balance is critical for brain development.”

“Parents may think their child is healthy and wonder why they should bring him to the doctor. But there are subtle things that I can see that parents don’t. It’s worth the small effort!”

Dr. Tabitha Wilson is available every Monday & Thursday. Call (641) 464-4470 to schedule an appointment at the Mt. Ayr Medical Clinic

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