Nurse Translates Firsthand Care to Heartfelt Grasp of Patient Needs

by Karen Schmidt

Barb Quiring

 Upon arrival of the ambulance, emergency room staff found the unconscious patient in diabetic shock. Her blood sugar level had plummeted; she was critically ill.

The staff at Hospital Vozandes-Quito (HVQ) in Ecuador stabilized Amara (not her real name) in the emergency room (ER), then admitted her to the intensive care unit (ICU). Her course of treatment took a number of days as the staff struggled to regulate her blood sugar.

When she regained consciousness and learned just how close she may have been to death, Amara expressed her gratefulness for the medical help. But she was also concerned about the cost of her treatment.

The mother of four children, Amara made a living repairing shoes in a small workshop. Her income wasn’t nearly adequate to pay for her hospital bill that had reached over US$7,000. However, one of Amara’s daughters worked at HVQ, a ministry of Reach Beyond and presented her need for financial help to the hospital’s Fondo de Amor (Charity Fund) committee.

That’s when Barb Quiring first heard about Amara. Having served as a nurse at HVQ, she had become a member of the Charity Fund committee that decides whom to help and with how much as patients face dire financial problems with little to pay. A percentage of physicians’ fees on HVQ-generated cases is applied to the Fondo de Amor as honorariums. Those same physicians may in turn, also bring in patients from their private practices, as part of physicians’ privileges at the hospital.

“We heard Amara’s case and decided that the Charity Fund could help pay for her care,” Quiring said. In the end, the fund covered 25 percent of Amara’s bill. Amara and her family also chipped in toward her medical costs. With the Charity Fund assistance, the family was able to pay off the bill and continue their lives without the dread of medical debt following them.

Quiring related Amara’s experience as an example—among many—in which she participated as a member of the Charity Fund committee. Through 2014 she had worked with the committee for 12 years, serving as the missionary/community member along with the hospital’s medical director, the financial director, a chaplain and a social worker.

“I’ve found it rewarding,” she related. “I felt that I was making a difference for people.” Her humble estimation of “making a difference” conspicuously understates her 35 years of nursing service with Reach Beyond.

When she first landed in Quito in 1980 as Barby Penn, she worked on the medical floors of the hospital. She remembers being “scared spitless” when asked to take over a position in the ER to provide English translation for patients who didn’t speak Spanish. “But I liked it,” she remembers.

“We also handled the consulta externa (outpatient clinic) and had many medical residents and students come through,” noted Quiring, who was one of those residents’ and students’ informal tutors. She demonstrated basic skills such as dressing changes and bedside care to these neophytes. Now, she points out, those fledglings are successful and influential physicians in Ecuador.

Quiring gained a wide range of experience, floating to fill positions as needed and also working in pediatrics and the isolation unit. While working in the ER, she found herself performing dressing changes on another missionary who had sustained a deep puncture wound while mountain climbing. The successive dressing changes that resulted in wound healing also led to Barb’s marriage to that patient, Rob Quiring, a teacher at Alliance Academy International (AAI).

When David, their first child, arrived, she changed direction and began working in the diabetic clinic a couple of days a week. While raising David and with the later addition of their daughter, Susan, Barb Quiring spent more time at home. But when the opportunity came to be involved with the hospital again via the Charity Fund committee, she was pleased to say sí.

Her experience as a nurse, her deep acculturation with the Ecuadorian people and her Spanish fluency were valuable assets that she participated weekly in committee meetings. Although Charity Fund committee members typically don’t meet the patients whom they agree to help, Quiring often resonated with the needs shared and the life situations patients faced.

“Last year we had a patient who was a student at AAI,” Quiring said. “She was a Cofán Indian who had come from the eastern jungle to live in Quito with Randy Borman, another missionary, who works with the tribe.”

She explained that these students are given the opportunity to attend a high school in Quito with the aim of graduating from college, then taking their new skills back to the people in their community.

“This student needed an appendectomy and obviously didn’t have money to pay for the hospital care. The Charity Fund helped her, and not long after we received a letter from her once she was back in school, telling us that she appreciated the help.”

From her multiple years of involvement on the Charity Fund committee, Quiring accumulated a mélange of stories of farmers, taxi drivers, grandmothers and a tinsmith. The patients she’s heard about often faced months of recuperation from car wrecks or complex surgeries or complications from tuberculosis.

Quiring’s nursing skills often have helped others on the committee understand the ramifications of the patient’s situation or the reason why such a large bill had accumulated.

“Sometimes when people are admitted to the hospital, they already have a chronic problem (like physical limitations or diabetes) that will need ongoing care,” she explained. “I can give the committee a patient care perspective” that adds more understanding toward consideration for financial help.

Quiring also served in the children’s ministry of Bible Study Fellowship (BSF) in Quito for a number of years, leading the only BSF Spanish preschool program in the world.

This summer the Quirings will be moving to Nebraska to address some family issues, charting a new path as stateside missionaries with Reach Beyond. It will be a substantial transition after Barb’s 35 years in Ecuador. She’s willing to accept whatever God intends for her and her family, but leaving won’t be easy.

“I love this country; I love these people,” she said.

 

Karen Schmidt and her husband, Frank, are former Reach Beyond missionaries now living in Camano Island, Wash. Karen works as a nurse, teacher and freelance writer.