Prescription for Wellness: First Aid on the Trail

First Aid on the Trail

By: Dr. Susan Layeux, Boundary Community Clinics

In Boundary County, we head out to forest and river trails to hike, pick berries, find mushrooms, track animals, hunt, ride mountain bikes, snowmobile and ride ATVs. Most excursions will never end in someone needing First Aid. However, as the mother of three Eagle Scouts, I would have to agree with the Boy Scout motto: “Be Prepared”. That is the first key to Trail Safety and First Aid. We need to be aware of our surroundings and the obstacles or animals we may encounter that could result in injury. So I will share some key ways to be prepared.

Carry water. Avoid dehydration by bringing along enough water for the time you plan to spend outside. The higher the temperature, the higher you go in altitude and the more physical you are, the more water you need (even in the winter). The base should be 8 ounces per hour. If you stay hydrated you are less likely to experience Fainting, Heat Stroke and mental dullness that can lead to other injuries. Water can also be used to wash wounds and to cook. Sometimes a simple water bottle per person is enough, but the Camelback backpacks are great if you will be out for hours.

Pack a basic First Aid kit. This could include antiseptic wipes or alcohol pads (or water), antibiotic ointment, assorted bandages, small tweezers for slivers (or ticks), gauze pads of various sizes, tape (even duct tape), elastic bandage (Ace wrap or Coban wrap that sticks to itself), moleskin or gel pads for blisters, burn cream packets, scissors, safety pins, hand sanitizer, triangular bandage or bandana (makeshift sling). You could even consider disposable non-latex gloves and a CPR breathing barrier if you will be far from help and in a large group. A few baby Aspirin and some Acetaminophen or Ibuprofen can be handy. And many kits come with a small first-aid booklet or guide to how to handle various injuries.

On insects. Prevent tick and mosquito bites with proper clothing and your favorite insect repellent. Check for ticks at the end of each day, and remove by grasping the head (if possible) with tweezers and pulling steadily and firmly. Prepare for hornet or bee stings. If allergic, be sure to bring your Epi-Pen. Even if not, bring a few Benadryl 25 mg (diphenhydramine) and take one immediately if there is significant trouble with swelling or breathing. This can also be used if you develop a rash from exposure to poison ivy or other noxious weeds.

Prepare for the weather. Apply sunscreen every 1-2 hours to exposed skin. Use a hat to keep your head cooler in the sun and warmer in the cold. Bring along a rain poncho or even garbage bag if wet weather is possible. Wear layers so that clothing can be adjusted according to changes in temperature through the day (or elevation).

Dress appropriately. Hiking boots provide better ankle support than sneakers on uneven terrain. Helmets are important for high-speed activities like biking, riding ATVs and snowmobiling. Neckerchiefs come in handy for covering skin, getting wet to put around neck to cool down, or to wash or bandage wounds.

General Safety. Always be sure that someone knows where you are going and how long you plan to be away. Carry a flashlight and matches. Carry a cell phone (even if you don’t have service, the phone can often be tracked if you get lost). Always go with a buddy. Back away from potentially dangerous animals while facing them and making a lot of noise.

The Community Health Fair is Saturday, May 12, from 9 am to noon. Stop by our Mountain Trail Safety Clinic. I will be there to answer First Aid questions and give you tips on how to make a Basic First Aid Kit. We live in a beautiful part of the world. Enjoy it – Safely.


Susan Layeux, MD is a Primary Care Physician at Boundary Community Clinics and Chief of Staff at Boundary Community Hospital.

Prescription for Wellness: Advance Directives

Prescription for Wellness from Boundary Community Clinics


Start the Conversation about Advance Directives

By: Janet Lukehart, FNP-C

Healthcare decisions can often be complicated and confusing even under the best of circumstances. Unexpected medical issues and emergencies may place you in a situation where you are unable to speak for yourself, leaving your family to make heathcare decisions for you. Under these circumstances, how will your family and medical providers know your preferences for life-saving efforts and treatment? This is where an Advance Directive comes in.

Stated simply, an Advance Directive shares your healthcare wishes, should you become incapacitated and unable to express yourself. You specify the medical treatments you would want provided or withheld, and designate who is permitted to make these medical decisions on your behalf. Most people decide their preferences based on personal values and conversations with loved ones. Should you change your mind, updates can easily be made by submitting a new form.

Three types of advance directives legally recognized in Idaho are the Living Will, the Durable Power of Attorney for Healthcare, and the Physician Orders for Scope of Treatment (POST). A Living Will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, and related decisions such as pain management or organ donation. In the absence of an advance directive, medical care providers are obligated to prolong your life, using artificial means if necessary. With a Durable Power of Attorney for Healthcare, you name the person who will make these decisions for you when you are unable. The POST replaces the traditional Idaho Do Not Resuscitate form and is a set of medical orders you ask your doctor to write. The POST is most applicable for those with terminal conditions.

The Advance Directive process need not be complicated nor expensive. Instructions and templates for advance directives are combined in a free document provided by the state of Idaho. Idaho also maintains an Advance Directive Registry. By filing your document with the registry your healthcare provider and loved ones will have ready access to your directive in a time of need. Visit for more information. Other free and low-cost resources are available at, and

If you do not already have an Advance Directive and would like more information and/or forms, please stop by the Start the Conversation about Advance Directives exhibit area at the Hospital’s Annual Health Fair on May 12, 2018. Your actions now might well save your family members stress and emotional turmoil in the future, and assure your healthcare choices are met.

Janet Lukehart is a primary care Nurse Practitioner at Boundary Community Clinics.

Prescription for Wellness: April is Autism Awareness Month

Prescription for Wellness from Boundary Community Clinics

April is Autism Awareness Month

By: Beverly J. Yercheck, ANP-C

To highlight the growing need for concern and awareness about autism, the Autism Society has celebrated National Autism Awareness Month since the 1970s. This is a good opportunity to promote autism awareness, autism acceptance, and to draw attention to the many families facing an autism diagnosis each year.

What is autism?

Autism is a spectrum condition that affects individuals differently and uniquely to varying degrees. Many of the symptoms of Autism involve communication and socialization. Frequently those with Autism have problems with change, avoid eye contact, have facial expressions that do not correspond to the situation, have problems with personal space, appear to lack empathy and may avoid physical contact. Frequently these individuals have problems making and maintaining relationships.

How is Autism diagnosed?

Signs and symptoms typically appear in early childhood and can be diagnosed by a pediatric provider or by school specialists with input from family and friends. Signs that a child needs an assessment for Autism are usually noticed by the parents or primary care providers. These early signs may include the following: a baby that does not babble or coo by 12 months; a baby that does not gesture with waving or pointing by 12 months; a baby that does not speak even single words by 15 months or say 2 word phrases on his own by 24 months; or if there is any loss of language or social skills over time. These signs do not mean a diagnosis of Autism but they do signal a need for professional assessment.

Since Autism can look differently in each individual, it takes a team approach to put together a plan to help the child navigate in a “neurotypical” world. Success of the individual greatly depends on resources and support within and aside from the family. The school system can assist with interventions to help bring out the best academically and help develop social skills. It is important to remember that the individual with Autism has all the same needs that non-Autistic people have, they just express those needs in different ways.

Bev Yercheck is a primary care adult Nurse Practitioner with Boundary Community Clinics in Bonners Ferry.


The Autism Awareness Ribbon — The Autism Awareness Puzzle Ribbon is the most enduring and recognized symbol of the autism community in the world. The puzzle pattern reflects the complexity of the autism spectrum. The different colors and shapes represent the diversity of the people and families living with the condition. The brightness of the ribbon signals hope — hope that through increased awareness of autism, and through early intervention and access to appropriate services/supports, people with autism will lead full lives able to interact with the world on their own terms. – Autism Society

Rural Health in Boundary County

Rural Health in Boundary County

By:  Jeannie Harkness
Boundary Community Clinics Manager

Across America rural settings allow for a simpler way of life. However, when it comes to health care, Rural Health Clinics are anything but simple. The Rural Health Services Act of 1977 has helped bring healthcare providers to rural areas, meeting the needs of families that would otherwise not have access to care. Physicians, Nurse Practitioners and Physician’s Assistants care for patients with problems ranging from the common cold to annual physicals, to chronic and serious issues including hypertension, diabetes and heart disease. Rural Health Clinics have helped residents of small communities, like Boundary County, enjoy healthier lifestyles and address more prominent healthcare needs.

Boundary Community Clinics has been certified as a Rural Health Clinic by the State of Idaho since 2014. To qualify as a Rural Health Clinic (RHC), a clinic must be either located in a non-urbanized area, designated as a medically underserved area, designated as a population group or have a geographic health professional shortage in the area.  In addition, Boundary Community Clinics was recently re-accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. as a Rural Health Clinic and is proud to be a part of the Rural Health Association.

With a full-time physician, two nurse practitioners, nurses, medical assistants and administrative staff all living in Boundary County, our rural health clinic is truly neighbors caring for neighbors.

Boundary Community Hospital Reaccreditation

News Release
For Immediate Release
October 17, 2017
Boundary Community Hospital



Bonners Ferry, Idaho — Boundary Community Hospital announces the successful completion of its accreditation process from DNV GL – Healthcare. By earning reaccreditation as a Critical Access Hospital, Boundary Community Hospital (BCH) has demonstrated it meets or exceeds patient safety standards (Conditions of Participation) set forth by the U.S. Centers for Medicare and Medicaid Services. DNV GL’s accreditation program is the only one to integrate the ISO 9001 Quality Management System with the Medicare Conditions of Participation.

“The DNV GL program is consistent with our long-term commitment to quality and patient safety,” says Tari Yourzek, RN, BSN, Chief Nursing Officer and Quality Manager. “The ability to integrate ISO 9001 quality standards with our clinical and financial processes is a major step forward.”

In addition, Boundary Community Clinics received reaccreditation as a Rural Health Clinic and the Clinical Medical Laboratory received their reaccreditation.

The Extended Care Facility and Nursing Home completed their annual survey by the Idaho Department of Health and Welfare.  The surveyors reported that the survey was 100% deficiency free for the second year in a row.  The Nutrition Services Department led by Valerie Strugar, DTR also had a 100% deficiency free report – this is their 22nd year in a row!  This is a team effort with Extended Care Facility staff working with Nutrition Services, Environmental Services and Facilities/Maintenance to provide the highest standard of care to the residents. “A deficiency free report from the surveyors is extremely rare for a long term care facility,” says Yourzek. “To have it two years in a row should be credited to the hard-working and dedicated team led by Director of Nursing, Tami Corsi, RN.”

These are excellent examples of the quality of care that our hospital, primary care clinic, and extended care facility employees are providing to the community.

When Time is of the Essence in an Emergency

August 2017

By: Sunshine Bartlett, RN
Boundary Community Hospital Emergency Department

The man sitting beside you in church slumps forward. When you speak with him his words are slurred. He seems unable to lift one of his arms.

You are at a family dinner. Your aunt mentions to you she has been having chest pain for the last 30 minutes. She doesn’t want to cause a fuss. She wants to know what you think she should do.

You are driving down the road. You come upon a truck which ran off the road and struck a tree.

What do these three situations have in common?

They are all considered Time Sensitive Emergencies.

Time sensitive emergencies are medical conditions where rapid treatment can make a big difference in the eventual outcome for a person.

The state of Idaho has recognized Stroke, Heart Attack and Trauma as circumstances where timely care can prevent and lessen disability and even death. Many of the Emergency Medical Systems (EMS) and hospitals throughout the state are adopting new systems to reduce delays for these people. These measures include calling ahead an alert to make these patients a priority, developing protocols to assure the highest level of care and expediting transfers to the most appropriate facility.

You are the most crucial piece in the chain. Without people in the community alerting medical personnel the process cannot begin.

What can you do if you recognize the signs of these critical situations?


Slurring of speech, facial droop and/or weakness on one side of the body.

Heart attack:

Chest pain or pressure which can move into the neck or arm, sweating, nausea and/or pale skin.


Any concerning trauma or injury.

First, remain calm and Call 911.  EMS in Boundary County have been trained to respond and treat these emergencies. They will notify the Hospital of the type of emergency so other preparations can be made.

Next, stay with the person. Dispatch may have questions for you which can help EMS locate and treat the person who is sick or injured.

In each of these cases, the quicker the person can get to medical care, the better the chance they will go on to lead a healthy and productive life. Your ability to recognize these critical situations and act may really make a difference in someone’s life.

Boundary Community Hospital in Boundary County and Bonner General Health in Bonner County have been designated as Level IV Trauma Centers by the State of Idaho for Time Sensitive Emergencies.



Exercise for Joint Stability

July 2017
By: Jeff Petersen, PT, DPT
Physical Therapist, Boundary Community Hospital Rehabilitation Services

How many times, on the sports field or playground, do you hear the kids talking about being “double-jointed”?  This is common slang for a condition called joint hypermobility or joint laxity and it simply means that someone is able to move their joints farther than most people can; and in some children (and adults) this condition may be the cause of joint pain.

The majority of patients I see who are under the age of 18 and not post-surgical, complain primarily of joint pain. In addition, they tend to score in the mild to moderate 4 – 6 point range, of the 9-point Beighton score for joint hypermobility.  This patient population represents only a very small percentage of the total population in this age group in Boundary County. Because many individuals do not seek treatment, this suggests the condition may be more widespread.

The problem with joint laxity is that the connective tissues involved, which typically provide joint stability, are looser than they should be, and allow excessive range of motion.  This can be congenital in nature, which typically presents throughout the body, or from a traumatic event affecting just one or a few joints specifically. These tissues do not stretch and rebound like muscle tissue, and therefore if they allow excessive range of motion, there is no changing that without surgical intervention.

On a more conservative note, if the muscles that attach to the joint connective tissues can be strengthened and trained to work more as joint stabilizers, they can help reduce the strain on the connective tissues, and provide increased joint stability when performing movements, especially with sports.

What options do you have to postpone or prevent issues with joint hypermobility? 

Most people do very well participating in a physical therapy program to evaluate deficits and establish an individual plan of care. The objective of the plan of care is to improve tolerance to functional mobility, especially sports and other recreational activities, and to reduce joint pain and associated symptoms.

Make a habit of including strength and stability training in a life-long, regular exercise program to minimize the effects of joint laxity.

Be sure to take advantage of the free Sports Physical Clinic at Boundary Community Hospital on August 1, 2017 from 5-7 pm.  The Sports Physical Clinic includes a screening by the Physical and Occupational Therapists in the Rehabilitation Department, providing evaluation for neuromusculoskeletal function in the kids, including range of motion, strength, balance and functional mobility.  The therapists will ask if the child has been experiencing any joint pain or other related symptoms.  This is excellent for early detection and intervention to avoid something small becoming something big later on.

Boundary Community Hospital offers the Sports Physical Clinic annually as a FREE service for our community. In accordance with Idaho High School Activities Association, any students in grades 7, 9, and 11 participating in sports, including cheerleading, must have a physical before the first practice starts. A physical is also required for those new to the sports program who did not have a physical last year, even if in grades 8, 10 and 12. Students and parents should enter at Outpatient Services off Comanche Street and check in at the Coaches’ table. Parents must be present for the clinic.



ECF Wins 10th Schoonover Award

News Release July 31, 2017

Excellence in Caring – Again

Bonners Ferry, ID — Boundary Community Hospital is proud to announce that its Extended Care Facility and Nursing Home has been recognized by the State of Idaho with their tenth L. Jean Schoonover Award for Excellence in Caring. This year the facility received the Gold Award distinguished by having an average Health Inspection rating of 4.6 to 5.0 (the highest rating).  Recipients of the award must demonstrate a dedication and commitment to providing the highest quality of care to the residents they serve.

Boundary County Nursing Home joins Kindred Nursing and Rehab in Mountain Valley as the only two Gold Award winners in 2017. “This is an excellent example of the quality of care that our hospital and extended care facility employees are providing to the community, especially those that need long term and skilled nursing care,” says Craig Johnson, CEO. “The focus is on the residents, making their environment more home-like, and finding and keeping staff that emphasizes the quality of care they provide.”

Under the guiding hand of Director of Nursing Tami Corsi, RN, the Extended Care Facility has started an initiative to make the residents feel more at home.  Her hands on leadership style and caring culture have allowed the staff to focus on care rather than procedures and schedules.  Working with Valerie Strugar, Nutrition Services Manager, Ms. Corsi has been a change catalyst recently by focusing on the Restorative Sleep Vitality Program to allow residents to get more natural sleep by adjusting meal times and expanding food choices, as well as expanding activities.

Culture of Caring, Culture of Quality

According to Chief Nursing Officer, Tari Yourzek, “The entire staff, both medical and non-medical, is committed to quality patient care and caring about the people of Boundary County, continuously making a conscious effort to improve our services. Their attitude toward a culture of quality is reflected in their efforts to stay ahead of standards of care, setting an example for other small rural hospitals and nursing homes. Quality healthcare can be defined as providing best practice care with the most up-to-date resources by empathetic and caring staff.”

The Extended Care Facility and Nursing Home at Boundary Community Hospital is a licensed skilled nursing home with a physician on staff to supervise each resident’s care providing both long-term and rehabilitative or short-term residency. The highly-skilled staff understands and specializes in long-term care, bringing a special nurturing atmosphere that can be felt every day throughout the facility.


2017 Golf Tournament Results

Fry Healthcare Foundation’s 9th Annual Golf Tournament

It was wet but Josh Figgins and Matt Odd played through the rain to win the Fry Healthcare Foundation’s 9th Annual Golf Tournament held on Friday, June 16, 2017 at Mirror Lake Golf Course in Bonners Ferry.

Winners-Figgins-and-Odd-webThe players “Tee’d” off to a shotgun start at noon and played 18 holes of golf, sometimes in monsoon conditions. Travis Delaney and Scott Rynearson captured second place with third place taken by Dick Staples and Dave Anderson. Longest Drive for Men was Travis Delaney, and Longest Drive for Women was Wendy Hawks.  Bill Gutnecht made the Longest Putt and Jamie Porter was Closest to the Pin. No one managed to make a Hole-in-One on hole #8 which was sponsored by Boundary Tractor, although several made it to the green.

Sponsors for the tournament included Idaho Forest Group, Yellowstone Insurance Exchange, Gardiner Prime Angus Ranch, Blanche Studer and Elaine Morgan, Edward Jones Investments, Craig and Donna Johnson, J. B.’s Tire and Automotive, Fousts Inc. Logging Contractors, E-Enterprises, and Riverside Auto Center.

Auburn Crest Hospice, Janice Claridge and Rick Lozoya, Selkirk Press, Bonners Ferry Living Local, Super 1 Foods, Ralph Lotspieck, Boundary Electric and Dixon Golf provided donations and prizes.

Life Flight Network and Pro-X Home Center donated a Traeger Grill that was awarded to Cathy Thaxton, the winner of the Great Golf Ball Drop.

The funds raised at this year’s tournament will be used to purchase a Nu-Step Recumbent Cross Trainer for the Rehabilitation Services Department at Boundary Community Hospital. According to Petra Timmermans, PT “The Nu-Step Trainer is wonderful for early rehabilitation of knee and hip surgeries because it allows for small movements, unlike a stationary bike where the knee and hip have to be able to flex over 90 degrees to make a full revolution. Patients are in total control of the movement and especially after surgery, it decreases the fear of pain. They are able to gradually increase the range of the movement at their own pace.”


Over the past twenty years, the Fry Healthcare Foundation and our community have raised over $1.2 Million to benefit the hospital. We are very grateful for your continued support that ultimately benefits everyone who relies on Boundary Community Hospital for emergency and routine care.


For More Information:

Fry Healthcare Foundation:  208-267-6912

Like us on Facebook to keep up to date on Fry Healthcare Foundation-sponsored events.

The Beat Goes On

The Beat Goes On

On May 1, the Spacelabs Cardiac Monitoring Central Station came online at Boundary Community Hospital.  Funded by the community through generous donations to the Fry Healthcare Foundation Festival of Hearts, the new Cardiac Monitoring system enables Boundary Community Hospital to monitor patients in the Emergency rooms and the Acute Care Hospital from one central location.  According to Paul Sogge, Spacelabs Healthcare Marketing Communications Manager, “Spacelabs Healthcare is proud to partner with Boundary Community Hospital to provide the latest in medical telemetry.  Spacelabs takes its name from the company’s origin in the early days of the U.S. Space Program. In 1969, Spacelabs medical telemetry monitored Neil Armstrong’s vitals on the moon. Today, the company’s technology is used by hospitals and care facilities around the world to watch over millions of patients every day. With the upgrade, Boundary County caregivers and patients will benefit from the latest telemetry system on the market.”

The hospital’s new Xhibit Central Station, with a high-resolution touchscreen display, will provide caregivers a detailed view of any patient on the network. Ambulatory patients will now be monitored with AriaTele telemetry transmitters, featuring full color screens to display heartrate, ECG, and SpO2 waveforms. Together, these solutions will deliver critical patient data across the hospital network, enabling better-informed decisions, increased efficiencies, and a safer environment for patients.


No one person can shine on this project and this install was no exception. According to James Miller, “This took a BCH team to pull off. After all the phone calls, e-mails, and tech questions, we are finally live with the telemetry and cardiac system. This is another great example of continually raising the standards of care at our community hospital. It is always important when taking care of people that we strive for nothing but the best.”

Boundary Community Hospital would like to thank the community for their support of the Hospital through the Fry Healthcare Foundation. This cardiac monitoring system is necessary, life-saving equipment that will benefit Boundary County and its residents for many years. ###