MOOSE LAKE - Her colleagues remember Rhonda Kay Skelton as selfless and caring, with a determination that wouldn't quit.
"Rhonda was the nurse every laboring mom wants at her side," said Mike Delfs, the CEO of Moose Lake's Mercy Hospital, where Skelton directed the obstetrics department.
When Skelton died unexpectedly at age 50 on Nov. 3, 2016, while donating part of her liver as a lifesaving gift to her husband, it left an absence no one knew how to fill.
"You could feel it," said Dr. Ray Christensen, who is on the faculty of the University of Minnesota Medical School's Duluth campus and practices one day a week at the hospital. "It was like the halls were weeping."
In a hospital with just 300 employees where she had worked for 25 years in her hometown, Skelton was known to everyone. But her loss was especially felt in the OB department, which also faced a particular challenge.
The hospital had one year left in its effort to obtain a "Baby-Friendly" designation, which has specific requirements to encourage breastfeeding and to maximize early contact between a mother and her baby.
It was a goal Skelton had been pushing toward for a decade.
"It wasn't (about) a plaque you hang on the wall," Delfs said. "She was passionate about this because she firmly believed it was the absolute best thing for her neighbors and her friends and her co-workers who were going to have babies."
But it was November, and the nurses had to decide by December if they were in for another year of meeting the exacting requirements the Baby-Friendly organization requires.
"It sounded so easy," said Allison Horton, an obstetrics nurse and certified lactation counselor who had worked with Skelton on the effort from the start.
Horton held her fingers a couple of inches apart.
"Well, when you have a booklet this thick, that we need this detail and this detail and this policy, it's like, oh my gosh, this is a whole lot of work."
'In her honor'
The OB nurses could have taken a year off from the process, although it would have meant a financial penalty for the hospital, Horton said.
That would have been fine with Delfs.
"We offered specifically, thinking maybe this wound is so fresh, maybe we should wait a year," he said. "We could have put it on hold."
The nurses knew it would be difficult, said Katie Olson, who trained under Skelton and now is OB director. In the midst of the pain they were feeling, in the midst of training new OB staff, they'd face a year of preparing for an assessment the following December on which everything would hang.
They said yes.
"We felt like this would give us something to focus on and essentially do it in her honor," Olson said.
During an interview in the hospital's conference room last week, Olson choked up several times, dabbing at her eyes with a tissue. The pain she displayed has been shared throughout the hospital for a year and a half.
"Sometimes it would be comforting to be here because you would feel like she was going to walk around the corner," Olson said, her voice shaking. "And you would see something that would remind you of her."
Trina Lower, the director of quality and health information, has worked at Mercy Hospital for 21 years and had known Skelton since she was a little girl, she said. They went to the same church when they were younger, and Lower attended Skelton's wedding.
After Skelton died, "it was really tough just to walk through the door," Lower said, a catch in her voice. "Walking in the door alone is really, really hard. For a couple of weeks, I couldn't do it."
The loss was felt by the larger community. To this day, Skelton's voice mail box at the hospital hasn't been taken down.
"We had people call because they wanted to hear her voice," Delfs said.
It 'meant the world'
But the nurses continued striving toward their goal, following the example Skelton had set. It had required "difficult conversations," Delfs said, particularly with the physicians who serve at Mercy Hospital.
"They were not supportive of it," he said. "It meant a change in practice, it meant a change in what (you) do as a doc, it meant a change in a lot of different things. But her passion and her determination were really what drove us forward."
Christensen chuckled as he described Skelton's style of winning an argument.
"If you didn't agree, she'd just kind of stand back and smile and wait," he said. "That was the way she was. She never got flustered."
As the nurses methodically finished the work Skelton had begun, they weathered the assessment in December with a sense of accomplishment, Olson said. Convinced that Mercy Hospital now was truly baby-friendly, whether or not they got the title, they ate out that night in Duluth and visited Marcia Hales' light display on Park Point.
But it wasn't until February that they got the official word. Mercy Hospital was Minnesota's second critical access hospital - those with no more than 25 beds, no closer than 25 miles to the next hospital - to be named a Baby-Friendly hospital. Olson got the news by phone while sitting at the nurse's station next to one of her colleagues.
"She was already crying before I even hung up the phone," Olson said.
Meanwhile, Lower had nominated Skelton for the Louis Gorin Award for Outstanding Achievement in Rural Health Care from the National Rural Health Association, named after a leader in health initiatives for rural America. Christensen had received that award in 1989. Lower got word in late February that Skelton had been chosen as the winner - the first person to receive it posthumously.
Hearing that "meant the world," Lower said. "It meant that Rhonda is really being recognized in the way that she needs to be."
Skelton's two daughters, who live in Boise, Idaho, accepted the award on May 10 at the National Rural Health Association's 41st annual Rural Health Conference in New Orleans. Lower's 17-year-old son had prepared a 3-minute video about Skelton that was shown just before they received it.
It was followed by a standing ovation.
"I don't think there was a dry eye in the room," said Lower, who was in attendance. "I was approached after by the CEO of the National Rural Health Association, and he said in the 17 years he's been with that group at the awards presentation, that's the only time he's ever seen a standing ovation."
Not that Mercy Hospital's nurses would forget Skelton anyway, but they're reminded every day as they enter their workplace under the words "Rhonda Kay Skelton Birthing Center." A glass pillar filled with purple and white sand and a framed photo of Skelton serve as a memorial at the corner of the nurses' station.
Moreover, at a time when many rural hospitals are closing their obstetrics wards, the Mercy Hospital OB nurses can know their hospital has the Baby-Friendly designation that she and they worked so hard to achieve.
"It was something that we all cared about but she - it was a vision for 10 years," Olson said. "It was something she was very passionate about."
To get involved
A Rhonda Kay Skelton Memorial Nursing Scholarship has been set up in Skelton's honor through The Mercy Foundation. To learn more, visit mercymooselake.org, click on "The Mercy Foundation" and then on the "Rhonda Kay Skelton Memorial Nursing Scholarship."