The nursing home has 180 beds, and as of mid-August served about 100 residents who are U.S. military Veterans or Veteran family members. Minnema, who became director of nursing in March, explained that new residents haven't been admitted of late because efforts were underway to stabilize the staff and services. "We will now start admitting again, slowly," she said, adding that eight to 10 residents will be admitted per month.
"Generally, we are adjusting to budget issues. You can't be in healthcare without needing to be cost effective. That's both challenging and stressful," Minnema said.
There are about 50 nurses and 75 CNAs who work full- and part-time at Fitzsimmons, according to Minnema. Though the full-time positions are well staffed, the facility is looking to recruit nurses for an internal float pool.
"The long-term goals have to do with stabilizing the facility and building teams, but also to look at culture change issues and how to make the nursing home more of a home atmosphere versus an institution," Minnema said. Cultivating a community atmosphere with consistent medical care is among Minnema's personal goals.
Team building is a huge piece of the puzzle for Fitzsimmons, and Minnema is working on teams for both nurse managers and direct care staff. "The challenge is not just having individuals who work, but how we develop an interdisciplinary team to look at problems," she said.
Fitzsimmons has an advantage in the effort to build community -- its resident population. "The residents and families are very involved and invested in their care and in developing a home," Minnema said.
Though never a member of the military, Minnema has come to respect and admire the special population she serves. "I've developed a real appreciation and understanding of history. I really enjoy listening to residents tell me about their war experiences and what life was like for them," she said.
Minnema said good long-term care nurses must have a unique set of skills and interests.
The successful ones enjoy long-term patient relationships and have an eye for detail. "It's different than in acute care. Sometimes it can be a struggle for acute care nurses to understand the level of detail that must be addressed on a daily basis in long-term care," she said.
Minnema speaks from experience in long-term care as both a manager and consultant. A nursing director since 1990, she's been a staff development coordinator in multiple locations and worked at a Walsenburg, Colo., VA nursing home as an interim director of nursing. For three years, from 1999-2002, she ran her own nursing home consulting business.
"It was interesting and good experience, but I missed being in one place and being on one team," she said of her time as an entrepreneur. "Always being in a new place can be wearing."
Today she applies the insight gleaned from consulting to her efforts at Fitzsimmons. "I think it helps to see what other people have done, and it helps to understand the struggles that everyone goes through in long-term care," she said.
Originally interested in psychology, Minnema said she obtained a nursing degree for practical reasons. She liked science, anatomy and physiology, and nursing provided a lucrative and flexible career.
She grew up in Michigan and received a bachelor's degree in psychology from Calvin College in Grand Rapids, Mich. Eight years later, she earned an RN degree from St. Mary's School of Nursing in Grand Rapids. After moving to Colorado in 1986 she earned a master's degree in counseling from the University of Northern Colorado.
Long-term care nursing has proven to be a successful career for Minnema. She even met her husband at a nursing home -- he was serving as the facility's food service director while she worked as director of nursing.
"Long-term care really is a specialty. In the past, it's been looked down on. But it's a unique set of skills," she said.
In her free time, Minnema plans to take up piano lessons and continue tending to her two dogs. She sometimes attends canine agility training events and competitions. The events show off the abilities of trained dogs on obstacle courses, catching Frisbees and performing various tricks. "It's pretty amazing what they do," she said.