Daniel Keuning, FNP Family Nurse Practitioner Pagosa Family Medicine, Pagosa Springs, CO

What is your background?

For several years the people of the town of Pagosa Springs made an impact on me through my work as an RN in home care and hospice. But in a small town, you wear many hats. I found myself responding to emergencies, running with the ambulance, assisting in the clinic, and traveling 60 miles to the nearest hospital to help out when the staffing was short in the intensive care unit. All of these duties allowed me to become more of a nurse and more attached to the community where I lived, worked, and played. I was able to cry at the bedside of a dying friend, say hi at the grocery store to the clerk who recovered from a one-car rollover, and celebrate a new life with friends who just had their first baby. In 1998, a group from the University of Colorado Health Science Center School of Nursing stopped by the clinic to see if they could help with outreach education. I was eager to talk to them and within three days I was online in my first Master’s degree class. Through the help of the Mountain and Plains Partnership (MAPP), I was able to complete my MSN as a Family Nurse Practitioner while living and working in my community. It wasn’t easy…just ask my wife and kids! I went to work in a rural community when I finished school in 2001. It just so happened that the rural communities were villages in south-central Alaska.

We moved our family up to Alaska for six months and I flew out to four villages and provided primary care to the native people of this region. Again, this was a place where community was valued. They taught me how to fish, hunt, take care of the land, pick berries, and how to enjoy long summer days. The challenges of independent practice where awesome. I happened to be in a village when there was a Meningitis outbreak and airlifted 12 very ill people out to the nearest medical center. In December, when the days became short and the nights long and cold, again southwest Colorado became home.

I now practice primary care and urgent care as a Family Nurse Practitioner in Pagosa Springs, Colorado, a small mountain town in frontier Archuleta County in the southwestern part of the State. Archuleta County is designated as both a Medically Underserved Area (MUA) and a Health Professions Shortage Area (HPSA). I work as a Family Nurse Practitioner (FNP) at the Dr. Mary Fisher Medical Center, a Division of the Upper San Juan Hospital District.

Daily, I see the positive effects of living in a small town. Things do not change quickly; the city hasn’t caught up to us. There are still plenty of fish and elk around town to keep us in awe of nature. I am privileged to care for my friends, visitors, newcomers, old-timers, the very sick and those who think they are sick. It is hard work but I am thankful to be here. I love life; I love the Lord who gave us life. Thanks for the experience.