Rhonda Veile has learned two things after decades working as a geriatric nurse: stay calm and never mess with bingo.

But since the COVID-19 pandemic hit a month and a half ago that has been challenging for staff at the Palouse Country Assisted Living facility in Fairfield, on both fronts.

Veile said bingo is an essential ritual for many residents. For them, it takes precedent over doctors appointments, haircuts, bathing and eating sometimes. That comforting ritual is still taking place, but the games are smaller and more spread out. Bingo changes, and the uptick of cases broadcast on the news everyday, has left many residents distraught, worrying about their routines, and if they’re going to be OK.

Veile’s calm, like seemingly everyone else’s, was disrupted when the effects of the global coronavirus pandemic began to reach Fairfield, a Spokane County town of a little over 600 people.

Fairfield’s only clinic closed last year, leaving Palouse Country Assisted Living as the health care facility in the area and Veile as facility’s only nurse.

As the only nurse, Veile is also the facility’s director of nursing, overseeing two certified nursing assistants who take care of many of the residents’ needs.

But access to other health care providers, especially doctors, has been extremely limited for the last few months. Spokane, where most of their doctors are, is about a 40-minute drive away and the demands of COVID-19 has made access even more difficult than usual.

While some doctors have been seeing patients over video since the outbreak, internet access in Fairfield is limited and many patients have been unable to see their doctors even remotely for at least a month and a half. A few nurses from Providence visit the facility, but they and emergency responders are some of the only non-staff members allowed in the facility.

And it’s not only medical providers who are no longer visiting the facility. Volunteers are no longer allowed inside, and neither is family.

“It’s very quiet, kind of eerie quiet,” she said.

Many of the 44 residents are from Fairfield or small farm towns around the area, such as Waverly or Latah, Veile said. She said they’re used to visits from family, birthday parties and regular games of bingo.

But along with having to work hard to stay calm, Veile has also had to mess with bingo and other activities to reduce the risk of a resident contracting COVID-19.

Residents who love bingo now must play social-distance-style with participants and games spread out.

Birthday parties have been reduced to just residents and a staff member playing the piano for them.

Visits from families have now been reduced to phone calls, or a greeting through a window.

Veile said the staff, many of whom have lived beside residents in the Fairfield area for years, are the only family they get to see everyday.

“Our activities staff has stepped up, but there’s only so much you can do,” she said. “That’s part of the stress, too, keeping everybody happy and functioning the best that we can.”

She works to keep herself smiling and maintain an outwardly calm demeanor whenever she is on the floor to reassure both residents, who are cut off from their families, and staff, who don’t have enough personal protective equipment.

“If something transpires, I have to keep a smile on my face when I walk down the hall,” she said. “I can’t look worried, (because) they can read me like a book.”

She said she has also been working desperately to get PPE for staff.

Members of the Fairfield community who quilt have made a cloth mask for every staff member, which has been helpful, but the facility has only 25 N95 masks for 43 employees.

“We don’t have the supplies if there was an outbreak” of COVID-19, she said.

So far, she said, the home has been lucky – but staff have also been proactive in their efforts to prevent the disease from entering the facility.

Most of the staff live within 10 miles of Palouse Country Assisted Living and rarely go into Spokane. They also have a strict protocol for staff entering and leaving the facility. There is a locker room where staff can pick up and leave their uniforms, a bathroom where they can sanitize before they enter the facility and protocols to ensure their temperatures are taken often.

Veile said there have been no symptomatic residents or staff members. Three staff members were tested after they were exposed to someone with COVID-19, but they all tested negative.

Veile said her long career in elder care has likely helped prepare her for this moment. She started taking care of her grandmother in high school, and has been drawn to the needs of older patients since she graduated college and became a nurse. She’s now worked in some form of elder care for 36 years, eight of which have been in the Fairfield facility.

She said she and the staff have been working harder to make sure the residents don’t completely isolate themselves in their rooms, stopping by to offer books and magazines, finding ways they can stay connected with other residents while social distancing and trying to make sure some of the celebrations they would have with their families, such as birthdays, can still happen in some form.

“It’s been more like family because we’ve been put together in this situation,” she said. “If you lived in a house and all you had were the people in that house, your differences kind of melt away. You can respect the differences, but you have to work together to make the house work.”