Ep. 60 - Breath, Boundaries, and Letting Go: Ventilation Discontinuation in Rural Long-Term Care

Prolonged mechanical ventilation in rural long-term care settings brings a unique set of clinical, ethical, and logistical challenges for care teams, residents, and their families. In this episode, we explore the realities of ventilator use in rural long-term care environments, where limited resources and geographic barriers can complicate care decisions and delivery. We also take a thoughtful look at the emotional and practical impact of ventilator discontinuation, highlighting the experiences of those directly affected. Join us for a nuanced conversation that sheds light on an often-overlooked aspect of long-term care and the difficult decisions that come with it.

Von Vitto, DNP, CNP, AGNP-C, ACHPN® Von Vitto, DNP, CNP, AGNP-C, ACHPN® is a board-certified adult-gerontology nurse practitioner and has advanced certification as a hospice and palliative nurse. He currently serves as a nurse practitioner at HospiceCare in The Berkshires, Inc. in Berkshire County, MA. Von brings years of experience in delivering geriatric and specialty palliative care in skilled nursing facilities and to community-dwelling patients. He is passionate about navigating serious illness conversations and the provision of goal-concordant care. Von has also mentored and precepted nurse educator and nurse practitioner students.

Julie Thurston Julie Thurston is a board-certified Adult-Gerontology Primary Care Nurse Practitioner with advanced certification in Hospice and Palliative Care who currently serves as a key member of the leadership team at HospiceCare in The Berkshires, Berkshire County, Massachusetts. In her role, Julie provides comprehensive patient and family-centered care, supports her organization in ongoing performance improvement projects, and mentors her staff in various professional development opportunities. During her tenure, Julie has embraced diverse roles including RN Case Manager, RN Weekend/Evening Triage, and Staff Educator. Her commitment to the provision of high-quality care across the continuum earned her an Integritus Healthcare Profiles in Care award. Additionally, she shares her expert knowledge and experience providing education throughout the local community for healthcare providers across multiple disciplines. Julie has been an active member of the Hospice and Palliative Nurses Association since 2010.

Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Dr. Brett Snodgrass has been a registered nurse for 28 years and a Family Nurse Practitioner for 18 years, practicing in multiple settings, including family practice, urgent care, emergency departments, administration, chronic pain and palliative medicine. She is currently the Operations Director for Palliative Medicine at Baptist Health Systems in Memphis, TN. She is board certified with the American Academy of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and an Advanced Certified Hospice and Palliative Nurse. She completed a Doctorate of Nursing Practice at the University of Alabama – Huntsville. She is a nationally recognized nurse practitioner speaker and teacher. Brett is a chronic pain expert, working for more than 20 years with chronic pain and palliative patients in a variety of settings. She is honored to be the HPNA 2025 podcast host. She is married with two daughters, two son in laws, one grandson, and now an empty nest cat. She and her family are actively involved in their church and she is an avid reader.