From Alone on the Night Shift to Always Connected: How Telehealth Transforms Rural Care  

Sheila Freed has been a nurse for over forty years, from big-city hospitals to tiny rural clinics where she sometimes worked the night shift completely alone. Today, as Clinical Operations Director for School Health and Senior Care at Avel eCare, she’s helping make sure no clinician has to face those moments without backup. In this episode, Sheila shares her journey through the evolution of digital health, how virtual care is changing life in rural communities, and why supporting the people who deliver care matters just as much as caring for patients themselves. 

When Sheila Freed started her nursing career, she went from a 700-bed Chicago hospital to a 20-bed facility in a South Dakota town of 800 people — where she was the only nurse on night shift. That experience shaped her understanding of what true rural care looks like: resource-strained, deeply personal, and often lonely. 

Years later, as telemedicine began to take hold, she saw firsthand how virtual connections could fill those gaps. She remembers a time when she had to intubate a friend’s mother alone on Christmas Day. Now, she watches rural clinicians perform the same procedure with an Avel eCare physician guiding them in real time — a change that still moves her to tears. 

Through Avel eCare’s school and senior-care programs, Sheila helps bring that same safety net to teachers, aides, and rural nurses who once felt isolated in their roles. A single button press now connects them instantly to a remote nurse who can assess symptoms, calm a crisis, or simply talk them through what just happened. 

But the power of telehealth isn’t just clinical. It’s emotional. Sheila’s team follows up after emergencies to check on staff, debrief, and connect them to behavioral-health support when needed — because, as she says, “the technology saves lives, but the support saves careers.” For many in rural America, that’s the difference between burning out and staying in the work they love.

Sheila Freed, BSN, RN, NCSN serves as the Clinical Operations Director for School Health and Senior Care at Avel eCare; which provides school nursing and behavior health services via live audio/visual technology to over 135 schools in 12 states.  She has been a building nurse, a School Health Supervisor and then the Director of Nurses/School Health Liaison for a public health unit. A strong advocate for children’s health she believes leveraging technology can solve access issues to rural as well as urban schools and provide every student with the opportunity to be healthy and safe at school, regardless of location. She is a 2015 Johnson and Johnson School Health Leadership Fellow and a Nationally Certified School Nurse. She received her BSN from the University of Wyoming.