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When she retired in May 2002, 43 years later, she had seen lots of changes in the facility, the organization, and in medicine.

She has witnessed the addition of the Koronis Manor in the 1960s, the remodeling of the hospital in 1983, the addition of 700 Stearns Place in 1987, the addition of a clinic in 1995, and the current $7.4 million construction and remodeling project.

"It's been quite a change: change in building, change in people," she said last week. "You're dealing with the same sick people. (But) you're using better medicine, better equipment, and better training. Your knowledge is so much greater."

Spanier, who grew up in a family of six on a dairy farm between New Munich and Freeport, comes from a nursing family, with several aunts in the field, including Sister Jolita Hoppe, an early nursing administrator at the St. Cloud Hospital. After graduating from Melrose High School, Etheline started her work in the medical field as an in-home health aide, but a six-week stint caring for a 18-month-old boy in a cast convinced her that she needed more training in the field.

So she went to nurse's college at Rice Memorial Hospital in Willmar, earning her Licensed Professional Nursing degree in one year of intense training. They had two sessions of classes each day as well as working on the hospital floor twice daily. She also did training at St. Luke's Hospital in St. Paul.

After graduating, she took a job at St. Michael's Hospital in Sauk Centre, where she worked for two years.

She came to Paynesville after marrying her husband, Mel, a native of Lake Henry who had a mail route in Paynesville at the time.

She was assigned as a general floor nurse in the hospital. In her first years, there wasn't nearly as much specialization in medicine as now. Departments like lab and x-ray, which now employ dozens of people each, were combined back then.

Hospital nurses cared for patients, assisted in obstetric and surgical procedures, and did whatever needed to be done, including sharpening needles and wrapping sponges for surgery in their spare time.

"You worked where they put you," explained Etheline. "You worked in every department. And you worked every shift, too." Spanier started on the 3-11 night shift.

When she started, the hospital was only a small portion of the current complex. (The current facility is at least five times the size of the original building.) "When you start thinking how big this place is compared to what it was, it's unbelievable," said Spanier.

While the building has grown, partly on account of the new technologies and additional services offered these days, patient stays have fallen. Back when Spanier started, a maternity mother and child might stay a week; now they go home in a couple of days. Back then, a patient who had their gallbladder removed might stay ten days to two weeks; now they can have outpatient surgery.

Some patients would even stay a month, especially those who were terminally ill. "It wasn't real common," she explained, "but it did happen."

In contrast these days, she said, "You really have to be sick in order to stay any length of time."

For the past year, Spanier has worked to deliver Enhanced External Counter Pulsation (EECP), a new noninvasive technique to treat angina. Rather than bypass surgery or plaque removal from the coronary arteries, EECP directs extra blood flow to the heart and promotes better blood flow to the heart through the growth of small arteries around the heart.

Though she decided to retire from work, she isn't done with nursing. One of the reasons she gave up working full time was to have more time to help her mother.

Etheline, who raised five kids with Mel, likes to keep vegetable and flower gardens, to sew, and to do other crafts. She plans to spend more time at her hobbies as well as with her ten grandchildren in retirement.

She and Mel have no firm plans for traveling, preferring to make overnight trips around the state.