At In It Together, our goal is helping every client to age the way they want, in the location they want.

Whatever challenges you are facing, we are In It Together.

Our professional team is dedicated to providing the level of care with attention to detail in oversight and delegation that is right for you or your loved ones.  Whether you need just a little help with scheduling and getting to a doctor's appointment, or need full time care in your home, we are here for you.  We work with healthcare systems so that you don't have to and can walk you through every step.


Why choose IITRN?

  • Special needs & long-term care assessments
  • Care planning
  • Manage medications
  • Nurse consulting and advocacy
  • Nurse Delegation
  • Nurse oversight and supervision in Washington state for both private pay and Medicaid clients
  • Observation and supervised visitation keeping your loved one safe and protected!
Jeff Paul
Jeff Paul

At the age of 14, Jeff purchased his first vehicle for $412.50!  Wow, can you say cheap!  By age 16, he had fixed up, bought and sold and bartered his way up to a 3-year-old VW Scirocco.  Jeff was certain his life career would be involved in cars; he was clearly a car guy.  At first, he worked for parts supply stores but was most interested in auto painting.  By the age of 30, he had worked as a regional sales rep for a major paint manufacturer and as a painter for the Boeing company.  Life changes including a wife and three kids prompted him to start an auto restoration shop.

Working in healthcare was the last thing he foresaw for himself.  While building the auto restoration business, his wife's grandfather chose to come to live with Jeff and his family.  The two years Frank lived with them were life changing for Jeff.  He assisted in caring for Frank, enjoying the time together and the stories of Frank’s life and history.  Although his love for fixing up cars was still present, he realized he wanted to be a part of something more meaningful-- after all the beauty of an old car was as much in the history of the driver as it was the car – why not invest in the driver?  The privilege and honor he felt in helping others were profound and uplifting.  Beth and Jeff spent a lot of time talking, thinking and looking at what options they could pursue to provide a compassionate, caring healthcare company.  From their shared commitment and vision, In It Together was born.


Donna Bashwiner
Donna Bashwiner

Nursing has afforded me the privilege of never being bored! I began my career just as health care was changing its emphasis on the delivery of service in the inpatient setting to more out-patient and home care settings. This change was very much in tune with my work style preferences and nursing skills. As a result, my clinical experience was heavily weighted in the delivery of care in these settings.  Working in these settings allowed me to connect with patients where they “lived”, perform teaching, and collaborate with other caregivers to meet the patient’s total needs. The blending of these functions in a job made every day an exciting challenge. As my career progressed and I obtained an advanced degree, I entered into more administrative field of work.  In nursing administration, I consistently worked for non-profit hospitals or organizations that incorporated the meeting of the patient’s needs as a pillar in their mission. Again as health care went through more changes, I discovered a field that quickly became my passion for many years and that was Quality Improvement.  Now that I want to work part-time, I have come full circle. I am back in a home care setting collaborating with caregivers and performing teaching to ensure the clients receive the best possible care in a homelike setting. This is what I love the most about working for IITRN. The clients, the caregivers, and the office staff I work with are all wonderful human beings and excellent at what they do. When I make a visit to a home, I look at the caregivers with admiration for doing the amazing work of being a caregiver. At the same time, I see in the face of every client a human being who deserves the best possible care that can be given to them in this stage of their life’s journey. I feel it is an absolute privilege to serve on this great team of IITRN and to serve our community in this manner.


Beth Paul
Beth Paul

In It Together RN (IITRN) is a professional nursing agency located in Vancouver, Washington. Beth Paul started this agency in October of 2016. Prior to October 2016, she provided nurse delegation and other nursing services to our community as an independent RN since 2010. She was first awarded a Medicaid nurse delegation contract in May of 2010.

Beth has been a registered nurse since 2003. She graduated from Clackamas Community College with my RN in June of 2003. She worked from 2003 until 2007 in hospital settings; first on Telemetry at Mid-Columbia Medical Center in The Dalles, Oregon and then on the Cardiac floor and the coronary care unit at St Vincent’s Medical Center. During this time, she also taught courses leading to certification as a nursing assistant at Clackamas Community College.

In early 2007, she transitioned to a role as a hospice case manager at Community Home Health and Hospice. Beth also served as an afterhours call nurse for both hospice and home health services.

Her varied career has enabled her to develop a wide base of nursing and assessment skills. She is comfortable serving clients throughout the life span, including pediatric patients. She has experience managing a variety of acute and chronic conditions in the home, including managing wounds and catheters. She has excellent assessment and triage skills including extensive experience with phone triage. Beth enjoys teaching clients, caregivers and family members, and she places a high priority on helping clients to reach their personal goals regarding their care.

Throughout her time working independently, she has put a high priority on maintaining her skills and awareness of best nursing practices. She regularly attends education and updates regarding the nurse delegation program. She has participated in countless webinars to increase her skill set in topics such as wound care and diabetes, as well as local seminars on community resources, elder abuse and prevention and other nursing topics. She has also had the opportunity to share her knowledge and experience by speaking at conferences and events sponsored by the Adult Family Home Council and the Southwest Washington Elder Abuse Prevention Coalition.

Please feel free to contact Beth if you have any other questions regarding her experience or skills.

We are here to support you!  Initial telephone consultations are always complimentary.

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