Elaine Couture, former regional chief executive at Providence Health & Services who retired in 2021, is currently living her "best life," staying active and involved following a move to Arizona three years ago. Despite her relocation, her impact on the Spokane community remains anchored in the medical institutions she helped lead and expand over a distinguished 34-year career.

Even after reaching among the highest rungs of the executive leadership ladder, Couture says her identity has never shifted from a "nurse first" perspective. Her career path has involved a steady climb of roles and responsibilities, from babysitter to candy striper to nurses' aide, followed by registered nurse and eventually CEO.

"My best job was actually being a nurse at the bedside," says Couture. "I loved taking care of people. ... I always felt like my job was to take care of the caregivers who were taking care of the people, the patients."

Her daughter, Traci Richmond, says that her mother's internal drive to serve has defined her legacy in Spokane's health care industry, where Couture has been known to stay with scared patients long after the end of her shift simply because they needed her support. Helping others is so ingrained in Couture's outlook that Richmond recalls learning that hours after she was born, Couture was up helping the short-staffed nursing unit answer phones and assist a grieving family.

"If there was someone that needed help, she was going to lean in and do it. I think that's what people will remember about her," Richmond says.

Under Couture's leadership, Spokane's health care landscape significantly evolved. She is considered an instrumental player in several landmark projects that positioned the region as a leader in care. Couture helped push the development of a full children's hospital and the pediatric emergency department at Sacred Heart, which helped fill a critical gap in regional care. She also helped spearhead joint ventures to bring more mental and behavioral health services to the community.

"I can't take credit for this stuff," she says. "This is about the continuation of work that somebody else has started. Things don't stay stagnant. They continue to evolve as they should."

As an executive, Couture's vision for health care in the Spokane area went beyond "sick care" provided by hospitals to include a focus on the social determinants of health, such as food security, housing, and education, she explains.

A primary example was her role in establishing a respite care program in partnership with Catholic Charities of Eastern Washington, which is considered one of her proudest achievements, she says. She explains that while many patients recover from surgery in a warm bed with someone to care for them, homeless individuals often have no place to go after being discharged from the hospital. The respite care program provides these individuals with a safe place to recover, ensuring they receive care with human dignity.

Despite initial resistance at the time from her chief financial officer due to funding concerns, Couture advocated for the project because she viewed it as a way to meet patients exactly where they were and provide the compassionate care they deserved.

"She said, 'If you would have gone by what I decided when I was saying no, we wouldn't have gotten all the national awards,'" Couture recalls.

In addition to her care for patients, Couture, 70, also worked to improve conditions for her colleagues.

She made history as the first female chief operating officer at Providence Sacred Heart, breaking a long-standing tradition of male top leadership, explaining that she intentionally built a balanced leadership team based on ability rather than gender. For instance, her decisions to place women in nontraditional executive roles such as chief financial officer and chief operating officer while men filled roles in human resources, were based on skills and merit rather than gender.

Her approach prioritized ability over tradition and helped ensure that leadership roles were held by the people best suited to lead, she says.

"Any success that I had in my career was really based on this wonderful team that surrounded me. I trusted them to make the right decisions," Couture says of the workforce culture at Providence.

Building this merit-based culture required more than just the right organizational structure; it demanded a specific way of engaging with others that prioritized human connection.

Couture lives by the mantra that "words matter," which is a lesson she learned from one of her many impactful mentors, Sister Rosalie Locati, a retired Sister of Providence. Her mantra translated into a leadership style focused on presence, active listening, and respect, she says.

"As a young leader, I would often go to her for advice or questions and she talked often about when you walk into a room, your presence matters," Richmond says, noting that her mother prides herself on the ability to command any room she enters. 

At work, this was accomplished by leaning in and asking hard questions in a respectful and open-minded way. On a personal level, Couture says having presence involves being present with others to provide connection and purpose.

In retirement, Couture views staying active and engaged as a way to maintain connections and personal wellness while also preventing isolation that can often impact people following the end of their career. Her active schedule includes golfing three to four times a week and attending Pilates. She also recently completed training to become a Stephen Minister at her church. The role allows her to provide a ministry of presence for members of her congregation who are experiencing loneliness or isolation, she explains.

"For example, Steven's Ministries and helping others gives me more way more purpose than golfing. But even when I'm on the golf course, my purpose is to be there with my friends," says Couture. "I always talk about that I didn't retire, I just graduated to another job. But, in retirement I think that it is important to stay active and keep yourself engaged with different things or I think it would be pretty easy to become isolated just sitting and not doing anything."

As an informal ambassador for Spokane and Eastern Washington from her home in Arizona, Couture says she maintains service on boards for Catholic Charities of Eastern Washington and Kadlec Regional Medical Center.