even就是最基本的“甚至，即使”的意思。后半句的意思是：现实生活中，这个小孩可能要坐在长凳上等两个小时才能见到个护士。even 是加重语气的作用，汉语中有时可以不翻译。

out 应该是副词。out west 是习惯搭配，一般看作整体记忆。通常指to or in a western part of an area. 你可以参考朗文词典的解释，但注意在不同语境，含义可能会有不同，另外有时West也可以大写：

请看两个例句：

After she had recovered, Stella helped Ticie, Eddy, and Sissee move into a house out west, on Maplewood Drive. 

Jessie was eager to embark on a career as a draftswoman out West, and Callie had set out to find her brother, who had come to California earlier.