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Meet Judy Vire: The Nurse Practitioner Bridging the Healthcare Gap in Rural Texas Communities

Meet Judy Vire: The Nurse Practitioner Bridging the Healthcare Gap in Rural Texas Communities

Nurse practitioner Judy Vire has dedicated her life to establishing care for patients in rural parts of Central Texas. Her clinic, Kocurek & James, is one of a few providers offering medical care to communities desperate for easier access.

Vire has a master’s degree in nursing, was a nursing educator, and worked in many nursing roles, but she said her love of small-town America and the people there inspires her life’s work.

Daily Nurse proudly names Judy Vire the Nurse of the Week for her dedication to providing access to care to small-town and rural communities and caring for the most vulnerable patients, those who are unable to leave their homes.

Vire and her family settled in Flatonia, where she helped open the Rural Health Clinic in Flatonia and Schulenberg. Medical care is paramount for people in this rural part of Central Texas .

“It’s critical. Without having access to care close to home, people would be commuting into Austin, Katy, Victoria — that’s at least an hour’s drive any way you go,” Vire says. “These small communities depend on having these home-grown clinics close to home for convenience and access to care.”

Vire often makes house calls to the most vulnerable patients who cannot leave their homes.

“Because it’s a rural area, we serve an older population. The 65 and older are our largest population, and they, of course, need the most care,” Vire explains.

Regardless of whether a patient is old or young, Vire believes establishing trust is most important.

“Healthcare is personal. And when you have to tell someone bad news that impacts their lives, that is very personal, and people let you do that and trust you to do that,” she says.

That trust, she says, is why she’s given over 40 years to this career. Throughout her time at the Schulenberg clinic, she has seen generations of families making a daily impact on these communities.

In 2003, Vire was named Nurse Practitioner of the Year, and this year, she’s a Remarkable Woman nominee.

“It feels wonderful, and I was very surprised because there are a whole lot of more remarkable women than myself,” she says.

When asked about her most treasured career accomplishment at this clinic, she said it’s time.

“Maybe it’s longevity,” Vire says. “I can’t believe it’s been 30-some-odd years, and I am still doing this. I am proud of that.”

Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter. 

Texas Nurse Shawntay Harris Makes History as First Black Woman Inducted into Academy of Emergency Nurses

Texas Nurse Shawntay Harris Makes History as First Black Woman Inducted into Academy of Emergency Nurses

Shawntay Harris is a nurse from Killeen, Texas, and founder of Eminent CPR , who recently became the first Black woman inducted into the Academy of Emergency Nurses.

Harris started her nursing career 23 years ago because she wanted to help people. She worked as an emergency nurse, then in 2006, opened Eminent CPR, a facility where people can learn CPR to help train others.

“It’s an AHA American Heart Association training center, and I also offer courses from the Emergency Nurses Association, then my own courses,” says Harris.

Harris’ hard work and dedication to the field for the last 23 years were nationally recognized when she was inducted into the Academy of Emergency Nurses. The program began in 2004 to highlight nurses who are significantly impacting the industry.

Daily Nurse is proud to honor Shawntay Harris as the Nurse of the Week for her dedication to emergency nursing and for inspiring nurses to join the profession.

The Academy of Emergency Nurses recognizes nurses who have made “enduring, substantial contributions to emergency nursing and helped advance the emergency nursing profession, including the healthcare system in which emergency nursing is delivered.

“When I was approached as a potential candidate to be inducted, I was like, ‘Oh, am I worthy? Have I done enough? How do I feel?’” Harris recalled. “Then when I looked at the other academy members, I was like, ‘Oh, no, there’s no one else who looks like me,’ — I will be making history if inducted.”

“It feels amazing to know that I’ve broken this ceiling so other nurses of color know they can, their work is great and exciting, has global impact, is sustainable, and they’ll see someone that looks like them,” she says.

Harris says she hopes to inspire current nurses of color and encourage more people to join the industry because diversity in healthcare is so important.

“Patients have better outcomes when treated by healthcare partners that look like them,” she adds.

Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter. 

“Why Can’t You Help Me?” Planned Parenthood Clinics Navigate a Post-Roe Landscape

“Why Can’t You Help Me?” Planned Parenthood Clinics Navigate a Post-Roe Landscape

Some clinics plan to relocate

Hanging on with ultrasounds

 

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Nurses at Texas Abortion Clinic After Fall of Roe: “Our Hands are Tied”

Nurses at Texas Abortion Clinic After Fall of Roe: “Our Hands are Tied”

While other nurses addressed the elephant in the waiting room, Jenny returned to the patient she had just left.

Bearing the bad news

Fear for the future

Published courtesy of The Texas Tribune, a nonpartisan, nonprofit media organization that informs Texans — and engages with them – about public policy, politics, government and statewide issues.

In the Wake of Uvalde, Trauma Surgeons Share Experience of Mass Shootings with Congress

In the Wake of Uvalde, Trauma Surgeons Share Experience of Mass Shootings with Congress

When Dr. Roy Guerrero, a pediatrician in Uvalde, Texas, testified before a U.S. House committee Wednesday about gun violence, he told lawmakers about the horror of seeing the bodies of two of the 19 children killed in the Robb Elementary massacre. They were so pulverized, he said, that they could be identified only by their clothing.

In recent years, the medical profession has developed techniques to help save more gunshot victims, such as evacuating patients rapidly. But trauma surgeons interviewed by KHN say that even those improvements can save only a fraction of patients when military-style rifles inflict the injury. Suffering gaping wounds, many victims die at the shooting scene and never make it to a hospital, they said. Those victims who do arrive at trauma centers appear to have more wounds than in years past, according to the surgeons. Originally published in Kaiser Health News.

But, the doctors added, the weapons used aren’t new. Instead, they said, the issue is that more of these especially deadly guns exist, and these weapons are being used more frequently in mass shootings and the day-to-day violence that plagues communities across the nation.

The doctors, frustrated by the carnage, are clamoring for broad measures to curb the rise in gun violence.

Weeks after the Uvalde school shooting, what steps the country will take to prevent another attack of this magnitude remain unclear. The House on Wednesday and Thursday passed measures aimed at reducing gun violence, but approval in the Senate seems uncertain at best.

Many physicians agree something substantial must be done. “One solution won’t solve this crisis,” said Dr. Ashley Hink of Charleston, South Carolina, who was working as a trauma surgery resident at the Medical University of South Carolina in 2015 when a white supremacist killed nine Black members of the Mother Emanuel African Methodist Episcopal Church. “If anyone wants to hang their hat on one solution, they’re clearly not informed enough about this problem.”

The weapons being fired in mass shootings — often defined as incidents in which at least four people are shot — aren’t just military-style rifles, such as the AR-15-style weapon used in Uvalde. Trauma surgeons said they are seeing a rise in the use of semiautomatic handguns, such as the one used during the Charleston church shooting. They can contain more ammunition than revolvers and fire more rapidly.

Overall gun violence has increased in recent years. In 2020, firearm injuries became the leading cause of death among children and adolescents. Gun-related homicides rose almost 35% in 2020, the Centers for Disease Control and Prevention reported in May. Most of those deaths are attributed to handguns.

study recently published by JAMA Network Open found that for every mass shooting death, about six other people were injured. Trauma surgeons interviewed by KHN said the number of wounds per patient appears to have increased.

“I feel we are seeing an increase in the intensity of violence over the past decade,” said Dr. Joseph Sakran, a trauma surgeon at Johns Hopkins Hospital in Baltimore. He cited the number of times a person is shot and said more gun victims are being shot at close range.

Survival rates in mass shootings depend on multiple factors, including the type of firearm used, the proximity of the shooter, and the number and location of the wounds, said Dr. Christopher Kang of Tacoma, Washington, who is president-elect of the American College of Emergency Physicians.

Several recent shootings have left few survivors.

The perpetrator of the Charleston massacre shot each of the nine people who were killed multiple times. Only one of those people was transported to the hospital, and, upon arrival, he had no pulse.

Last year, shootings at three Atlanta-area spas left eight dead — only one person who was shot survived.

The chaos at a mass shooting scene — and the presence of an “active” shooter — can add crucial delays to getting victims to a hospital, said Dr. John Armstrong, a professor of surgery at the University of South Florida. “With higher-energy weapons, one sees greater injury, greater tissue destruction, greater bleeding,” he added.

Dr. Sanjay Gupta, a neurosurgeon who is chief medical correspondent for CNN, wrote about the energy and force of gunshots from an AR-15-style rifle, the type also used in the recent mass shooting in Buffalo, New York. That energy is equal to dropping a watermelon onto cement, Gupta said, quoting Dr. Ernest Moore, director of surgical research at the Denver Health Medical Center.

Medical advances over the years, including lessons learned from the battlefields of Iraq and Afghanistan, have helped save the lives of shooting victims, said Armstrong, who trained U.S. Army surgical teams.

Those techniques, he said, include appropriate use of tourniquets, rapid evacuations of the wounded, and the use of “whole blood” to treat patients who need large amounts of all the components of blood, such as those who have lost a significant amount of blood. It’s used instead of blood that has been separated into plasma, platelets, and red blood cells.

Another effective strategy is to train bystanders to help shooting victims. A protocol called “Stop the Bleed” teaches people how to apply pressure to a wound, pack a wound to control bleeding, and apply a tourniquet. Stop the Bleed arose after the 2012 shooting at Sandy Hook Elementary School in Newtown, Connecticut, where 20 children and six adults were killed.

The CDC, which in the past two years has been able to conduct gun research after years of congressional prohibitions, has funded more than a dozen projects to address the problem of gun violence from a public health perspective. Those projects include studies on firearm injuries and the collection of data on those wounds from emergency rooms across the country.

For some doctors, gun violence has fueled political action. Dr. Annie Andrews, a pediatrician at the Medical University of South Carolina, is running as a Democrat for a seat in the U.S. House on a platform to prevent gun violence. After the school shooting in Uvalde, Andrews said, many women in her neighborhood reached out to ask, “What can be done about this? I’m worried about my kids.”

Dr. Ronald Stewart, chair of surgery at San Antonio-based University Health, told KHN that the people shot in Uvalde had wounds from “high energy, high velocity” rounds. Four of them — including three children — were taken to University Hospital, which offers high-level trauma care.

The hospital and Stewart had seen such carnage before. In 2017, the San Antonio hospital treated victims from the Sutherland Springs church shooting that left more than two dozen dead.

Two of the four Uvalde shooting victims have been discharged, University Health spokesperson Elizabeth Allen said, and the other two remained hospitalized as of Thursday.

It will take a bipartisan effort that doesn’t threaten Second Amendment rights to make meaningful change on what Stewart, a gun owner, called a “significant epidemic.” Stewart noted that public safety measures have curbed unintentional injuries in car crashes. For intentional violence, he said, progress hasn’t been made.

 

  • KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
UTA Nursing Opens Rural Health Center

UTA Nursing Opens Rural Health Center

The College of Nursing and Health Innovation (CONHI) at The University of Texas at Arlington has launched a new center to enhance access to health care for Texas’ rural communities.

The Center for Rural Health and Nursing is funded by a $4 million legislative appropriation by the state of Texas. The funding will support the center’s efforts to improve rural nursing education and the health outcomes of rural populations.

“I am very thankful of the Legislature for its support of the University’s efforts to educate and train the next generation of rural health care providers,” said Teik C. Lim, UTA interim president. “Through this new center, we can significantly expand the reach of one of the nation’s top nursing programs to improve the health of rural Texans.”

Elizabeth Merwin, the center’s executive director and dean of CONHI, hopes the center will develop and foster a model for providing nursing education to rural residents aiming to become registered nurses and nurse practitioners. This model will support and educate those students while they reside in their home communities. It will also aim to reduce the shortage of nurses and other health providers in an effort to support access to health care for Texas’ rural populations.

“Thanks to generous funding by the state of Texas, CONHI will be able to form sustainable partnerships with rural communities that improve the quality of life for underserved populations in those areas,” Merwin said. “Our goal is to form close relationships with key organizations and stakeholders within rural communities in Texas to improve access to health care by enhancing the health professional workforce.”

In its first year, the center will develop partnerships in rural communities to perform educational needs assessments of registered nurses and nurse practitioners. Once needs have been identified, the center will provide training to support the communities’ current health care providers and educate new, incoming nurses and health professionals.

“UTA has a proven track record both in Texas and nationwide as a leading center of excellence for nursing education,” state Sen. Kelly Hancock said. “I have great confidence in the university’s ability, through its new Center for Rural Health and Nursing, to bring its nationally recognized nursing education and training programs to improve both nursing education and health outcomes in our state’s rural communities.”

Aspen Drude, the center’s manager, said the center aims to support existing providers and recruit young people from rural populations to become nurses in their communities.

“We want to make sure students who are in rural high schools and community colleges have paths into our programs,” Drude said. “We hope that our continuing education programs will meet the needs of current nurses and increase opportunities for rural residents, while meeting the workforce needs of the rural community.”

The center’s nursing education initiatives will be supported by Elanda Douglas, a clinical assistant professor and nurse practitioner with extensive experience as a family nurse practitioner.

“It’s really important for nursing students to understand that when they work in rural communities, they have to be well-rounded because they could be the only nurse in the clinic,” Douglas said. “Our rural health curriculum will prepare students with a broad set of skills to meet the day-to-day demands of rural care.”

According to the Centers for Disease Control and Prevention, rural Americans face numerous health disparities compared with their urban counterparts. They are more likely to die from heart disease, cancer, unintentional injury, respiratory disease and stroke. Factors that put them at greater risk include higher rates of smoking, lower physical activity and less access to health care and health insurance. Rural communities also face unique workforce challenges and, too often, shortages of health care providers.

Reshma Thomas is a first-year student in CONHI’s Master of Science in Nursing program who has joined the center as a student nursing assistant. As a family nurse practitioner in training, Thomas is passionate about serving vulnerable rural populations.

“Nearly 25% of Texas’ population lives in rural communities and suffers from harmful health disparities and lack of care,” Thomas said. “Providing preventive care and raising the health care standards in these communities is vital.”

More on the center and updates can be found at its new website https://ruralhealthcenter.uta.edu/.