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/.

Look Who’s Vaxxing Too: BSNs Perfect Jab Skills at Kids’ Vaccination Clinic

Look Who’s Vaxxing Too: BSNs Perfect Jab Skills at Kids’ Vaccination Clinic

Stephanie Morgan, PhD, RN, FNP-BC, is no stranger to setting up and maintaining COVID-19 vaccination clinics. Thanks to her work with the team of nursing faculty and students, other health care providers, and volunteers that was formed in December 2020 when the vaccine first became available, she has been able to pull together and train teams to work with children, ages 5 to 11 in elementary and middle schools in Del Valle, an underserved community in southeast Austin.


Managing a vaccination event

Dr. Stephanie Morgan

On many weekdays, Dr. Morgan, director of The University of Texas at Austin School of Nursing’s Wellness Center, can be found preparing for a vaccine event scheduled for the following day.

“Depending on the size of the event we need one to two non-clinical check-in individuals, two to four vaccinators, one to two mixers, one observation individual and a clinical lead,” she said. “On the day of the event, we estimate the number of vaccines to be administered and pack vaccine and supplies according to that estimation.”

The team arrives at the event one hour before the start time to set up and prepare the first vials of vaccine. Once they assemble, they conduct a brief with team members so everyone is clear on the plan and can ask questions.

“Likewise, when the vaccine clinic event is over, we debrief to determine what worked well and identify opportunities for improvement next time,” Dr. Morgan said. “At the conclusion, an event report is required to capture a summary that includes the type of vaccine(s) administered, doses given (first, second, immunocompromised or booster) and totals. It also includes doses wasted and if the waste was in a vial or syringe.”


BSNs learn the Covid-19 vaccine routine—and pick up some clinical pediatric experience

Across town, Amayrany Maya-Mora, BSN, RN, and public health nurse at the School of Nursing’s Children’s Wellness Clinic (CWC), begins her day by checking the clinic’s refrigerator and freezer temperatures to ensure that all vaccines are maintained in the proper storage conditions. She then checks in with the front office staff to see if any children are waiting to receive vaccines during the morning walk-in clinic.

“During our daily walk-in clinic at CWC, which runs from 8 to 9 a.m., we usually serve around five to seven children,” Maya-Mora said. “I follow this up by entering vaccine data into Immtrac, the state vaccine registry, order vaccines and supplies, and prepare for any upcoming vaccine events.”

The CWC staff spent a lot of time prior to the Centers for Disease Control and Prevention authorization of the Pfizer and BioNTech SE COVID-19 vaccine for use in children 5 to 11 years old. Once the authorization was given in October 2021, the UT Austin School of Nursing was primed to begin providing it at both the CWC and the Family Wellness Clinic in addition to the area schools.

“Although the basic foundation for providing vaccinations at CWC was already in place, we still needed to provide more specific training,” Maya-Mora said. “We already give vaccines to children, but the COVID vaccine is different in its storage and reconstitution. Plus, we knew training would help boost the confidence of outside volunteers and nursing students. Vaccinating young children can be stressful if not done properly.”

“It’s important to be honest with children.”

Fortunately, Eduardo Chavez, PhD, RN, and a clinical assistant professor at the School of Nursing, had created a power-point training outlining creative ways to help volunteers feel confident and create a more relaxed atmosphere for children getting vaccinated. The slide show demonstrated how to safely hold pediatric patients, addressed appropriate needle lengths and provided communication techniques on how to talk honestly to children. “It’s important to be honest with children,” Maya-Mora added.

In addition, the team provided information to parents and others in the community.

“We made available information about studies and trials regarding the risk of side effects and what types of side effects they might expect,” Maya-Mora said. “There has been a great response, and parents have been very excited about our being able to partner with the Del Valle Independent School District and offer vaccines at their children’s schools. Unlike the CWC, not all pediatric clinics around the Austin area offer the vaccine, so we also provide Saturday clinics at Dailey Middle School and at the Opportunity Center at Del Valle High School. These walk-in clinics will be open through January from 9 a.m. to 2 p.m. It’s very important for parents to remember it’s a two-shot process.”

“Because the School of Nursing was prepared to administer vaccines as soon as they arrived, Del Valle ISD was the first Travis County school district to offer vaccinations in their schools with both doses available before the end of the year,” Dr. Morgan said. “That will amount to an average of 70 vaccinations given at each of the nine elementary schools in Del Valle. Parents who take advantage of these free clinics in their own communities can now relax, knowing that their kids — and their schools — are safer. Vaccinating children is an art, but with training, encouragement, and teamwork, we can increase the number of vaccinators and ensure that children are able to receive the COVID vaccine.”

Texas Staffing Shortage Shuts Down Rural Labor and Delivery Units

Texas Staffing Shortage Shuts Down Rural Labor and Delivery Units

Cuts to services

Transferring to larger hospitals

Vaccine misinformation impacts staff, patients

Nurse (Couple) of the Week: Texas BSNs Combine Proposal with Pinning at Grad Ceremony

Nurse (Couple) of the Week: Texas BSNs Combine Proposal with Pinning at Grad Ceremony

A BSN pinning ceremony during a global pandemic is a dramatic event in itself. Amid the celebratory atmosphere, there is almost a mood of military enlistment among nursing grads. Newly minted BSNs are getting ready to work on the “frontlines,” and as we have seen over the past two years, many standout nurses have served in the armed forces. So, is it really that surprising that some nurses – like our Nurse (Couple) of the Week – are pairing off on route to the Covid Front?

Romantics like VBSN (Veteran to Bachelor of Science in Nursing) Darvin Del Rio like to make an impression when asking someone to become their life partner, and if you make one major rite of passage a gateway to another, it will definitely be an event to remember.

The San Antonio firefighter and flight paramedic felt that the woman of his dreams deserved nothing less than a “fairy tale proposal,” so – with the Dean’s blessing – he popped the question to his girlfriend/classmate/fellow vet Leianne Maugeri at their Texas Tech University Health Sciences Center School of Nursing BSN pinning ceremony.

Did she say “yes?”

According to the combat medic and brand-new nurse, “Of course, I said yes! I admire this man so much and am honored to spend the rest of my life with him.”

Apparently, Mr. Del Rio’s stratagem hit the target straight on, as his new fiancée added, “This was more than I ever dreamed of, and for that I will be forever grateful. Thank you, Devin, for showing me what it’s like to feel undoubtedly loved and cherished.”

Del Rio and his intended were first introduced in 2017 at Fort Bliss (yes; Fort Bliss, where else?). A year later, they were sharing a home. As the pandemic began to spread, the pair – like many veterans – saw nursing as a natural step from military to civilian service. With their paramedic and combat medicine experience, they made swift progress through the TTU accelerated VBSN program. Maugeri noted that the VBSN seemed tailor-made for them, given “our 9-plus years of experience in trauma and emergency medicine. This fast-paced environment is something we’ve become accustomed to through the military so it definitely stood above the rest.”

Maugeri’s fiancé said “completing the program in one year was a bonus,” but sounded both proud and humbled to confess, “Leianne has the better grades, hands down. She’s smarter than me by far. How she ended up with me, I don’t know. But I do thank my lucky stars for it. Sometimes it’s better not to question.”

However, it sounds like there is no question about this love match. When asked about one another, both nurses respond in terms that could easily double as self-penned wedding vows:

She: “It is crazy to think of all that we have endured together over the last four years — from serving as active-duty flight paramedics to graduating this nursing program together. It’s a wonderful thing to have gone through so much with my very best friend. I feel incredibly blessed.”

For his part, Del Rio waxes poetic: “She has a presence about her that lights the room…. Living with her these last four years is what has made me sure now more than ever.” He concluded with a vow that would win anyone’s heart: “Thank you, Leianne, for bringing out the best in me. Know that no matter what happens between us, I’ll always love you for the stability you’ve brought to this rocky world of mine. So long as I live, I’ll continue to give you the world.”

We wish the love-struck BSNs the very best. May they enjoy a long, happy marriage, and make a difference in patients’ lives for many years to come.

For more on the newly affianced grads, see the story at Lubbock Online.

Nurse of the Week: Pediatric NP Joseph Vine Returns to Work After 56 Days on a Ventilator

Nurse of the Week: Pediatric NP Joseph Vine Returns to Work After 56 Days on a Ventilator

San Antonio, Texas NP Joseph Vine must be a descendant of the Unsinkable Molly Brown. After a brutal bout with Covid-19 left him in a medically induced coma for two months last year, our Nurse of the Week proceeded to push through a lengthy recovery period. Now, glad to be back treating youngsters at his pediatric urgent care clinic, he says, “I’m almost back to where I was before.”

But Vine endured a frightening ordeal in the interim between “before” and now. In June 2020, Covid entered the life of the 41-year-old father of three. Coughing and gasping for breath, he reached the ED at Northeast Baptist Hospital – just barely. “I was feeling so horrible,” he told News 4 San Antonio. “I was sure I had Covid, and basically as soon as I got to the ER, they were telling me they were going to have to intubate me.” His prospects for survival were dubious. In fact, Vine’s wife Anayuri said, “They thought he was not going to make it.” The couple had been married less than two years and Anayuri had recently given birth to a girl when Vine was admitted. Suddenly, her husband was inaccessible, lying comatose in the ICU and breathing with the aid of machines. For Anayuri and the baby, he had effectively vanished. “I couldn’t see him for two months,” she recalled.

Vine survived, after spending 56 days on a ventilator. His return to consciousness in August 2020 was met with relief – and relieved surprise – by his wife, friends, and doctors. He recalls, “I actually came out of it, which they never thought I would do… They were like, ‘Wow, he’s actually awake!’ A lot of people didn’t expect that to happen.”

When Northeast Baptist finally discharged him in October last year, Vine, like many post ICU patients, was almost as helpless as a newborn infant. (The NP, who has no insurance, had to cope with financial helplessness as well. He emerged with nearly $2 million in medical costs, and friends helped raise the funds for his rehabilitation treatment).

When he came home, Vine was suffering from nerve damage, and his right foot was entirely out of commission. Doctors warned that the foot might never regain its function. “They said,” he recalled, “If it’s not going to be here in 48 hours from when we first observed it, it’s most likely not coming back at all.” However, drawing upon the special reserves of discipline, determination, and “Yes I can” attitude that allows nurses to do what they do, the NP learned to walk again before his baby daughter Charlotte had mastered crawling. Charlotte – who was born just five months before Vine entered the hospital and is now 21 months old – had to become reacquainted with her father when he finally came home. She will be able to keep pace with Dad better than most toddlers, as he’s still wearing a foot brace, but Vine cheerfully remarked, “… I’m a lot more mobile now. I’m very encouraged. I think it’s going to come back even more.”

As his recovery progressed, Vine started treating patients via telehealth while still on a walker. By January 2021, he returned to the clinic on a part-time basis and transitioned to full-time two months later. “Being here and making a difference and helping people was a motivating goal to get back to. I missed the connections with my patients.” Since his recovery from Covid, Vine is also well-positioned to comfort families when one of his young patients contracts the disease. “When I talk to families, they’re often nervous, scared. It may be their first time that this has touched their family. I’m able to give them advice or help relieve some of the symptoms and talk about the course, and then also follow up with them… kind of being part of their process to make sure that nothing’s getting worse for them. That seems to really help them.”

For more on Joseph Vine’s story, see News 4 San Antonio and this excellent long-read at the San Antonio Express News.

Latest Texas DSH COVID-19 Stats Should Be a Wakeup Call for Vax Hesitant

Latest Texas DSH COVID-19 Stats Should Be a Wakeup Call for Vax Hesitant

New data from the Texas health department released on November 7 proves what health officials have been trying to tell vaccine-hesitant Texans for months: The COVID-19 vaccine dramatically prevents death and is the best tool to prevent transmission of the deadly virus.

“We know that some people want to see actual numbers and that they want to see it for their own community. And so we are hoping that this reaches some of those people who have been hesitant and really just questioning the benefits of the vaccines.”

—Dr. Jennifer A. Shuford, state epidemiologist

Out of nearly 29,000 Texans who have died from COVID-related illnesses since mid-January, only 8% of them were fully vaccinated against the virus, according to a report detailing the Texas Department of State Health Services’ findings.

And more than half of those deaths among vaccinated people were among Texans older than 75, the age group that is most vulnerable to the virus, the study shows.

“We’ve known for a while that vaccines were going to have a protective effect on a large segment of our population,” said Dr. Jennifer A. Shuford, state epidemiologist. “By looking at our own population and seeing what the impact of the vaccines have been on that population, we’re hoping just to be able to reach people here in Texas and show them the difference that being fully vaccinated can make in their lives and for their communities.”

The state health department study covers most of the positive cases and COVID-19 deaths reported in Texas among residents from Jan. 15 to Oct. 1. It’s the first time state officials have been able to statistically measure the true impact of the vaccine on the pandemic in Texas — which has one of the highest death tolls in the nation. The majority of Texans ages 16 and up didn’t become eligible for the vaccine until late March.

Texas TribuneState health officials also found the vaccine greatly reduced the risk of virus transmission, including the highly contagious delta variant that ravaged the state over the summer.

Only 3% of 1.5 million positive COVID-19 tests examined since mid-January occurred in people who were already vaccinated.

State researchers matched electronic lab reports and death certificates with state immunization records and measured cases and deaths since mid-January, a month after the first shots were administered in Texas.

The study was done using data similar to those used by other states that conducted similar studies and methods recommended by the U.S. Centers for Disease Control and Prevention, Shuford said.

And while the outcome was not particularly surprising, Shuford said, officials hope that the new data will increase trust in the benefits of the shot.

“Texas is a unique place; it’s got a lot of diversity, geographic and population-wise,” Shuford said. “We know that some people want to see actual numbers and that they want to see it for their own community. And so we are hoping that this reaches some of those people who have been hesitant and really just questioning the benefits of the vaccines.”

In Texas, it literally requires a disaster — like a pandemic — before the state records precise information about vaccinations. As a result, there is a record for every single COVID-19 vaccine dose of the name and age of the person who received it plus the date it was administered. Normally, vaccination records are shown to schools by parents, but details of all vaccinations are not regularly kept by a state registry in Texas, unlike nearly every other state, because it’s a voluntary system.

However, state officials still don’t have official numbers on how many vaccinated people were hospitalized with COVID-19 because hospitals are not required to report that level of data under state law.

But the state’s largest hospital districts and counties have reported that at least 90% of the hospitalized Texans with the virus were unvaccinated.

The state’s new health data comes as Republican state leaders grapple with local cities and school districts about masking, which has been proven to reduce transmission of the virus, and with federal officials over vaccine mandates.

About 53% of the Texas population is fully vaccinated. More than 70,000 Texans have died from COVID-19 since the pandemic began.

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Mandi Cai contributed to this report.

Disclosure: University of Texas System has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

The Texas Tribune is a member-supported, nonpartisan newsroom informing and engaging Texans on state politics and policy. Learn more at texastribune.org.

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