A month after the U.S. Supreme Court overturned Roe v. Wade, Texas’ two dozen abortion clinics are slowly coming to terms with a future where their work is virtually outlawed.
Some clinics have already announced that they are shutting down operations and moving to New Mexico and other states that are expected to protect abortion access. Others, including Planned Parenthood, say they will stay and continue to provide other sexual and reproductive health services.
But keeping the doors open will likely come at a high cost for these clinics — financially, politically and psychologically — as they absorb more patients with fewer options.
“It’s really hard to find words in the English language that honor what the experience has been like,” said Dr. Bhavik Kumar, medical director of primary and trans care at Planned Parenthood Gulf Coast in Houston. “It’s just devastation.”
Planned Parenthood clinics in Texas have had to turn away patients in dire situations, according to an open letter provided to The Texas Tribune, including minors and a woman who already had children but had been told by her doctor that she could die if she carried another pregnancy to term.
“People are looking at you and asking you, like, ‘Why can’t you help me?’ ‘Can you make an exception?’” Kumar said. “We hear that all the time, and it just feels so inhumane and unethical … to have to do this over and over again.”
Kumar thought years of navigating abortion restrictions in Texas had prepared him for the overturn of Roe v. Wade. But he wasn’t prepared for the fear that his patients are feeling amid this new legal landscape.
He said he saw a patient last week who was worried about the consequences of even mentioning abortion.
“We’re here in a clinic where we’ve provided abortion care for decades. I’m an abortion-providing doctor, and I talk very openly about abortion,” he said. “But she just had so much fear and apprehension, and was uncertain if she could actually say the words out loud and ask for that help.”
Even if Planned Parenthood can’t offer abortion anymore, it’s committed to staying put and helping Texans access an array of other reproductive health services, including birth control, cancer screenings and testing for sexually transmitted diseases.
Its clinics have been dealing with a surge in demand for long-acting reversible contraception, like IUDs, and information about birth control options including vasectomies, all while expanding their education operations.
But keeping the doors open will mean continuing to contend with a Legislature intent on seeing them shut down. Texas elected officials have spent much of the last decade working to defund Planned Parenthood by removing it from Medicaid and other publicly funded programs.
Even as the state halts abortion services entirely in Texas, Planned Parenthood does not anticipate it stopping those attempts to financially hamstring its work.
“The state has been relentless because of who we are and what we stand for, and that’s unapologetic access to comprehensive sexual reproductive health care, which includes abortion,” Kumar said.
Some clinics plan to relocate
Other Texas clinics are shutting down operations entirely and relocating to “haven states” to continue providing abortions.
Whole Woman’s Health, which started in Texas in 2003 and at one point operated six clinics around the state, has announced plans to relocate to New Mexico.
The group has been slowly pivoting its operations in recent years toward states that protect abortion access, building clinics in Maryland and Virginia and a new location near the airport in Minneapolis. It has invested in a program to help patients travel to these states from Texas.
Now, the organization is closing its remaining four Texas clinics and relocating those operations to an as-yet undisclosed location in New Mexico.
“[Whole Woman’s Health] has served Texans for nearly 20 years, and our love for Texans runs deep,” president and CEO Amy Hagstrom Miller said in a statement. “Even when the courts and the politicians have turned their backs on Texans, we never will.”
Alamo Women’s Reproductive Services, an independent abortion provider, has also announced it will close its San Antonio clinic and a sister facility in Tulsa and relocate to Albuquerque, New Mexico, and Carbondale, Illinois.
New Mexico is Texas’ only direct neighbor that is expected to preserve abortion access, although “neighbor” is a relative term — Las Cruces is more than a 10-hour drive from Dallas or Houston.
The clinics that remain in Texas providing non-abortion care are preparing to serve as the conduit to these out-of-state clinics.
“We understand and deeply empathize with providers who have been forced to close their clinics and move out of state,” said Melaney Linton, president and CEO of Planned Parenthood Gulf Coast, in a statement. “We will continue to work closely with them as we help patients navigate their best options.”
But many Texans will not be able to leave the state, due to finances, child care needs or immigration status.
“Sometimes we hear that it was difficult for them to even come into the clinic that’s closer to home, maybe within 10 miles of where they actually live, let alone having to travel to another state to get that care,” Kumar said. “So it’s very, very scary for folks.”
Hanging on with ultrasounds
For many of the providers who have been on the front lines of contentious legal fights over abortion access in recent years, the overturn of Roe v. Wade was not a surprise. But now that it’s here, they say the reality is worse than they could have imagined.
Most of the patients who come to Houston Women’s Reproductive Services these days already know they want an abortion — and are willing to travel to out of state to get one. Clinic director Kathy Kleinfeld and her staff are in touch with other clinics around the country, helping patients navigate the various legal requirements, wait times and travel logistics that govern abortion access right now.
“It’s very helpful to have someone to talk this through with, who can say, ‘OK, I know this feels overwhelming right now. But have you ever lived in another state? Do you have any friends or family elsewhere?’” she said. “That gets the wheels turning, and if we’re not here to do that, they’re going to have to figure it out on their own.”
For the last month, Houston Women’s has provided only ultrasounds. Kleinfeld said it has seen a steady trickle of patients and identified ectopic pregnancies, false positives and patients who are actively miscarrying.
“In all those circumstances, women would be wasting precious time and money to travel out of state when in fact they may not need the service,” she said. “So it is important to have those ultrasounds in a medical environment where they receive accurate and compassionate care.”
Kleinfeld worries that if that option isn’t available, more people will turn to crisis pregnancy centers. These religiously affiliated nonprofits often offer ultrasounds, but some use coercive and deceptive practices to discourage clients from pursuing abortions.
Kleinfeld said she’s been encouraged by the support her clinic has received, but they’ve scaled back staff and are being realistic about how long they can remain open without their main source of income.
“We’ll do it as long as we can,” she said. “I’m not gonna sell my house and live under the bridge. I’m not going to go that far, but … I think we’re gonna see a lot of creative thinking here and a lot of innovative ideas from some of the brightest people.”
Disclosure: Planned Parenthood 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 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.”
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.
“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.”
A few weeks ago, a woman gave birth at Hereford Regional Medical Center, a critical access hospital in the Texas Panhandle.
Or, rather, the woman gave birth in the parking lot at Hereford Regional Medical Center after driving over an hour to get there, according to Jeff Barnhart, the hospital’s chief executive.
Barnhart said he’s heard it all over the years: patients giving birth at rest stops and in ambulances and in the car on the side of the road. The hospital’s patients come from a 1,600-square-mile area in the Texas Panhandle, and some of them just don’t make it in time.
But now, even patients who do make it to the hospital have another variable to contend with: critical staffing shortages and exploding COVID-19 case counts. There are days when Hereford Regional doesn’t have enough nurses to operate the labor and delivery unit, forcing it to divert patients 50 miles northeast, to Amarillo.
“We give them a medical exam and see if there’s time to get them in an ambulance to another hospital that can take them,” he said. “But sometimes, that baby’s coming and there’s just not time.”
Those patients give birth in the emergency room, an increasingly common occurrence as rural hospitals limit or cease labor and delivery services due to insufficient staffing.
Nationally, the health care system is facing an unprecedented labor shortage as nurses retire, resign, burn out or leave staff positions for more lucrative travel nursing contracts. Rural hospitals, many of which already operate with a shoestring staff, are especially hard hit.
Declining populations and cuts to Medicaid and Medicare funding have made Texas the national leader in rural hospital closings, with some 26 closures — permanent or temporary — of rural facilities in the last decade. Two-thirds of the state’s 157 rural hospitals are public, which means less flexibility in salary negotiations. Administrators also say it’s often difficult to recruit medical personnel to smaller towns in remote counties.
Struggling to survive, the remaining hospitals in Texas’ rural communities have had to cut back services. And when that happens, labor and delivery is often the first to go.
Only 40% of Texas’ rural hospitals still have a labor and delivery unit, according to the Texas Organization of Rural and Community Hospitals, leaving whole swaths of the state without access to nearby obstetrics care.
“If we’ve got nurses to cover a day, of course, we’re going to try to take care of everything that we can here,” Barnhart said. “But it’s just a scheduling crisis, and whenever we can’t make it work, we just let the hospitals in Amarillo know so they can expect it.”
Cuts to services
Adrian Billings has been delivering babies at Big Bend Regional Medical Center for 15 years, serving patients across a 2,000-square-mile area in West Texas. The hospital delivers about 200 babies a year, he said, with pregnant patients sometimes driving over 100 miles to give birth.
But in recent months, for the first time since he’s worked there, the hospital has limited the hours the labor and delivery unit is open. Over the holidays, the unit shut down entirely for two weeks. For a while, it was only open Monday through Thursday morning.
“When that happens, essentially, it’s a maternity care desert Thursday morning through Monday morning out here,” he said.
He said the hospital tried to schedule inductions during the week as much as possible, but childbirth can be hard to predict. If a patient goes into labor during the off hours, they either give birth in the emergency room or are sent 60 miles away to Fort Stockton.
A spokesperson for Big Bend Regional said in an email that the hospital recently hired additional nurses who will soon allow it to resume full-time maternity care. But many rural hospitals say they simply aren’t able to keep up in today’s ultracompetitive labor market.
“We only have six doctors at our hospital,” said Jennifer Liedtke, the director of the labor and delivery unit at Rolling Plains Memorial Hospital in Sweetwater, about 40 miles west of Abilene. “When you’re talking about a census of 20-plus patients, we’re carrying a full load trying to get everyone seen. … It’s rough.”
Rolling Plains typically tries to have three labor and delivery nurses scheduled for each shift. But recently, Liedtke said the team is scraping by with one nurse and a shift supervisor who can step in as needed. Her nurses often get pulled into other units when there are no deliveries.
“There’s not a patient back there today, so both of [the nurses] are working the COVID unit right now,” she said. “So if we do have a patient come, they have to go shower and change into all new scrubs and stuff before that patient will have to come back.”
Many of the longtime nurses at Rolling Plains retired during the pandemic, Liedtke said, and it’s been difficult to find replacements. On Monday, all five of the hospital’s ICU beds were occupied, according to state health numbers.
“We’re trying to recruit right out of school right now, but a lot of the young nurses are going into travel nurse positions,” said Liedtke, who is also a family physician and OB-GYN. “They can sign big, big contracts … and that’s just not something we’re going to be able to match.”
Liedtke said it’s especially difficult to recruit nurses to work in the obstetrics unit of a rural hospital. At a larger facility, there might be different nurses dedicated to labor and delivery, the nursery, and postpartum care. But at Rolling Plains Memorial, one nurse has to handle all those roles.
Labor and delivery is a major investment for rural hospitals, requiring specialized nurses and a recommended 2-to-1 nurse-to-patient ratio during delivery. It’s rarely a money-making enterprise for these hospitals, particularly if they’re serving uninsured or Medicaid patients.g
John Henderson, president of the Texas Organization of Rural and Community Hospitals, said struggling hospitals often see labor and delivery as an easy target for cuts. But he worries that these short-term closures and limited services will create a ripple effect that will ultimately leave rural hospitals worse off.
“You’ve compounded the problem by forcing people to leave the community when they need care,” he said.
If patients give birth at a hospital in a larger city, he worries they may be less likely to return to the local hospital for future medical care.
“It won’t just be obstetrics,” he said. “They’ll probably end up seeing a pediatrician [at the larger hospital], and the next time they have a sprained ankle, that’s where they’re going.”
Transferring to larger hospitals
Many rural hospitals have already shaved down their services as much as possible, asking nurses to do double duty or transferring patients to larger hospitals for more specialized care.
Fewer than half of the state’s rural hospitals perform surgeries or have specialists such as cardiologists on staff, and many don’t have an intensive care unit. In normal times, it’s enough. But these days, there’s a logjam of patients who are waiting for a higher level of critical care than some of these hospitals can give on a long-term basis.
In the tiny Southeast Texas town of Anahuac, the local hospital is feeling the effects of soaring COVID-19 hospitalizations in Houston, an hour east.
“All of Houston’s medical center [complex of several hospitals] is in code red, meaning everyone is at capacity,” said William Kiefer, CEO of Chambers Health, which runs Anahuac’s hospital, OmniPoint Health. “And so the downstream effect of that is that we have two patients … who require transfer. We’ve had them for days. They’re not going anywhere.”
Rural hospitals say they can usually find beds in larger hospitals for patients who need to give birth, but even that’s become more tenuous as omicron and staffing shortages rage.
Teresa Baker, an OB/GYN with Texas Tech University Health Sciences Center in Amarillo, said she can always tell when there’s been an interruption in service somewhere else in the Panhandle. Suddenly patients are coming from farther away, later in the labor process, and often arriving via ambulance.
“We’re happy to take them,” Baker said. “The hospitals are doing a very selfless thing by shipping those patients, because they know they can’t handle them without the right staffing. The altruism is apparent.”
But hospitals in Amarillo are being walloped by the omicron variant just like everywhere else. During a recent shift, Baker said, seven out of 10 of their laboring patients were positive for COVID-19.
“We just assume everybody’s positive,” she said. “If the baby is born at full term and is healthy, then we can keep the mom and baby together, and the dad, because we can isolate them in the room.”
But many of the babies the hospital delivers have to go to the neonatal intensive care unit for additional care, which becomes much more difficult if the mother has tested positive for COVID-19.
“That’s what makes your heart bleed,” Baker said, “because these moms don’t even get to see their babies or nurse their babies because they’re positive. And it’s just a terrible situation.”
She said for the first time during the pandemic, the hospital has had to figure out issues like how to discharge babies from the NICU to COVID-positive parents.
“I said, what are they going to do, just meet her at the back door with her baby?” she recalls asking the nurse. “Because she can’t come into the hospital unless she absolutely needs to.”
Vaccine misinformation impacts staff, patients
Hospitals around the state are also contending with vaccine hesitancy among staff and patients. That’s just another challenge that’s hitting rural hospitals harder than better-resourced urban facilities.
For a time, Liedtke worried the labor and delivery unit at Rolling Plains Memorial might have to shut down, thanks to a federal vaccine mandate for health care workers that is tied up in the courts.
“To be very clear, I would love to see everyone vaccinated,” she said. “But from a staffing perspective, we were probably going to lose half of our [obstetrics] nurses.”
Other hospitals report similar concerns, saying they’re aware of large percentages of their nurses and hospital staff who would resign if they were required to get a vaccine.
OB/GYN doctors and nurses are also struggling to communicate vaccine information to their pregnant patients, many of whom are wary about a perceived lack of information about the effects of the vaccine on pregnancies.
“It’s so emotional for these moms, and I know they’re trying to make the best decision they can for their babies,” said Baker. “We just have to meet them where they are and just keep revisiting it.”
Baker said she tries to remind patients that the risks associated with getting very sick from COVID-19 outweigh any potential risks from the vaccine.
Holly Dunn, a maternal fetal medicine specialist in Abilene, has seen an uptick in patients needing specialized care because they develop COVID-19 symptoms during pregnancy.
“It’s more common now for my patients to have COVID or have had COVID than not,” she said.
She said it’s her unvaccinated patients who are developing serious pregnancy complications and fetal development issues, and even experiencing stillbirths. She’s implored her patients to get vaccinated for themselves and their children, and tells them about her own experience: She recently had a healthy baby after getting vaccinated.
“So I practice what I preach,” she said. “That gives me some street cred with my patients. If we can convince even one patient, it’s a victory.”
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?”
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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.
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.”
