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The Grueling Task Of Running A Rural Health Clinic During The Pandemic

a nurse giving a patient a vaccine
Courtesy Natalie Bachynsky
Nurse Practitioner Natalie Bachynsky immunizing patient Dawn Lambright with the COVID-19 vaccine at her Houston County Family Medical Clinic in Crockett, Texas.

From Texas Standard

Texas cities and rural areas have all struggled with the spread of COVID-19. But rural areas face an extra disadvantage: a disappearing health care infrastructure. That means many people in rural communities have few, if any, choices when it comes to getting health care nearby.

Natalie Bachynsky has been on the front lines of the COVID-19 pandemic in rural Texas. She's a nurse practitioner who owns and operates the Houston County Family Medical Clinic in Crockett, Texas, a small city of about 6,500, two hours north of Houston. The clinic opened last February, and even before the pandemic, its services were in high demand.

"Even before I opened, I had people coming to my gate, to my house, you know, approaching me in the school parking lot, dropping my daughter off. I mean, there is a need. And in a small town, people will find you wherever you are," Bachynsky told Texas Standard.

When the pandemic reached Texas last March, Bachynsky struggled to get the supplies and tests she needed. She says at first, she could only get seven to 10 tests at a time. Plus, her schedule has been grueling. At times, she has slept at the clinic because she was too tired to drive the 30 minutes home.

"I spend most of my life here at this clinic now," Bachynsky said. "It is overwhelming. And, you know, I think what really keeps me going is the support of the community and patients being so thankful and really, you know, pushing us to to move forward."

To her relief, the clinic received its first shipment of COVID-19 vaccines on Thursday – earlier than she expected.

"We had ordered it from the state and really anticipated that we would be a little bit further down the line, being a rural county," Bachynsky said.

She felt the demand immediately. "Desperate" patients have even called her from Houston and Dallas to see if they could get vaccinated at her clinic.

And that's part of the problem of managing a rural clinic: Bachynsky has limited resources to serve an already underserved population. She says the state has stepped in to provide some protective apparent. But her clinic's needs are still great.

"Out here we have a lot of COVID, too, per capita. And the difference is that we don't have ICUs here. We don't have the facilities to be able to manage patients that do become very sick with COVID. And so although our population is not as great as the cities, our needs are just, you know, tremendous," Bachynsky said.

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Texas Standard reporter Joy Diaz has amassed a lengthy and highly recognized body of work in public media reporting. Prior to joining Texas Standard, Joy was a reporter with Austin NPR station KUT on and off since 2005. There, she covered city news and politics, education, healthcare and immigration.
Caroline Covington is Texas Standard's digital producer/reporter. She joined the team full time after finishing her master's in journalism at the UT J-School. She specializes in mental health reporting, and has a growing interest in data visualization. Before Texas Standard, Caroline was a freelancer for public radio, digital news outlets and podcasts, and produced a podcast pilot for Audible. Prior to journalism, she wrote and edited for marketing teams in the pharmaceutical and cosmetics industries. She has a bachelor's in biology from UC Santa Barbara and a master's in French Studies from NYU.
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