The small city of Barstow, Calif., sits in the remote Mojave Desert between Los Angeles and Las Vegas. It's rural, yet hardly isolated, at a major crossroads with a lot of people coming and going. An outbreak of the coronavirus could overwhelm its 30-bed hospital.
There was already a severe shortage of doctors and nurses in rural America before the COVID-19 crisis — and the growing sector of traveling nurses and doctors might be part of the solution.
Dr. Naomi Lawrence-Reid, a travel physician and pediatrician, says healthcare workers in Barstow were "already trying to keep their heads above water" before coronavirus became a concern. "It was high flu season, lots of upper respiratory infections, already a busy time in the emergency room," she says.
Lawrence-Reid splits her time between her home in San Diego and temporary posts in Barstow. She sees herself as playing a pivotal role now helping out in a long-struggling community where some homes are crowded with multiple generations of families. Viruses spread quickly even in normal times.
Lawrence-Reid also says a lot of the doctors tend to be near retirement, a common challenge today in rural areas.
"If things continue the way they're going it could be considered irresponsible of them to put themselves at risk," she says. "Especially if there are other physicians, younger physicians that are, at least at this time, less at risk."
Traveling nurses and doctors like Lawrence-Reid, 36, tend to be younger and more mobile and could play a key role in filling at least some gaps in rural hospitals struggling to prepare for the coronavirus.
In recent days, one of the country's largest healthcare staffing companies, Aya Healthcare, dispatched 300 travel clinicians to rural hospitals. The company is racing to try and meet a demand for 1,300 more.
"We've had full crews working nearly 24/7, seven days a week," says April Hansen, a vice president at the company.
Hansen says one big thing that's helping them now is that many states have just eased licensing requirements in response to COVID-19. That's making it easier for travel nurses to move from state to state, avoiding sometimes duplicative applications and screening. Hansen says this is key for rural hospitals that need flexibility.
"Making the process easier and accepting out of state licenses from other areas immediately opens up supply chain channels that were not available to them prior to this change," Hanson says.
Just like everywhere else, a fast depleting supply of personal protective equipment remains a huge concern for rural medicine.
Travel nurse Clayton Hamilton says so far supplies at his hospital in rural Northern California are OK. The hospital hasn't yet reported any confirmed cases.
"I haven't had any issues finding PPE [Personal Protective Equipment] yet, but hopefully the community takes it seriously with social distancing so it doesn't come to that point," Hamilton says.
Hamilton is nearing the end of a 13-week assignment. Most of his prior experience was in larger urban hospitals. He was eager to bring his expertise to a smaller facility. But he's worried that as this crisis worsens, travel nurses and docs will be lured back to the cities where hospitals can pay more and offer overtime.
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