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House Call: How some nurse practitioners in rural Ky. are providing care during the pandemic

Published: Jan. 25, 2021 at 2:12 PM EST
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ESTILL COUNTY, Ky. (WKYT) - In one Eastern Kentucky community, doctors are scarce, hospital beds few and medical care sometimes comes with a house call.

”When COVID hit, and everything shut down, we did not shut down. We were still here, we were answering the phones, we were doing telehealth, and reaching out to the people in the community to let them know that we’re here, we’re here for you.”

The Estill Medical Clinic goes way beyond basic healthcare.

“We’ve started keeping a little clothing bank here, and we can show you some of the supplies that we have, we have pants, and shirts, and clothes and shoes, things that we can just hand out to people,” Donna Isfort said.

Isfort and Liz Taheny are two of the three nurse practitioners there.

“It’s not just about medicine. It’s not just about a pill. It’s so much more than that,” Isfort said.

Isfort grew up in Estill County, and after working as a flight nurse in Lexington, she decided many years ago it was time to come back home.

“I was born and raised here. These are my people. You make a commitment to care for your own,” Isfort said.

They screen each patient to better understand their basic needs.

In the county of about 14,000 people, welcome signs say it’s “where the bluegrass kisses the mountains.” But the people there face some big challenges, including lost jobs from railroad cars that sit silent and a coal industry that is struggling. The only hospital in the county has an ER, but does not do surgery. Isfort says many people there are not comfortable going to what she calls, “the big city of Lexington” for their healthcare.

“Mountain people have a lot of pride. And sometimes that pride can get in the way, even when they’re ill, sick, need to seek healthcare, because they may not have a ride to the doctor, they may not have money to pay for the doctor visit,” Isfort said.

Trust is the key.

“It’s extremely important. We are a very personalized community, like to know who we are talking to,” patient Robert Perez said. “The family aesthetic is extremely important. We love it here. We like to know when we come in, we know Liz and Donna. We know we’re going to be really taken care of, in this community family is extremely important. And they make you feel like that every time you come in.”

Making house calls is a regular part of their practice.

“When a patient allows you to come into their home, you’re a guest, but in another sense, you’re part of their family,” Isfort said.

“This is one of the tightest knit EMS, health care communities that you’re ever going to come across,” Jimmie Wise, longtime director of the Estill County Emergency Medical Services said.

Wise says coronavirus scared many people here into staying home, and not reaching out for help when they were sick.

“One of the challenges we saw, is that when we did see somebody, they were sick, I mean they were really, really, really sick,” Wise said.

And that puts more pressure on the nurse practitioners who treat a wide range of medical concerns. Dr. Dustin Devers from Berea consults with them when he’s needed. In Estill County, healthcare is a team effort.

“I get tearful because it’s God’s work because we’re going above and beyond,” Liz Taheny said.

“How honorable and how humbling is that, that your fellow community, your people in town trust you to care for them,” Isfort said.

Estill County was one of the last in Kentucky to report a COVID-19 case. They went three months without one. Since then, more than 700 people have recovered from the virus and 13 people have died.

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