Blog

The Frontier community is proud to have students and alumni serving on the front lines of the COVID-19 pandemic. Throughout the next few weeks, we are committed to sharing their stories in order to provide insight, hope and encouragement. Thank you to all the health care workers who are risking their own well-being daily to serve our nation. Click here to read more stories of courage and dedication. 

During the COVID-19 pandemic, limitations have been a common storyline. Healthcare professionals have dealt with limited supplies of personal protective equipment (PPE), limited space in which to house and care for patients, insufficient testing supplies and a limited workforce. 

Limitations in healthcare are not new to rural southeastern Kentucky, where the majority of counties are designated as medically underserved areas (MUAs). Despite its beauty, the region’s remote locations and rural clinics and hospitals struggle to attract primary healthcare providers from larger cities and communities. The problem is magnified by a lack of specialized healthcare providers in these rural and underserved areas. A 2018 study published in the American Journal of Preventative Medicine found that 65 percent of non-metropolitan counties in the United States lacked a psychiatrist. 

Kevin Scalf, PHMNP-BC, is a psychiatric-mental health nurse practitioner (PMHNP) at Hazard Appalachian Regional Healthcare Psychiatric Center in Hazard, Ky. Originally from nearby Manchester, Ky., Scalf is also a Regional Clinical Faculty member at Frontier Nursing University (FNU). He has been a PMHNP since 2011 and a Registered Nurse for 24 years. 

“I serve a population of adults that struggle with psychiatric illness in rural southeastern Kentucky,” Scalf said. “The residents of this region have limited support systems and very significant economic challenges while living with persistent mental illness. As a result of these limited support systems and economic struggles, they often find it challenging to make healthy decisions and follow up with their primary care providers on a routine basis. The healthcare gaps include a shortage of mental health providers, which is especially true for patients suffering from conditions such as autism spectrum disorder, intellectual disabilities and substance abuse.”

These issues existed even before the pandemic. Now, for many in the region, COVID-19 has added another component to their mental health struggles. 

“COVID-19 has increased isolation among our population. Isolation is a risk factor for mental health destabilization,” Scalf said, noting that many patients in the area lack the mechanisms to attend virtual appointments. “Patients who suffer from anxiety and fear related to COVID-19 can sometimes be afraid to go to their primary care provider, resulting in decreased follow-up visits. This can be a significant risk factor for acute exacerbations of mental illness.”

The pandemic has altered Scalf’s daily regimen as well. Each day, before entering the hospital, all staff members go through a triage area where their temperature is taken and they are asked to disclose any symptoms associated with COVID-19. Only then are they allowed to proceed into patient care areas with hospital-approved masks. 

“New patients admitted to the psychiatric hospital are placed into a centralized unit where they are closely monitored for symptoms of COVID-19,” Scalf said. “After they have been screened and assessed for a period of time, they are transferred to other appropriate units.”

Adapting to these new conditions and procedures is not easy for anyone, but Scalf credits FNU with helping to prepare him to navigate through times of change.

“FNU has given me additional education, tools, and skills that I can take into the world and use to bring about meaningful change in our region,” said Scalf, who is on track to earn his Doctorate of Nursing Practice from FNU this spring. “How do we help our patients and each other adjust to a new way of normal in our country? In moving forward, we need to come together and prepare ourselves with the fact that life may be different for a significant amount of time.”

Coming together has been part of FNU’s strategic response to the pandemic. In efforts to help ease uncertainty and anxiety, FNU has provided frequent virtual support sessions for students, faculty and staff along with regular updates about the pandemic and the university’s response. 

“FNU has been very helpful in staying current on the latest emerging COVID-19 updates,” Scalf said. “FNU has offered faculty, staff and student support sessions that have helped us come together and draw strength from one another. These sessions not only demonstrate FNU’s culture of caring but also helps us to realize that social distancing does not always mean social isolation.”