Stacey Tosado, Dylan Clark and Isabelle Shaw at the Northern Navajo Medical Center in Shiprock, N.M.

When Isabelle Shaw, MSN, RN, learned about an opportunity to support care teams and patients in Navajo Nation — at one point considered an epicenter of the pandemic — she felt compelled to volunteer her time and nursing skills at the Northern Navajo Medical Center in Shiprock, N.M.

“I was motivated after watching recent news coverage on the Navajo Nation’s struggle with COVID-19,” said Shaw, of the Brigham Thoracic Intensive Care Unit. “Navajo Nation historically has suffered so many injustices. This was an opportunity to help.”

She was part of the first team of nurses to travel to Shiprock through an effort coordinated by the Brigham and Women’s Outreach Program (BWOP) with IHS, which has collaborated with the Navajo Area Indian Health Service (IHS) since 2009.

Given the high COVID-19 infection and death rates in Navajo Nation and critical staffing shortages in Shiprock, BWOP leaders asked Maddy Pearson, DNP, RN, NEA-BC, senior vice president of Clinical Services and chief nursing officer, for support in offering opportunities for staff to volunteer.

The response was overwhelming. To date, more than 25 nurses and emergency services assistants (ESAs) are scheduled to travel to Shiprock in groups of three to four for up to two weeks at a time throughout the summer and fall.

“I was touched, but not surprised, by the willingness of so many nurses and ESAs to offer their time and skills for this critical work,” Pearson said. “I’m deeply grateful for their profound commitment to making a difference here at the Brigham, in Shiprock and anywhere they heed the call to care for those who need it most.”

Dire Need

Social, economic and cultural factors have made the virus more likely to spread in Navajo communities, which have experienced higher infection and death rates per capita than any state in the U.S.

“This population has high rates of poverty and underlying health conditions already,” said Ellen Bell, MBA, MPH, senior project manager for BWOP. “Those risk factors are compounded by cultural norms — large gatherings and community congregation are deeply important, and many intergenerational families are living in close quarters.”

Although the height of the surge has passed, Northern Navajo Medical Center is facing a 50 percent nurse vacancy rate in both the intensive care unit and Emergency Department, where Brigham volunteers are serving.

Stacey Tosado

“My greatest challenge was simply diving into the unknown: working in a new facility with new staff and adapting to a different workflow,” said Stacey Tosado, BSN, RN, of the ICU Float Pool, who traveled with Shaw and Dylan Clark, BSN, RN, CCRN, on the first volunteer team at the end of July. “But leadership, nursing and support staff truly welcomed us with open arms.”

Tosado and Shaw were moved by the immense suffering the community has experienced.

“The ICU nursing staff is a very dedicated, skilled community-based team that has suffered great losses during the pandemic,” Shaw said. “Not only have they worked grueling schedules, but they have also cared for friends, family and co-workers who have died. The toll the pandemic has taken is palpable.”

An Inspiring Team

Shaw, Tosado and Clark were inspired by their colleagues in Shiprock and the care they deliver to patients and families, even amid the challenges of the pandemic.

“The nursing team here follows their patients for their entire lives,” said Clark, of the Cardiac Surgery ICU. “The ICU nurses provide great care across all specialties with fewer resources than I am used to having at the Brigham, which is something to learn from.”

Dylan Clark in front of Shiprock

Tosado agreed. “The nurses do amazing work serving as advocates for their patients with the extensive knowledge of their medical history, past hospitalizations, family history and social circumstances,” she said. “We were so impressed with what a cohesive team they are and how they managed patients throughout their peak in the COVID-19 crisis, despite their lack of staff and resources.”

Shaw said she was humbled to work with such an outstanding team. “This experience is one that I will not forget as I leave my new friends, along with a piece of my heart, behind in Navajo Nation,” she said.

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