In response to the COVID-19 pandemic, nurses in the Salinas Valley Memorial Healthcare System and SVMHS leadership have created a remarkably innovative program that protects the health of the region’s farmworkers and their families – and persists to this day.
A Dire Need Emerges
Two challenges drove the initiative. First, farmworkers and their families are extremely vulnerable to COVID-19. Many are undocumented, lack access to healthcare services and safety net programs and live in overcrowded, multifamily configurations.
At the same time, the pandemic initially forced the closure of many clinics and outpatient services and the postponement of elective surgeries and procedures, resulting in massive layoffs nationwide, including of nurses. Determined to avoid those layoffs, SVMHS leaders worked with the region’s agriculture companies and the Grower-Shipper Association (GSA) to create two nurse-led programs that address farmworkers’ needs for education about the virus, care when needed and housing support.
“The program resonated deeply with me because I come from a family of laborers who depended on agricultural work to support their families…their stories were mirrored in the many experiences shared with us during our outreach.”
Brittnee Sandoval, BSN, RN, CMSRN
“I’m so proud of our nurses’ commitment to doing this work, even in the beginning when it was so scary,” says Chief Nursing Officer Lisa Paulo, MSN/MPA, RN, CENP, one of the program’s architects along with Agnes Lalata, MSN, RN, CMSRN, CNML, Director of Med-Surg, and Ihovana Aguirre, BSN, RN, Patient Experience Coordinator.
“The program resonated deeply with me because I come from a family of laborers who depended on agricultural work to support their families… their stories were mirrored in the many experiences shared with us during our outreach,” says Brittnee Sandoval, BSN, RN, CMSRN.
“Being bilingual and coming from similar backgrounds, they could relate to us and felt comfortable asking us questions,” says Erica Gonzalez, BSN, RN. “I found this to be very rewarding…that we could help during this difficult period for all of us and…make a change in our community.”
Collaborative, Interprofessional Programs
The programs’ two components are firmly rooted in the SVMHS Professional Practice Model and nursing mission to Heal, Protect, Empower and Teach. Equally important, says Paulo, “SVMHS leadership had the vision to invest resources early on, which resulted in substantial cost savings, public health benefits and support of the SVMHS workforce.”
The Education Program uses bilingual RNs to provide COVID-19 education in the agriculture fields and processing plants. Nurses convey strategies to keep farmworkers and their families safe, including vaccine education. SVMHS infection prevention and marketing teams have created educational materials in both English and Spanish.
The Housing Outreach Program uses SVMHS RNs to support quarantined clients in hotels, including daily visits, phone check-ins, education, supplies and medications. When needed, RNs facilitate collaboration with primary care providers, clinical services via the SVMHS Mobile Clinic, and Emergency Services. Risk management staff, physician leadership and pharmacists developed a protocol to provide medications as needed. In addition, nutrition services staff provides food, while materials management staff provides supplies and protective gear for the SVMHS staff as well as farmworkers and their families.
Extraordinary Results
By any measure, the programs have been an unqualified success. They:
- Improved the SVMHS nursing professional practice environment, including improved engagement through innovative RN-led interprofessional collaborations both within the SVMHS organization, as well as with the GSA and local hotels
- Decreased COVID-19 positivity rates and increased vaccination rates in Monterey County
- As of this writing, 83% of eligible residents have received at least one COVID-19 vaccine dose and in May 2021 the Salinas metro area had the lowest case rate of COVID-19 in the U.S.
- Educated over 13,000 agricultural workers from 18 businesses
- Worked with more than 400 agricultural workers in the Housing Outreach Program
- Decreased ED visits and hospitalizations in the community’s vulnerable, uninsured population, with projected organizational cost savings of over $1.1 million
- Facilitated the nation’s access to produce by avoiding supply chain disruption
“This project demonstrated the essence of SVMH’s mission, vision and values to improve the health and well-being of our community,” says Sandoval. “One gentleman said something that has stayed with me. He said, ‘I feel grateful that the hospital cares what happens to us. I feel a sense of comfort knowing that there are people like you in our community that come to us, in the middle of this field, even getting your shoes muddy to make sure we have good information that we can take home with us to protect our families.’ I am honored to work for an organization that is invested in the health of its community.”
