When Betty Martinez was in the Galápagos islands, she was amazed by how the sea lions, pelicans, crabs, lizards and blue-footed boobies coexisted with humans as restaurants and shops carried on with daily business. On a morning walk, she and Alasia Ledford spotted two sea lions sprawled on patio chairs with a table and a cup between them.

“It was as if the sea lions had met up for morning coffee and a chat before starting a day of sunbathing,” says Ledford.

Adds Martinez, “Nature has its place, and the people have their places, but both watch and admire each other there.”

Images of lounging sea lions and tortoises as big as boulders immediately come to mind when we think about travel in the Galápagos Islands. But, as part of an ongoing relationship between UNC’s School of Nursing and the Universidad San Francisco Quito, these two graduate-level nursing students travelled with Julee Waldrop, DNP, PNP, FAANP, FAAN, professor of Nursing to support the islands’ human inhabitants and provide professional development to the skilled nursing force that cares for them.

UNC’s Center for Galápagos Studies coordinates UNC’s Galápagos-related research, teaching, and outreach activities in Chapel Hill with the joint UNC/USFQ Galápagos Science Center located on San Cristóbal Island in the Galápagos Archipelago. The partnership is designed to foster research, education, and outreach programs, advance conservation efforts in the Galápagos and promote better understanding of protected areas worldwide.

“When we think of the Galápagos, we think of the vast natural ecosystems related to marine science and endangered species, but there is also a human population and culture there with very unique issues,” says Waldrop, who has been traveling to the islands for research and service for nearly a decade. “The School of Nursing has had a sustained focus on the human life of the island to share expertise in healthcare and ultimately improve the quality of life for the islands’ inhabitants”

The School helped conduct a needs assessment with the area’s nurses four years ago, just as a new hospital was built in San Cristóbal. They learned nurses needed professional development in evidence-based care, quality and safety, and they decided to commit human and institutional resources to help with those needs.

This year, Waldrop enlisted Martinez and Ledford who created a program to teach nurses about pregnancy and prenatal emergencies and how to make sure all patients are given respectful care and treatment. The team consulted the nursing staff prior to traveling to San Cristóbal Island to find out about their areas of interest and where they felt they needed further skill development. Topics that continued to emerge in conversations with nursing staff were clinical leadership, patient-centered care and collaborative-decision making.

Martinez is a pediatric nurse practitioner interested in children’s and family health issues and working toward her doctorate in nursing practice degree. For her, conducting research with both patients and the healthcare professionals of at Hospital Oskar Jandl on San Cristóbal Island provided great insight into their lives.

Betty Martinez and Alasia Ledford at the Galapagos Symposia
Betty Martinez and Alasia Ledford at the Galapagos Symposia

“I got to understand the culture of the islands and its needs,” she says. “I felt I was able to help provide them with some support and mentoring. I appreciate the resources I have here at Carolina, and I hope to share more resources and information with the people in Galápagos, especially in respect to children’s health.”

Teaching evidence-based health practices in the Galápagos gives UNC a chance to better understand the families living on the island and the health challenges they face. Though the nurse is recognized as an important member of the hospital, they are rarely seen as healthcare leaders professionally, unlike the prominence nurses have in the U.S. The nurses the team met had a thirst for knowledge and willingness to improve, and the School’s team recognized the opportunity for great potential to provide more education and collaboration.

Ledford says the nurses they worked with in the Galápagos were true generalists – one day they may be assisting in the surgical unit and the next day they may be monitoring a baby on antibiotics. As a result, when facing a critically acute situation, the nurses may not have the depth of knowledge or skills needed to address certain situations.

“This is a challenge because they end up having some knowledge about many things but never really gain in-depth knowledge about any one thing,” says Ledford. “It creates more challenges for nurses professionally in the Galápagos, limiting the scope of practice of nurses and the leadership role of nurses on the medical team.”

Ledford says she is now eager to incorporate more research into professional development, not only to enhance communication around evidenced-based practice and policies, but also to understand better how to effectively deliver professional development and use it to catalyze quality improvement.

“Separate from the professional development piece, I had the opportunity to assist with a qualitative study around maternal stress and child development, which has really sparked my interest in using community-based participatory research to design interventions.”

Being immersed in another culture and how people see and do things in other areas of the world is good training for nurses, says Waldrop. And, the kind of engagement the School has with the Galápagos gives them an opportunity to do more than visit and research – but to provide a true service to a people they’ve come to care about.

“We have been collecting data since our first study in 2010, and that information continues to verify that women with young children in the Galápagos are under a lot of stress and relatively isolated in many instances because of the culture,” she says. “We will continue to try to find out what type of delivery of education as far as child development, psychoeducation and coping mechanisms could provide the right kind of support.”