What makes Kelly McGrady such an asset to her community? Could it be childhood adversity? Her military training? An exceptional leadership program she attended? Her faith in God?
It's tempting to credit any and all of these influences for McGrady's ability to get things done under extraordinary circumstances, but perhaps her achievements spring from a more intrinsic source. McGrady is a member of the Mandan, Hidatsa, and Arikara (MHA) Nation, also known as the Three Affiliated Tribes, and a health facilitator at the Sage Coulee Outreach and Wellness Facility in Bismarck, North Dakota.
She says it's been a tough year for the nation's people, who operate the health center where she works. She counted 176 MHA deaths in 2020-from COVID-19, chronic health conditions, drug overdoses, and suicide. She says the losses have been devastating and the grief compounded by the fact that tribal members were not able to come together to conduct funeral rites. On the work front, she says, "It's been wild."
A 'ONE-WOMAN' VACCINATION SERVICE
After deciding to move to Bismarck for family reasons at the start of 2020, she took her current job overseeing prevention and screening services, primarily for members of the MHA Nation. She was hired to administer childhood vaccinations, screen patients for HIV and hepatitis C, and accompany elders to their medical appointments; but with a pandemic unfolding, her responsibilities grew. She followed the Centers for Disease Control and Prevention guidelines and tested community members for COVID-19. Then, in 2021, while waiting for vaccines to arrive, she reached out to the state to procure vaccines for 130 tribal elders.
"Initially, we were told no right away, and I said, 'Help me help my people; I can't let them die.'" The state agreed to make doses available for this particularly vulnerable group, and since then McGrady has obtained Pfizer and Moderna vaccines for the community at large.
While relying on a "phenomenal support staff," she has essentially become a one-woman vaccination service for Bismarck's MHA Nation residents and others in the community who meet state eligibility requirements. "I'm the ordering person, I'm the data entry person. I draw up the syringes and inject them, and I'm the person to answer questions and help patients relax and calm their fears. Because everybody's coming in with a lot of fears."
Native American distrust of the U.S. government when it comes to health matters has deep roots, McGrady says. The MHA Nation traces its affiliation to the 1837 Great Plains smallpox epidemic, which wiped out a significant portion of the tribes' members. "We have some elder folks that say, 'No, I won't take the vaccine.' Some are actually offended. But some are relieved that it's me administering them, somebody they know and care for and trust."
YOUTH SUICIDE PREVENTION
COVID-19 is not the first crisis McGrady has encountered as a nurse. In 2016, she took on the role of school nurse at the K-12 school her children attended in New Town, North Dakota, on the MHA Nation reservation. She also became an at-risk mentor for middle and high school students. Less than a year later, in January 2017, 10 students attempted suicide.
McGrady turned to the reservation psychiatrist, Monica Taylor-Desir, and began referring students and families who needed help. Soon after, the two women met at a Gathering of Native Americans, a process for addressing community-identified issues, and began collaborating on youth suicide prevention. Taylor-Desir invited McGrady to join her in applying to Clinical Scholars (https://clinicalscholarsnli.org), a national leadership program for health care providers supported by the Robert Wood Johnson Foundation. McGrady had no idea "what the heck it was," but she said "sure" to the opportunity, which she credits with changing her perspective on life.
"It helped me to reflect on who I am and how people perceive me both personally and professionally," she says. As a self-described "latchkey kid" and couch-surfing teen who "learned to be my own everything," she felt as though she were being introduced to an alternative reality, one where professionals were "down to earth" and there was "goodness in asking for help."
The Clinical Scholars program also gave her an appreciation for the importance of self-care and relying more on prayer to balance her personal and professional lives. She calls the experience "awe inspiring." More concretely, it prompted her to enroll at the University of North Dakota to earn a bachelor's degree and gave her the confidence, courage, and organizational skills to forge on at work and keep her family safe during the pandemic.
The program also benefited New Town families. Together, McGrady's team of clinical scholars, which also included a pediatrician and a social worker, created Building Resilience, Building Health, a support program for Native American families of teens with one or more mental health diagnoses. Group sessions taught family members about teens' conditions and fostered better communication between the generations. The team brought telehealth to the schools so students could access psychological counseling services; introduced QPR (Question, Persuade, Refer) suicide prevention training (see https://qprinstitute.com) in New Town and the surrounding communities; and organized lectures on adverse childhood experiences (ACEs) and trauma-informed care at health centers throughout the MHA Nation reservation.
McGrady is not shy about sharing the fact that her own upbringing was full of ACEs, and she's eager for others to understand how these ACEs permeate the lives of far too many Native American children. She, herself, attempted suicide at the tender age of nine but rebounded with the help of numerous adoptive parents and a fierce determination that she now recognizes as resilience. She joined the National Guard as a junior in high school, graduated, and received training as both a combat medic and an emergency medical technician, skills she employed during a subsequent stint in the U.S. Army.
CARING FOR OTHERS
After the birth of her second child, McGrady left the service and took the first step in her nursing journey, becoming a certified nursing assistant. She was inspired to pursue the career by aunts who were nurses and by her childhood experience helping a grandparent inject insulin-then a high school health careers course cemented that decision. Ultimately, she pursued education as an LPN and then an RN.
McGrady worked on a dialysis unit; as a home health care nurse; and as a health policy adviser to a tribal councilman, which allowed her to connect with others who shared her concerns. But her experiences as a New Town school nurse appear to have set her on a path toward leadership. In addition to her suicide prevention work, she served on the town's community and parks and recreation boards. When opportunity knocked, she stepped up to seize it.
McGrady credits God with opening doors, seeing her through the rough times, and helping her stay present, and the military for giving her the physical fitness and composure to focus on the task at hand in the midst of "life's chaotic storms." Her childhood experiences have imbued her with empathy and insight, and she can't say enough positive things about her experiences in the Clinical Scholars program.
But her heritage clearly plays a foundational role in making her the person she is today-one whose lifelong focus on caring for others has carried her forward and placed her in situations where she can do tremendous good. When she talks about her people, she is quick to note their resilience. "They've survived so much," she says, alluding to the smallpox epidemic and other dark chapters of their history. She wants her people to use that resilience as a superpower. "Make goals. Make dreams. Live them!" she exclaims.
McGrady has set ambitious goals for herself as well. She says the Clinical Scholars program gave her a "hunger to keep on reading and be that lifelong learner." She has applied to a master's program at the University of North Dakota with the goal of becoming an NP and eventually opening a youth wellness center modeled on the one created by Nadine Burke Harris in San Francisco. Embarking on this next quest, McGrady describes herself as tenacious. She says the journey is "a long one, and I don't know where it's going to lead me, but I'm just going to leave it all up to God and keep pushing through it."-Nicole Fauteux