Yes, I'm currently paying back my scholarship by service obligation. I don't want to give any details since this is a public forum and the Native nursing community is so....small.
I'm only 1 year into it and have 3 to go, which isn't very long, but I was very, very naive when I signed the contract. The idea of full scholarship would appeal to anyone, but if I'd had any idea how bad things were for the IHS and their facilities, I would never have agreed to the contract.
I had a choice of location, and after researching conditions at IHS facilities on reservations, choose an urban position. But I don't think it would matter much. The urban facilities are even more underfunded and forgotten than the reservation facilities, despite urban Native people having the greatest need and density in population.
It's not really the funding that's the issue. It's the general mentality that permeates my workplace. As we all know, there is always some ugly truth in every stereotype, and I spend my days with co-workers who conform to a very unfortunate stereotype: that of the lazy, government Indian. Before you recoil in politically correct shock, keep in mind I'm a full-blood Indian myself - and let me explain.
I love my people, but as I get older, (I'm 37), I move farther and farther away from a place of sympathy about our plight as a culture. I grew up in poverty in a mix of reservation and urban upbringing, like most of my Indian co-workers. But that is where the commonality ends, for me.
The thing that I cannot contend with, on a day-to-day basis, is the painfully apparent lack of educated people with solid work ethics that are employed by the facility I work for. The standards and morale are so incredibly low around here that it's depressing.
Our social workers/case managers don't have college degrees or licenses. Our supervisors and directors are rarely present. When they are, they sit in their offices with doors closed. No new employees are provided with any kind of orientation. Meetings are unproductive and silent. Charting and documentation is still done by hand on carbons. 2 hour lunches are common, and everyone clocks out at 5PM and leaves like they can't wait to get out.
Basic customer service and even social skills are marginal at best. People are rude, unmotivated, unproductive, under-educated, and it trickles down to the clients/patients all the time. On top of all that, a good majority of the workers here have alcohol and drug problems themselves. Everyone turns a blind eye to it. The directors have no problem buying a 52' flat screen monitor/TV for their "conference room" but the licensed staff are crucially underpaid in salary (many thousands below market) and the building is falling apart and filthy.
I could go on and on and on, but basically, doing the IHS scholarship/service obligation is NOT a good choice for a person who wants to work in a system where people at least try to do things correctly or strive for any kind of excellence. Indians have been addicted to government charity for too long (and increasingly, casino revenue) and it has destroyed many Indian people's will to better themselves, by themselves. I see this every day in both my co-workers and my clients. Medication compliance is at nearly zero, and substance abuse, diabetes and MRSA are ravaging the urban Native population at 10 times the rate of reservation populations.
I know it's only a few more years. Maybe when I was in my 20's I might have tolerated working in a place like this better. But at my age, this just makes me want to RETIRE from both nursing and being Native as soon as I can! I thought this would be an exciting new chapter in my professional life, and that I would be doing something positive for my people. Instead, I'm stuck in a situation where opportunities to make a difference are met with INDIFFERENCE, and as much as I try to do a good job and stay positive, I get beaten down every day to the point of feeling like I might as well give up, take a 2 hour lunch and be rude to the clients like everyone else.
So there you have it. Thanks.