Native American Nursing
- 0Feb 13, '02 by UWECfuturenurseHi everyone,
It seems like the public health area isn't a very popular one to post at, but I thought I'd throw a few questions out there anyway. I'm currently beginning an honors BSN program. For honors we have to pick an area of concentration and prepare a project. I'm very interested in public health, especially access to health care on Indian reservations. Can anyone let me know what some of the issues are regarding this? Any info would be greatly appreciated!
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- 0Sep 24, '02 by KarenARI just looked at a web site yesterday that had a TON of jobs listed with a Native American health service (???). I think it was on MedHunters.com.
Side note - I'm required to do a similar project (although I don't get any honors for it! drat!), and I'm looking for information on public health programs that start with prenatal care and follow the moms/parents/babies until the child's 2nd or 3rd birthday...something where a nurse helps with that transition into parenthood. I've only found one or two programs so far. So if you see anything along those lines, please drop me a line!
- 0Sep 24, '02 by nightingaleI think the suggestions on websites will help you. Let me share my experience of working with the Indian population:
I worked on my senior program (not honors but was allowed to choose also) on Wellness in Cardiac Health. I volunteered to teach a program on Cardiac Health Maintenance. I was able to borrow the screen projector to view my power point information to the listeners of my “lecture”. The lecture was held at the Zia Pueblo outside of Cuba, New Mexico. It was most rewarding; I was disappointed to learn that there were no reservations in the area I subsequently moved to after graduation.
Issues in Indian Health that I was exposed to were poorly managed and understood Cardiac Health, Alcoholism, and Diabetes.
The lifespan of the Indian Population is very poorly projected. I am going from memory but I seem to recall it to be in the late 40’s or early 50’s. Statistics on groups of populations look good for the American Indian after 70 and that is because most have passed away. The population of American Indians is so rewarding to work with; I wish I could and may just work with them again someday.
Whatever you choose, have fun with it!
- 0Sep 24, '02 by spineCNORI worked as a nurse for the Indian Health Service for 6 years in the past. Where I worked-the Navajo Reservation- there are several clinics and health centers and 4 hospitals - Tuba City, Chinle, Fort Defiance and Gallup.
Care at these facilities is free to any registered member of a tribe that is recognized by the US Federal government.
Access issues that I am aware of - one of the biggest access issues on the reservation is transportation to the health facilities. Many people live in EXTREMELY isolated areas and have no reliable transportation. This is a barrier to people who needed care for chronic conditions (diabetes, HTN, etc) and for routine prenatal care visits.
There is an EMS system, but many people do not have telephones, requiring people in need of emergency care to travel to the nearest store, trading post, etc. to activate the EMS system. When EMT's are dispatched they often have to travel long distances over muddy, holey dirt roads to get to the patient, which may greatly reduce the likelihood that a trauma or heart attack patient will survive.
Another access issue- many of the Navajo elders do not speak English well, if at all. Navajo was not traditionally a written language, though there is a written version, but I do not believe that many Navajo elders read Navajo.
There is little to no written teaching materials in Navajo, or other Native American languages.
Most healthcare professionals working on the Navajo Res (doctors, RN's, pharmacists)are Anglo (non-Indian) and do not speak Navajo- it is a very difficult language to learn. So these healthcare professionals have to communicate with non-English speaking patients through available interpretors - unit secretaries, nursing assistants, LPN's, family members, or anyone handy who speaks Navajo. As there are no medical terms in Navajo using someone with little medical knowledge to interpret can get rather dicey.
When I was last on the Rez (3 years ago) there was no certification program for Navajo interpreters, similar to certification for those who interpret in sign language for hearing impaired people.
So here are 2 access issues - transportation and language. Hope this helps. If I can be of any help feel free to PM me.
Best of luck with your project!Last edit by spineCNOR on Sep 24, '02
- 0Sep 24, '02 by jodeWorking with the Navajo was a very rewarding experience. I agree with all that spineCNOR has shared with you. I worked in Chinle and Pinon and language is certainly a barrier, but the techs were all trained as interpretors. Diabetes is a big health care issue for the Native American. There is a very good Diabetes Educator at Chinle Hospital. Alcoholism is also a big problem. Feel free to PM me for more info if I can help you in any way.
- 0Jan 11, '04 by mercyteapotThe one access issue I might add is that there don't seem to be a lot of Native Americans with nursing degrees. I don't work for an Indian Health Center, but I do work with them in my County (San Diego). None of them are staffed with even one Native American nurse. There are sometimes cultural issues that a non-Native American needs to be aware of, and there are sometimes trust issues that make it difficult to establish rapport with patients.