Overall

This week I have experienced generosity from so many people! Starting with the nurses at Cherokee Hospital who have shared their wealth of knowledge and experiences with us, they even shared some of their own personal stories. Everyone was so welcoming and accepting of us, and sometimes it’s not always that way in our hometown hospitals so it was very nice to be greeted in this manner. Kayla, Kim, and Victoria took time out of their work life and personal life to show us around Cherokee giving me and my fellow classmates a better understanding of the unique way people are cared for and also more about the culture. We were allowed to sit in church service which was amazing. To hear the pastor preach really touched me, how he was trying to decide if he would purchase a new vehicle, so he had been test driving it, and ask the Lord to show him a sign. The sign was that the very first thing he would haul in the back of the truck were the clothing we donated to the Sub Oxone Rehab Clinic. I am a believer and I know that God works in mysterious ways and I believe that was definitely a sign. One kind gesture has trickled down an effected multiple lives is another way I have experience generosity this week. Lastly, my classmates were generous in many ways, from cooking, cleaning, reminding others of things, helping each other looked for things we misplaced and simply sharing material things and kind gestures it was much appreciated. As far as my instructors went they did everything to cater to us (the students) and it didn’t go without notice, they gave us so many options of what we could do and where we could go, they went out of their way many days to make sure everyone was comfortable and well taken care of, and I am thankful.

While I was here I was very observant in the way patients were cared for. I learned how helpful it can be to be non-judgmental and leave your own personal issues at the door when you want into work. Making the patient feel comfortable, and centering your care on the patient’s entire existence such as their family, home, work social environment to make sure they are healing not just physically but emotionally, understanding the non-medical factors that play a part in each patients diagnosis is so important to improving their health. I took all this information in and I also watch and saw how this positively affected the patient nurse relationship, I will be utilizing all the skills and information gained in this experience to care for my future patients.

I feel like diabetes and substance abuse primary preventions are very important in this culture. The language academies are also important in keeping the culture alive. There is a new generation that is ready and eager to learn and teach about their culture and passed on traditions. Keeping the youth active in the culture is the best way to keep it thriving. It’s important to do so, so that the traditions don’t die.

White water rafting was completely out of my comfort zone. I was eager to sign up and excited to do it, but I was also very nervous. Thinking about all the things that could possibly go wrong, seeing that I’m usually pretty clumsy. My guide was Josh at Endless River and he was amazing. It was a very personal and informative adventure that came along with lots of thrill and excitement. I even jumped in the water which I was later informed that it was only 52 degrees after they pulled me back into the raft. I enjoyed every second of rafting.

As far as my blog from the first day I feel the same way, I’m glad I got a chance to have this experience. I can always come to Cherokee, and do the outside of clinical activities but I could have never received the first hand insight and knowledge about this culture unless I was on this trip. I’m so very happy that I was able to come, and I’m leaving with more than a suitcase full of souvenirs but a new appreciation for culture, honesty and holistic care.

Friday Night Blog

Some of the most critical and prevalent issues in this culture would be substance abuse, diabetes, premature infants who have been exposed to substances.

Diabetes can be genetic but it is also due to the poor food choices and stressful environment.

As far as substance abuse goes, that can’t be genetics but it can be passed down through generations. If you are around or raised by people who abuse drugs or other substances it can influence you heavily to do the same thing. If your culture copes in that way is another way it can be passed down to someone. I learned at the Unto These Hills drama, that when the Cherokee people were basically held captive and forced to walk the trail of tears that the white soldiers would come and trade them different things in exchange for alcohol which is how the Cherokee people coped because they could not change their circumstances.

Premature infants who have been exposed to substances is a really big issue in this culture, which is due to many things, deficient knowledge and health maintenance. This stems off the big substance abuse issues, which trickles down in to newborn babies, who are fighting for their lives before they even take their first breath. This isn’t just a Cherokee issue though, this is a growing problem in America period. The lack of education of what drugs can do to your unborn fetus is an issue, when people are addicted it’s not so easy to just quit, and coming out even admitting you have a problem is an issue. This makes getting the help you need really hard to do and in the end this issues are passed along to the fetus.

The nurse’s role in health promotion and health maintenance is to provide education, and resources, it’s our job to stop an issue before it actually starts. The next portion would be screening which is secondary prevention but it helps to catch things early and stop them before they get out of hand. It’s our job to provide resources and to help in maintaining our patient’s health.

In my opinion the patient is always the center of the health care system here in Cherokee, healing the patient’s mind and body is important here, gathering all data and treating everything accordingly. I feel like it’s different at home, at the center of the health care system is money. They rules and regulations don’t always allow a person to do everything they can do for the patient, because they would be over stepping their boundaries. I feel like we are so busy checking off a list of what should and shouldn’t be done, we lose sight on caring for the patient entirely, holistically. I really wish we could move to a systems such as the one that Cherokee Hospital has.

Mission

Mission hospital was huge, and they were currently building on. We only went through mother-baby, pediatric, and NICU and it was just amazing to see them have that med beds available especially compared to home were one of our hospitals just has a few rooms for pediatric patients, and there isn’t a NICU at all. There is another hospital where I’m from that has an amazing children’s hospital and it actually reminded me of that. There is a large population of exposed and premature infants from all over the area, it was heartbreaking to see all of the babies today, but there was also a lot of hope and there were beautiful stories of survival posted right up front for all to see. I thought the level of care being given was phenomenal, and all the services they offered for mom, baby and family was very helpful for those conditions.

Hospitalization effects children and their families in many ways, first of all you are in a new area, that’s not home, with strangers and you are sick, so it’s a place you need to be, not always a place you want to be. This organization applies family centered care starting from making the rooms big enough so that there is room for family to come and stay with the patient. Its encouraged to have your family there with you. Mission is the bigger hospital of the surrounding area, so the smaller hospitals feed into it, because they have more room, more staff and they are more equipped equipment when it comes to major traumas. They have child life services to help children go through different procedures and just feel more comfortable in the hospital setting, which is a service we offer at home so I thought that was really neat to see.

There was a really big difference when comparing Asheville to Cherokee. Cherokee was so rural, and it Asheville is a city. The landscape is the same but the towns are completely different. It seemed as if there were more things to do in Ashville, certainly a larger population. Ashville actually seemed more of a tourist town than anything to me.

Today what stood out to me the most was the Mission’s Children Hospital. It was simply amazing to see all they did for children under one roof. It was an inviting environment. The paintings on the wall were amazing. The education for the MRI was so neat. Teaching children through play is the best way. Our wonderful tour guide was so informative, she was definitely empowering and uplifting.  The Mission’s children Hospital made caring for children so much fun, it took what is most of the time a bad time in a child’s life, and turned it into something very fun. The approach they have on treating pediatric patients can really take the fear of hospitals visits. Today’s visit made me really excited about pediatrics how they give all the care that adults would get but in a kid friendly way.

Day 4

In this culture I’ve learned that a lot of the grandparents are put into positions where they are raising their grandchildren. The elders of the community have the authority, because they are the most respected in the community.

There is lots of foster parenting, and adoption in this culture, there mixed race families, there are grandparents raising children, and traditional families, such as husband, wife and child. I didn’t observe single mothers, I’m not saying it isn’t something that actually happens but I didn’t hear about it. I also didn’t hear anything about the father’s role in the family structure. In my own culture there are a lot of single mothers, not many single fathers, but when there are single fathers they are praised.

The support systems in the community are the grandparents the elders it seems like.  Another this is that the community supports the community. From what I have observed it’s not really judgmental, most people are understanding and pushing people towards positive outcomes. The community aspect is amazing it’s like one big encouraging family.  

Most families and children who are resilient have been through trauma, and they have some type of support system to help them along.

0.4 Miles

Today we had the option to hike up Mingo Falls. Of course I said yes, I was really unprepared for what I was about to encounter!

So although I'm frail I am by no means in shape within the first five minutes I was out of breath wondering how everyone was hiking up these steep steps so fast.

The below photo is me contemplating if I could go on any more! (5 minutes in!)⬇️

Mingo Falls is on the Cherokee Indian Reservation (Qualla Boundary), just outside Great Smoky Mountains National Park. No special permits are required for access to the reservation. At 120 feet tall, the waterfall is one of the tallest and most spectacular in the southern Appalachians. The hike to the waterfall is only 0.4 miles in length, but is considered moderate in difficulty. (https://www.nps.gov/grsm/planyourvisit/mingo-falls.htm)

So I caught my breath and kept going and it wasn't long before I got to see the most beautiful sight.... 

Day 3

The health care system in this community is ran by the people and for the people. The health care system caters to the needs of the people of the community. Understanding the historic generation trauma was important in how the way the hospital was ran. Setting everything up so that all needs are met in the easiest way possible, and your contact is personal, it doesn’t keep changing. The way the hospital was set up to run in a way that meets a vast amount of needs of the people, and it definitely does that. it’s true to its mission and vision statement. The tribal council runs the hospital which are elected individuals of the community and the hospital is funded by the casino.

When someone come in the hospital with a need, it’s handled in every aspect possible. There are so many services available, and if the services are not available they will ship you out to the nearest hospital where it is. To me they do everything they can to help out their patients. Offering dental, mental health, physical therapy, oncology, ob on Wednesdays, pharmacy services, primary care services, and plenty other specialty services in one place is what every hospital needs to care for their patient in every way. Out hospitals don’t do that at home they don’t have one place that will fill every health need you have. Out hospitals will offer you resources, but, they won’t go over and beyond to make sure that those resources are attainable for you or your loved ones, it’s simply putting the information out there.         

There are so many alternative medicines commonly practiced in this culture. When we visited the Cherokee Museum on our second day we got to learn a little about alternative medicines. There was a video that told the story of how plants got their healing power. It started off with humans who were hunger and to ease their hunger they slaughtered the animals which made the animals mad. The animals called a council and said that for every animal killed a disease would be released to plague the humans. The plants like the humans, and had heard what the animals had done, so they called a council and decided to help the humans, so for every disease the plants offered a cure.  This is why every plant has a use. The cures were told to the medicine man who is charge of healing the people. This was a fascinating story. Still to this day alternative medicines are used in this culture amongst the Native people.

"Moore" to Come!

My plan is to post pictures from the day as well, which tomorrow I'll post photos I forgot to post, and in tomorrow night's blog I'll include my photos within the blog! Excited about tomorrows itinerary.