The generosity this week has been amazing.  I came into this with no specific expectations of the staff and other people we came in contact with.  The staff at Cherokee was very patient with us providing us with information on how the of the hospital functions.  They took the time to explain the culture values and beliefs.  Also every person we encounter was very kind and more than willing to answer all the questions we had. We had two of the healthcare staff spend their lunch break explaining the history behind the Native American history and what lead them to the community.  Their generous acts is greatly appreciative for all that was done to make our visit a memorable one.

Some things I did while visiting that will help to improve the health of others observing how the Native American organize their healthcare facility. I feel that by understanding that education and follow up care it important to maintain ones health.  I was able to see how the healthcare team made phone calls and home visits to ensure that the patients where coming in to appointments and screenings.  Also I was able to understand how other values and beliefs are priority to their health.

I feel that this culture is able to get healthier and keep their heritage for future generations by taking the necessary steps in managing their health.  The adults can lead by example and by educating their children on how important it is to use the resources provided by the healthcare facility. This can provide a sense of unity and belonging with the each member.  This is important to the culture heritage and allows the later generation to learn the history or the previous generation. This can also create a great support system for the members.

This week I did a couple of things that was out of my comfort zone.  I’ve never gotten the opportunity to spend any amount of time in a secluded area.  We spent a week in a cabin in the mountains where the nearest store and medical facilities are miles away.  I also did two water activities that was completely out of my zone.  I tried both activities and was only able to complete one. I very fearful of drowning and heights.  I eased my nerves enough to get me on a raft and completed a two hour journey down the river. 

I’ve been changed from this experience on how I see my own culture.  I know some background on the African American culture but I haven’t took the time to research as I’ve done for the Native American culture.  After hearing the history of the Native American culture from various speakers it open my eyes to how their culture have some similarities.  The speaker who spoke on historical trauma and how it has effect the lives of so many cultures.  The experience has provided me with a clearer outlook on how family dynamics are compromised due to those pass traumas.

I can’t say it enough how this experience will allow me to understand and provide care to multiple cultures.  I’ve enjoyed this week with some amazing people who also added to my learning with their views on this experience.

 

Blog day 5

6/9/2016  

How did the 130 bed, only children’s hospital in Western North Carolina compare to your previous experiences in health care? Consider how hospitalization effects children and their families. How does this organization apply family- centered care? How does the environment in Asheville, NC compare or contrast to Cherokee, NC? What stood out to you the most today?

Today is day five of our Pediatric Travel course.  I have enjoyed every day that visiting the hospitals and learning about the culture.  Outside of the healthcare facilities we learned about the culture through plays and other presentations.  By coming from a community that’s completely different it’s great to see things that could be possibly implemented in your healthcare.

The Western North Carolina Children’s Hospital is very similar to OSF Children’s Hospital. The units in the PEDs and PICU had the same type of set in both hospitals.  The patient areas of both PEDs and PICU unit have private rooms and allows for enough for parent/family visitors. In this aspect both hospitals have the same type of set-up.  The Neonatal ICU located in Asheville holds up to 51 patients.  Compared to OSF this facility layout is similar to the older version of OSF’s NICU.  At the Asheville location the patient areas are separated by only privacy curtains.  With the new floor at OSF they created several pods that included up to 12 private patient rooms.  This was to better serve the families so that they could spend more time with their infant.  One problem with the open patient area is a patient privacy.  For example if an infant needs urgent care, other families could hear and see everything that is happening with the infant.  Other similarities is feeding prep, patient-staff rounding, flight staff, infection precautions, committees, criteria for gestational admissions, primary care nurse and transition process.  OSF follows the same type of protocol for imaging by having their own x-ray equipment to eliminate possible spreading of infections to the patients. I did notice some differences in between the units.  I noticed that the parents scrubs before entering the unit for 30 seconds and at OSF it two minutes.  I did think it was a great idea to have the sinks low enough for the moms in case they are in a wheel chair unlike OSF.  OSF is equiped to care for cardiac patient whereas the NC facility doesn’t. Medication errors one of the biggest problem in health care.  The NC facility has their staff wear a sash so that others knows to not disturb the nurse when they’re administering medications. Both hospital has similarities and differences and they are making changes to better serve their staff by incorporating family centered care.

Family centered care is applied by the NC facility by providing the family an opportunity to work with the health care team.  The team include the physician, nurse, PA, pharmacist and NNPs that meet in a room to discuss the plan of care with the patient families.  This allows the families to ask questions and offer their input. The families are also provide sleeping rooms and food trays for the families.

The Asheville and Cherokee facility each has their own unique environment that fits their community.  The Asheville facility is a larger city with multiple different cultures and the Cherokees is the complete opposite. The Cherokee hospital was semi quiet and a low flow of patient.  The Cherokee Indian Hospital’s design was unique to the culture and the languages on the sign signs throughout the hospital was Cherokee and English.  The signs at the Asheville hospital was English and Spanish.  Also the Asheville city had more business and much more traffic than the Cherokee.  The Cherokee area is more of relaxed and rural environment, which is the exact opposite of Asheville.

The thing that stood out the most is that in both cities the staff was very helpful and inspiring.  Also by visiting the Reuter Children’s Outpatient Clinic and the Cherokee they both have the same goal to make services available in one central location.

Bathroom cronicles

Look at what I saw in the bathroom at the winery!! 

Yay or Nay?  Why?

Blog 4

6/8/2016

I learned that the child-rearing practice in this culture is somewhat difficult.  The Native American didn’t have the capabilities to bond and manage stressful situations.  The culture does provide the children education that incorporates the Cherokee language and English.  The children are raised to understand the values of the culture.   

The elders are the individuals with the highest respect and authority in the culture.  The elders are the ones who educate the younger generation on the knowledge of the culture. The elders are the individual with the most wisdom on the Native American values and beliefs.

I was able to observe a young dad bringing in his son for an appointment. The dad stated that his son’s mother was home with the other child.  The dad was very attentive to his young son and was very expressive of his concerns with the child.  Another type was an elderly woman who came in with a friend for support. The elder woman expressed how she’d been caring for her grandson and that he kept her very busy.  The family structure I observed are similar to many other families.  More often are the grandparents are caring for their grandchildren.  This may occur if the parents are involved in dangerous lifestyles or they’re not willing to care for their children.   

The support system in the community is very different from what I’m familiar with.  The families of the community value family.  The members of the Tribe ensure that the Native American are financially equip to care for living expenses.  My group was informed that the healthcare services that the community members receives is free, subsidize housing, and stipends.

Blog 3

6/7/2016  

What a great first day!  The Cherokee Indian Hospital is a beautiful facility that is structured and filled with artifacts that represents the Native American culture.  The staff was amazing in providing us with information on the hospital and how they provide care to the members of the community. The healthcare system in this community is ran by the Native American tribe.  The tribe members sets the rules for who receives care and how the healthcare should be incorporated to their culture. I learned from one of the staff members that if a person fills that they have been treated poorly they can file a complaint to the Cherokee Agency for a review.

The members of the healthcare team consisted of the physician, physician assistant, RN case manager, LPN, CNA (case manager assistant), dietitian, behavioral health therapist, pharmacist, and nurse educator.  I was able to observe how all the members interacted with one another on the patient’s plan of care.  One example as the PA was writing orders for one of the patient she was able to communicate with the pharmacist on the medication to prescribe for the patient.

When the patients comes into the hospital for care they’re seen for their admitting problem and also the staff is able to pull up an alarm screen.  The alarm display allows the healthcare providers to see if the patients are due for mammograms, immunizations, or other things due.  The patient who’s able to be treated at the facility are only Native Americans.  The services that’s available to the patients are all free including medications.  The team is great with making sure that the patient are coming to their follow up all appointments.  I was able to see how the case manager would call other facilities to see if a patient came in for offsite referrals.

The similarities that I observed with the organization was teamwork, education, and effective patient centered care.  The healthcare team members worked great together by getting the patient information and collaborating with other team members. One of the patient who came in for their visited was given a number of things to do.  The patient was asked to stop taking specific medications, start new perceptions and follow up appoints.  After speaking with the patient on the changes the PA asked the patient to repeat back what she needed to do.  Some differences I saw time management, arranging referrals, and payments for services.  I witness how the PA was very eager in making sure that the patient received everything she needed before leaving the hospital.  I was amazed at how she spent the time outside of the patient room making calls and referrals.

The complementary and alternative therapies used by the facility is yoga, acupuncture, and massage.  The nurse case manager also mention that the facility would soon have chiropractic treatments.  I asked about what alternative medications or other alternative therapies are used by the community and was told that the patient aren’t willing to share if they are using other treatments.  The Native American uses yellow roots for sore throats (Village presentation).

Blog 2

Now that I’ve arrived at Cherokee, my first impression was that everything looked fresh and calming.  This is my first time to North Carolina and the environment that I’ve seen so far is nice and clean.  I love how the signs tells you which part of the city you’re entering.  The signs are all appropriate for the nature theme of the area.

What I found most interesting about the culture’s history is how the tribes where demanded to leave their territory.  This disrupted their normal lifestyles and took away important parts of their culture.  The tribes where then only given certain areas to keep and operate as the traditional Native Americans

The values and beliefs that I felt was similar to my own was the family staying with their elders throughout the hospice and death process.  In my family if there’s a family member ill or going through any problems, we all come together to support each other.  

The culture’s heritage is integrated into the children in the community by continuing to push them to follow the traditions of the Native American culture.  The Native American’s want the language and the traditions to pass on to generations after generations.

Some of the common threads in this community that is similar to my community is that there is a big drug, alcohol, and other negative lifestyles that impact the children of the community.  Also the hospital provides a number of different areas of healthcare for the members of the Native community. This ensures that the patients to receive the care they need at once.

To conclude today was a great learning experience through the tour of the Cherokee Indian hospital, the Museum of the Cherokee Indian, and the views of the community. 

Blog Day !

I’m most excited about personally observing another Native American culture.  This is a great opportunity to see how the health care professionals interact with the patients and how the patients receive the care.  Even though I’ve read about the culture differences with the culture, I’ll be able to ask questions.  Also by having the chance to interact with the staff and the patient will allow me to understand their perception.

The only thing that I have some slight anxiety about is offending the members of the culture.  I hope that I don’t say something that may ban me from the facilities.  I also feel confident that I have enough knowledge that respect is a key factor with the elderly. 

In a previous nursing class we watched a video on how the parents didn’t care for the children appropriately.  The parent abused alcohol and had major gambling addiction.  This affect the children because they were forced to be care by other family members and live in unhealthy living arrangements. This also affected the children’s attendance and performances at school. According to the West North Carolina Healthy Kids Network 33% of the children are overweight or obese. 

My thoughts about the native community is that they are determined to ensure that the native traditions are carried on for many generations.  The organizations include the patients as part owners of the facility, and also through youth outreach programs.  The Cherokee Nation organization provides services to the youth so they understand the importance of maintaining the Cherokee traditions.

I don’t I have any biases or prejudices that needs to be set aside about the culture.  I feel that this opportunity is to allow me to understand hoe the health care system works and how the members of the population utilize the resources offered.  I think that by understanding the culture and the limitations that might prevent them from maintaining their health is much more important than being bias.  I feel that the majority communities has issues that needs to be organized and we all play key roles in getting them changed.  

NUKA

Background

             The South-central Foundation is an Alaska Native-owed, nonprofit health care organization that is committed to serving the Native communities.  One of its biggest dedications was to provide the community with healthcare related services to improve the changes of it members. Beginning in 1984 until the present time the foundation has improved the services to the Native American healthcare system.  

NUKA Native American Healthcare Model

            NUKA is an Alaskan Native word used to describe the Native American Healthcare Model, which means strong, big structures and living things.  The model was design to provide holistic care to the patients.  The services under the program include prenatal care, substance abuse therapy, dentistry, educational program, PT, elderly programs and much more. 

           The NUKA model includes the customer-owner in the managing of their health.  The members of the healthcare team focuses on including the patient in the process, to create communication, and trusting relationships with the members of the community.