Thinking that I am leaving in less than 24 hours on this little journey to North Carolina is exciting and makes me a little anxious because I am unsure of what is to come in the next week.  I am leaving my family for a week, something I have never done. I think I am more scared about it than they are. J

But I will not lie I am very excited to go on this trip, I think it will be fun and educational.  I am also curious to learn more about the Cherokee and their culture. It will be interesting to tour the hospital first and then go to the museums before starting clinical rotations. It will allow us to get a better understanding of their hospital and what it is trying to accomplish for their communities overall heath.  I want to learn and try to understand their delivery of healthcare. The Nuka model has a unique and very different focus than the traditional Western model we are accustom too.

I am nervous about starting clinical observations because it is in a different environment than what I am used. I am concerned that I may say or do the wrong thing. The last thing I would want to do is offend anyone. It is comforting to know I will be with two other classmates.  But I am also very excited to get to see a variety of patients in different age groups. It’s been about 6 months since being in my Peds/Ob clinical rotation so it will be nice to get some interaction with that patient population.

According to the US Census in 2014 the median income in the counties surrounding Cherokee is $21,658 to 37,878 is considerably lower than the national average of $53,657. Living in poverty has a negative effect on the entire family especially children because there is an increased risk of mortality, medical conditions, depression, abuse and violence within the family. These make the children on the reservation and in the surrounding counties more susceptible to adverse situations including neglect, abuse, poor nutrition and a lack of access to health care. The Eastern Band of Cherokee Indians, Public Health & Human Services is making strides to combat this problem with programs like Safe Babies Program for maltreated infants & toddlers. The program works to protect and prevent trauma to the children in the tribe. They focus on educating the parents and provide mentors to guide and develop positive parenting skills. There are foster care programs to help the children while the parents are working on getting better established. When researching foster care 70% of Native American children are initially placed with relatives compared to 35% for other races.  This tells me the importance of family and community in the Native American people.

I have never had personal interactions with Native Americans but I am eager to get the opportunity to have this interaction. I do not feel I have any preconceived notions or bias towards this population other than limited knowledge. Documentaries we watched in previous classes highlighted the lack of revenue besides casinos and tourisms. That type of environment lead to poor lifestyle choices such as alcohol and drug abuse. I am curious to see how widespread that problem is and its effects on the community.  I am however impressed by their strong connection to their heritage and cultural traditions and ceremonies.  I think they may still be leery of outsiders because of their history after the United States was colonized. I think this is an understandable reaction. I will not let this affect my experience because I am more interested in learning about them and how I can use that information as a nurse in practice.

Reference

Jordan Institutes of Family. (2015). Management assistance for child welfare, work first, and food & nutrition services in North Carolina. Retrieved from: http://ssw.unc.edu/ma/

Public Health & Human Services. (2016). Family safety. Retrieved from: http://www.cherokee-hmd.com/family-safety/index.html

U.S. Census Bureau (2015, December). Median household income of the total population by county: 2014. Retrieved from: http://www.census.gov/did/www/saipe/data/highlights/files/2014/F1_MP_14.pdf