June 7th and 8th

Yesterday at the Cherokee Indian Hospital we observed their health care system, patient care, and their culture. I had two rotations yesterday my first rotation was on inpatient and my second rotation was on prenatal. On my rotations, I had a couple of amazing experiences that will stick with my through the rest of my nursing career. Although these situations were difficult and challenging to work with and not be bias or judgemental, they taught me a many lessons about life and they prepared me for what is to come in my nursing career. Although these situations were extremely emotional, I am grateful for these experiences because I learned that even if I do not agree with a situation I still have to support the family and provide proper care and safety for patient in the best way I possibly can.
The health care system at the Cherokee Indian Hospital is ran by the Tribe, the Tribe makes the ultimate decisions about what the best practice and decision is. The heath care system at Cherokee works together in a way I have never seen before. They hold rounds in the morning before the start their day. In their rounds, the Doctor runs it and then someone from every interdisciplinary practice is represented. At the round I was at, there was a doctor, social worker, CNA, charge nurse, nurse manager, physical therapy, nutritionist, and infectious disease doctor. All of the disciplines put in their input and talked about the care of the patients. They all communicated with respect to eachothers views and opinions and were very open to discussing problems, questions, and helping solve any issues they had. The health care system does not turn away anyone that comes into the ER but they will not admit Non-Native, instead they transport them to another hospital. If the individual is a Native, they will receive all primary cares at the Cherokee hospital and can be admitted and kept as a patient. The way the Cherokee Hospital operates is different than anything I have ever seen. Back home, we try to focus on holistic care and whats best for the patient, but at Cherokee, the focus on holistic care in a whole different way. They meet all needs for the family and do thing we can not do in hospitals because they are run by the Tribe and not the state. Another difference is at home, we focus on how fast we can get patients out and make sure they do not return in the next 30 days, here they focus on getting them better and helping keep them better as a life long process. When I asked the Natives about the complementary medicines they use, they would not tell me besides that they use herbal methods. Other complementary medicine ways they use are touch, acupuncture, massage, and other ways. Also for the children teething they use Yellow Root necklaces because they help dry secretions so that they do not drool as much.
Childbearing practices at the Cherokee are free. When I was in the prenatal rotation, I was able to observe the care they received. The patient that I observed receiving prenatal care, received about the same care we did at home but they asked the moms if they had a tribe card. The mothers that go to Cherokee hospital only receive two ultra sounds unless they are in a high risk pregnancy and at home the mother receives at least three ultrasounds. Another difference in prenatal care is that the hospital provides prenatal and post care but they will prefer not to do births at the hospital in Ashville. They prefer the mothers deliver in Ashville because substance abuse is so common around here, many babies are born with addictions. In the community, the elders are the most respected individuals. This is because in the Cherokee culture, the elders are highly respected and they have the final say because they have the most life experience. I observed many different family structures today. There were nuclear families, blended families, and single mothers. From what I observed in the prenatal, woman have many children. The least amount of children of the mothers was 4 and the most was 7. To me this was different because back home the biggest families I am used to seeing are 4-5 children. In the community, the support system seems to be the elders, family members, and the healthcare system. The health care system at Cherokee Hospital provides many opportunities of support for the individuals such as AA meeting, social work, and then information on other services there are. Family is a huge part of the Cherokee culture, therefore their main support system in their family and relatives. When  talking about resilience in relationship to children and family, children fight and heal so rapidly. Children above all others have the most resilience, they heal quickly and recover from stress by being optimistic and changing how they think about challenges and adversities ("I Am Safe and Secure: Promoting Resilience in Young Children | National Association for the Education of Young Children | NAEYC", 2016). Another reason for resilience in children is their ability to adapt and survive through everything. 


References

Health Department, Child Health Programs. (2016). Swaincountync.gov. Retrieved 4 June 2016, from http://www.swaincountync.gov/health-child-health.html