Today we received a tour of the Mission Hospital in Asheville and the Pediatric Outpatient Mission Clinic. The Mission Hospital differed greatly from the Cherokee Indian Hospital in many ways. The Mission Hospital is way bigger than the Cherokee Hospital we were originally at. Mission Hospital had a pediatric ICU, pediatric step down, a regular pediatric floor, and a NICU, this differs greatly from the Cherokee Hospital because they do not even have a specific pediatric unit, just an outpatient clinic. Also, the hospital has an ethics comity unlike the Cherokee hospital where the Tribe has the final say in cares and decision making. Another difference in the culture sensitivity. At Cherokee, they allow as many family members in a room that can safely fit, at Mission, they have a restriction on the number of family members, no mater what the culture. In the Pediatric ICU, they only allow 2 family members in at a time and in the NICU, they only allow two people in at a time, that have to be accompanied by one of the child's parents, unless it is a grandparent. Another difference that I notice is the way the hospital is decorated. At Mission, they have the hallways decorated in way that kids would enjoy and they have fun names for each of the hallways such as "humming bird way". At Cherokee, they decorate the hospital in regards to the culture and nature to help the Natives feel more comfortable. Each hospital is accommodating to each communities needs and culture the best they can, and since the cultures differ, it makes sense that they have different aspects incorporated into the care. In the hospital, children tend to regress and the family is under a lot of emotional distress. In order to accommodate the needs of the child and the family, they have pull out beds in the Pediatric units and in NICU they have a designated sleeping area from families whose children are patients there. Also, the Pediatric unit has rooms to do any painful or invasive procedures on the children so that children will always feel as safe as possible in their room. Also in order to help the children, they have child life services that help children cope and understand procedures so that they are not as stressful as possible. The environment in Asheville is a lot more fast paced than the environment in Cherokee. Asheville has a lot more traffic, tourist and things are more expensive I noticed. In Cherokee the town is more laid back and friendly. Asheville seemed to be less concerned with being polite to others as in Cherokee people will stop and talk to you. Other than that, they both have the same beautiful mountain view, the only difference in Asheville is a bigger town were Cherokee is rural and has less buildings and traffic. What stood out most to me today was the NICU. The NICU nurses were amazing. The were so informative and willing to share stories and let us experience everything we could while we were on tour. The NICU nurses also gave us great advice that will stick with me all through out my career. The best advice one of the nurses told us is that once you stop crying in your car after work, or in the shower, or to a loved one is when you have stopped caring and its time to move on to a different unit because one of the most important parts of nursing is compassion and you have to care to have compassion.