By Megan M. Krischke, contributor
University of Washington School of Nursing students have the unique opportunity to complete a community health rotation on one of two Native American reservations on Washington’s Kitsap Peninsula—the only rural public health clinical offered by the school of nursing.
The experience has not only helped students learn about a unique group of people, but also how to relate to any patient population in future community health work.
Recently, teams of student nurses were assigned to the Fort Gamble S’klallam reservation and to the Suquamish reservation, focusing on four different projects.
One group of students partnered with family services personnel in an obesity prevention program mirroring TV’s “The Biggest Loser,” in which the person who lost the most weight won a car. Other students developed a nutrition program for an early childhood development center.
A third group was involved in educating the staff of an early childhood development center about the prevention of Hepatitis B infections. The remaining group conducted and transcribed interviews with individuals for a community assessment. The goal of the assessment was to understand the community’s perception of its strengths and problem issues and to discover which issues were most important to the community.
Donna Neagle, a senior in the UW nursing program, was part of the team that conducted the community assessment.
“We worked within the Suquamish tribe on the Kitsap Peninsula and also with the surrounding community. We interviewed people about health care, education and the environment. We also asked both communities, tribal and non-tribal, about their feelings toward the other community,” Neagle said.
“The most important thing we learned was that you can’t come in with your own agenda,” she reported. “You have to come in as a learner and then help the community see what its strengths are and how to reach the goals that they think are important.”
“The Suquamish community seemed to have goals of improving health and education and greening their community,” Neagle continued. “The Native community puts a lot of value on their elders and the elders showed excitement about what the younger generation might do with their lives.”
“We have been conducting clinical rotations on the reservations for about ten years now,” said Robin Evans-Agnew RN, MN, who was overseeing the rotation. “A large part of this experience is to learn about protocol and indigenous methodologies.”
One way the class honored Native protocols was by having each student assemble a craft during the semester. The group then did a “giveaway,” a traditional gift giving ceremony, during which they presented the crafts to the community to show their appreciation for allowing the students to be on the reservation and for taking the time to talk with them.
“It is so different from what we are used to—the focusing on giving care to one person at a time,” commented Andrew Mason, student nurse, in a video the group made about their experience. “Instead, you are focusing on everyone, the whole community. It has been really powerful for me to see how much of a difference you can make if you are patient. “
“I hope that they are able to take away an image of nursing that doesn’t involve a hospital bed but rather an opportunity to engage in deep relationships with people in a way that is not clinically bound,” remarked Evans-Agnew about his goals for the clinical.
“You are invited into someone else’s home, you are on the reservation and you are a guest there and that is different than taking care of someone who is in a clinic or hospital,” he explained. “You have to have a different way of relating. You aren’t in power. It is work of deep humility.”
The video the students made about their experience can be viewed online.
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