Monday, June 6, 2016

Day One at Cherokee



            Today we visited Cherokee Indian Hospital for orientation. We met up with our Nurse Educator, Kayla, who gave us a tour of the hospital. Following the hospital, we went to the Cherokee Museum, and met up with Jerry Wolfe, who shared with us some Cherokee history and traditional stories about animals found in the area.  Two were about how the chipmunk got his stripes and the Opossum his ugly tail. He was also a World War II veteran. Today is the anniversary of D-day and he described his experience that day. It was incredibly humbling that this highly respected elder took the time to share with our group. 
            Cherokee hospital was built to reflect the culture and beliefs of the Cherokee community. The Cherokee value nature, which was reflected in the construction throughout the hospital. Our contact Kayla told us that when designing the hospital, the team met with tribal elders to get their input about what they wanted included as far as services offered in the hospital and design. The client’s rooms and all of the hallways in the building had large windows to view the mountains. I’ll include a photo below looking out of the window. Even in their main lobby, the floor was the pattern of a river with animal tracks and fish. There were live trees and plants inside, the beams were made to resemble trees, and traditional symbols were incorporated throughout. There was a beautiful water-spider mosaic on the floor, which linked back to a traditional Cherokee story about the origin of fire.  
            Cherokee members value family and community being near when an individual is sick or in poor health. The rooms were constructed to be big enough to have pull-out beds and adequate space for multiple family members at all times. They also have hospice rooms which have the same size room as a normal in-patient, but in addition have a door to an adjoining room just for family and friends. These include a kitchenette area as well to make the families stay comfortable. There is a small booth-like area that the nurse sits in so she can view both sides, but still give privacy. Picture included below. The hospital also offered multiple services in one location: physical therapy, in-patient, and dental are some examples. Having these areas in one central location helps increase access to care and the likelihood that client’s will follow-up. 
            Something Kayla told us that I found interesting and challenging to process is that Cherokee hospital states the right to discriminate because they are a sovereign nation. Cherokee hospital hires non-members to staff the hospital. She shared that even if you have been at the hospital longer or have more experience, a Cherokee member with less experience can be hired over you for promotion positions. Another really interesting tid-bit we learned was that Cherokee does genetic blood testing to determine the percent of Cherokee a child is in the the first few days after birth. If the individual meets the certain percent of Cherokee, they can get full benefits and treatment at the hospital and clinics for free. If they do not meet that percent, they do not qualify and are known as non-beneficiaries. 
            A big take-away today for me was that the Cherokee are proud of their culture. A frequent theme I heard throughout the day was their desire to preserve it and pass their traditions onto the next generation. Something I thought was interesting about Cherokee history was that the Eastern Band of Cherokee is actually made up of tribal members who refused to go on the Trail of Tears, and instead hid in the mountains. Later, they had to buy the land back that their tribe originally was driven off of. 

            One of the values I learned about today was that women traditionally were respected in their culture; it was a Matriarch society. Women worked the fields, choose their spouses, and owned their land. Women and Elders are highly respected and are active in leadership. Their tradition of strong women reminded me of my own family, which is made up mostly of women who are leaders. The Cherokee highly value their elders, which is reflected in their care. Our contact Kayla said that when an Elder becomes sick, family members take over care. Businesses often give the family members time off in order to care for their elders. In my culture at large, this is different. Elders are often mistreated. Our elderly are often placed in nursing homes to be cared for rather than the home by family members. Although the nursing home staff may be wonderful caregivers, their patient to staffing ratios do not always enable them to give the best possible care. When my mother can no longer live on her own, I hope that my sisters and I can care for her. I wish that my culture had this level of respect for our older adults. A value I thought was interesting was their belief in a mind-body-spirit healing. They discussed how drug and alcohol abuse is common in the area, and that it relates back to historical trauma. Kayla said that their focus of care is that they must treat the mental health issues (ex. Coping, drug abuse), before focusing solely on treating their physical health problem (ex. Diabetes). She related it back that poor coping mechanisms, such as overeating or eating unhealthy foods, can lead to developing chronic health issues of diabetes later. This was a fascinating approach. 
            A way that Cherokee try to pass their culture on to children are through teaching them their tribes history, stories, and language. Today, Kayla informed our group that there is a program that teaches Cherokee children the traditional language. Parents whose children are enrolled in this program must sign a contract agreeing only to speak the Cherokee language to the child as well. Despite the emphasis on preservation, the Cherokee are not necessary isolated. Many of the children we saw today were wearing t-shirts depicting popular children cartoon shows. Cherokee also has many shops and attractions for tourists. A big portion of the tribe’s revenue came from the Casino. I spoke to three different tourists who said they planned on visiting the casino. The boundary is located near the larger city of Asheville as well, so the children are exposed to the broader United States culture. 
            My favorite part of the day was getting the opportunity to learn more about the Cherokee culture through stories by Jerry Wolfe and the Cherokee Museum. Tomorrow is our first observation day at the Cherokee hospital. Check out some photos below!

 This image is of the Cherokee hospital. Nature was represented throughout.
 Here is an image of the scene looking out of a client's room at Cherokee.
 A typical in-patient bed at Cherokee.
 This is the "nursing-booth' in the hospice rooms. This booth has windows into the conjoined room for the family and the patient's room.
 The Cherokee Indian Museum 
 Fellow student Caity and I pose by a painted bear. These painted bears are located throughout Cherokee, each representing aspects of Cherokee culture.
 A delicious meal fellow students and instructor Niki made for us at the cabin tonight.
 We woke up in the mountains! Our groups view looking at from our deck at the cabin. It was fairly dark when we arrived, so we had no idea how beautiful the view was.
This was the river mosaic on the floor at the hospital. It included animal prints, stones, and fish.

10 comments:

  1. Deanna,
    I also found it difficult to process the Cherokee's right to discriminate. It is such a bizarre concept because we have grown in a culture that does not accept discrimination. I wrote in my blog about how after thinking about this for some time, while I would not choose this, I can understand the purpose in decision. We've learned that the Eastern Band of Cherokee's purpose is to promote the health and growth of their people and in doing so, this requires them to place members at a higher priority than non-members. It is strange to me but definitely eye opening. Good job!

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    1. This is also how I felt initially- yet non Cherokee are very happy to work there and be part of this type of health care model. What is it that keeps them despite this? What is the advantage of having more Cherokee vs. non Cherokee employees? I wonder what the break down of numbers are for this?

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    2. Lisa,
      From what I've heard staff say, it's the model of care implemented at Cherokee that they really enjoy. The NUKA model is very attractive!

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  2. Deanna, great entry!I love how you included the layout of the hospital and how it complements the Cherokee. I thought that the hospital features captured the Native American way of living. The culture is big on incorporating the natural environment into their everyday lifestyle. I also feel that it is wonderful that the Native Americans are providing the younger generation with resources to help keep the tradition going. Great post thanks for sharing your photos!

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  3. Deanna, great entry!I love how you included the layout of the hospital and how it complements the Cherokee. I thought that the hospital features captured the Native American way of living. The culture is big on incorporating the natural environment into their everyday lifestyle. I also feel that it is wonderful that the Native Americans are providing the younger generation with resources to help keep the tradition going. Great post thanks for sharing your photos!

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  4. Deanna, great entry!I love how you included the layout of the hospital and how it complements the Cherokee. I thought that the hospital features captured the Native American way of living. The culture is big on incorporating the natural environment into their everyday lifestyle. I also feel that it is wonderful that the Native Americans are providing the younger generation with resources to help keep the tradition going. Great post thanks for sharing your photos!

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  5. Deanna,
    I found it interesting to learn about the womens role in the tribe. The more I learned was that the women are highly respected and looked to for advice. I also found it interesting there were not similar gender stereotypes as in our culture. Men and women were expected to know how to do everything in the tribe whether it was hunting, cooking or child rearing. I think their society was ahead of its time.

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    1. Yes, I found this very interesting too. I wonder if that continues to be present in their culture? From the sounds of it, many of the males struggle. Why do you think that may be?

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  7. Deanna,
    I too enjoyed the story telling the most. Mr. Wolf is very respected and you could tell he was glad to share his unique history with us. How ironic that it was D day anniversary and he was able to paint a picture of this event as well.

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