It is only six days until I embark on this new journey that I have been eagerly waiting for since January 2016. I will be traveling down to North Carolina with a group of ten exceptional women who have chosen to dedicate their time to strengthening their knowledge in the nursing care of pediatric patients. Additionally, we will be spending our week observing the healthcare practices, systems, cultural, and societal influences of the the Eastern Band of Cherokee Indians in Swain and Jackson County.

I am most excited to have the opportunity to deepen my knowledge in pediatric nursing. I first found my passion for this specialty in Fall of 2015. I was providing care to a two-month old infant and inexplainably, I finally felt at home. Nursing requires the ability to critically assess a patients current health status, anticipate future heath concerns, demonstrate the ability to perform safe and effective skills, provide thorough education, and exude compassion and empathy while trying to balance all of those responsibilities. I found when I was working with pediatric patients, that every aspect of holistic nursing seemed to "come together" and make sense. I am privileged to have the opportunity to deepen my knowledge and advance my skills in an area that I have felt called too and find so much meaning in. I am also very excited to learn about Native American culture and health care practices of the Cherokee people. I have always loved traveling and I have a strong desire to learn about the world and differing views. I hope to obtain knowledge about new health practices and contrast them with the "westernized medicine" I am accustomed too. I believe there is high value in opening your mind to news ways of life and it is an important trait for any healthcare professional to have.

While I have had limited exposure to the Native American health care practices, my instructor asked us to review a new healthcare system called the NUKA Model that is currently being implemented among our population. This model is innovative in the idea that it attempts to redesign primary care through creating a customer-owner based service industry healthcare system. Clients are seen as the "drivers of their health" and so primary physicians, nurses, and all other healthcare professionals, accommodate to the specific needs of that patient. In this system, a team of healthcare professionals is assigned to each patient. This team has a professional in each major area of health i.e. MD, RN, Physical therapist, Behavioral therapist, OB/GYN and so on. This aids in achieving one of the major goals of all healthcare entities; that is continuity of care. Since this system has been implemented in the Alaskan Native community they have seen a major decrease in the need for doctor visits, a more fluid movement of patient data between providers, and a greater overall patient satisfaction rate. I personally believe this is an amazing system. While this statistic is not specific to just the Eastern Band of Cherokee Indians, Jackson County performed a Community Health Assessment in 2011 that revealed a significant health disparity among their pediatric population. "In 2009, 26.3% of children under the age of 18 in Jackson County live below the Federal Poverty Line. This is 16.8% more children than overall in North Carolina in in 2009. Poverty can result in negative health consequences, such as increased risk of mortality, increased prevalence of medical conditions and disease incidence, depression, intimate partner violence, and poor health behaviors” (Lippard, A. 2011. pg. 32). This statistic alone reveals the lingering health risks that our population is susceptible to and residing on a reservation adds to these risks. I am interested to see if the NUKA health model will aid in resolving some, or potentially all, of these risks through having a consistent, available, and attentive healthcare team for all members of the community.

It is always important to self-reflect about potential biases or prejudices before entering a new culture and way of life. I truly do not feel as though I have any. As stated previously, I love learning about new cultures and different ways to live. I have already begun to contemplate how a healthcare system such as the NUKA model would work in my community. I believe the community in which I come from is very stagnant. We have a difficult time accepting and embracing change. However, there is much to be said about the progression of medicine, nursing, and healthcare, and I look forward to incorporating new concepts and cultural influences into my future practice.

Reference

Lippard, A. (2011). Jackson County Community Health Assessment. Retrieved from http://www.missionhealth.org/mydocuments/download.php?f=9069da_5e6a6d62dc694560c2ddffa0bdd63839.pdf