Yesterday was our last day at the Cherokee Indian boundary and today is our last in North Carolina. It is impossible to encompass in this blog all that I have learned while on this trip. I have not been “lectured” about the Cherokee Indian culture nor about advanced pediatric care; I have had the opportunity to experience it all firsthand. Starting from our first day at Cherokee Indian Hospital I have been so amazed at the generosity that this culture exemplifies. The Cherokee culture is made of a very tight-knit community where they protect and care for one another. The generosity that the community shows to each other can be seen through the “per capita” system the tribe uses, free healthcare, free education, and the years of hard work members have done to progress and keep alive the Native American Indian beliefs and values. Their generosity extends past their community however. The CIH was willing to allow us eleven outsiders to step into their world and be observers of their practices and way of life. Not only this, but many of the people we worked with went out of their way to make this a wonderful experience. For example, one of the most highly respected ER nurses Victoria spent lunch with us and educated us about Native American culture, pertinent issues that the community is still having, and ways to advance our nursing careers. One of the things Victoria told us that I will always remember was to always advocate for ourselves. She explained that as nurses, you must be able to stand up not only for your patients, but for yourself as well and if we learned how to do that, we could succeed in becoming great nurses. Victoria wanted us to have such a great experience that she set up a surprise for us students yesterday. We were taken to what is referred to as the Kituwah. The Kituwah is a plot of land that the Cherokees had to repurchase from the government I believe roughly twenty or so years ago. What is special about Kituwah is that the mound in the middle of the farmland is where the Cherokees believe the first Cherokee Indian was created and placed on this Earth by God. I felt so honored to be taken to such a sacred place of the Cherokee people. It showed me the desire that the Cherokee people have for the world to learn about who they are and though I had felt welcome prior to this experience, it made me feel as though we had formed a friendship between our two groups. 

While I have been here I believe I have contributed to improving the health of others by immersing myself in the historical experiences of the Cherokee, assessing their unique health system and analyzing its application to my culture, and grasping the foundations of Cherokee culture and reflecting on how it will affect my nursing care with a Native American patient. Beginning from the time of the first settlers, the Cherokee have experienced suffering and degradation unimaginable to most. Deprived of their land, separated from their families, and forced to assimilate to a system of values and beliefs not of their own, the Cherokee people struggle with this historical trauma to this day. This has inadvertently affected both the mental and physical health throughout the community. What I am able to take from all of this is a deeper compassion for those patients whose ancestral roots are attached to mass suffering. When working with patients such as the Cherokees, I can be more sensitive and exude a deeper and more genuine compassion for the health alterations they experience because I have greater understanding of where their mental, spiritual, social, or even physical illnesses began. 

Despite the historical trauma this incredible community has experienced, they have flourished in the midst of it. Regardless of the opposition they initially encountered, the tribe made the decision to build a casino on the boundary in order to become sole regulators. This allowed them to also be responsible for the entire healthcare system. Since then, the community created a health care system in likeness of the NUKA health care model and it has increased the health of their community in terms of both primary preventative and tertiary care. Patients are now the center of focus and the health care team is dedicated to providing care in a systematic holistic manner. Additionally, now that the community has become self-sufficient they have created health care programs, schools, museums, and tourist sites that honor and keep their culture alive. These new programs are so critical to the Cherokee people because they will ensure the continuation of their heritage by improving the health, education, and pride/self-esteem for all members. 

While reflecting about the different experiences I have had throughout the week, there were many that took me out of my comfort zone. My first day at the primary care clinic was like stepping into a new world. I am not use to a healthcare facility that isn’t fast paced, task oriented, and individual in their approach to delivering care. When observing the employees at CIH, it really took time to wrap my head around how the interdisciplinary collaboration that I was seeing and how it was so effective to providing quality patient care. Another instance where I found myself out of my comfort zone was when we visited with a certified healing touch RN. This nurse taught us all about a new approach to pain management literally called “healing touch”. She showed us different ways to feel energy, re-balance your “chakra” (which are circles of energy surrounding the body), meditation, and how some healthcare professionals believe that just by moving your hands over a patient’s body in certain ways, they can decrease their pain levels. Though I am uncertain as to whether this practice is completely valid, I do believe there is power in touch and I am thankful I stepped out of my comfort zone to try a new experience. 

I cannot believe the end to this trip has come so soon. Though I am eager to see those whom I have missed, I know this has been a once in a lifetime opportunity that has impacted me in ways beyond what I anticipated. My beliefs on health care practices have been challenged while here at Cherokee. I have now seen how a health care system that has been designed based on the patient and culture, rather than incorporating the patient and culture into an already present health care system. I have seen how different disciplines of health care can in fact work together in a respectful and efficient manner. I have seen now how all of this has created better patient outcomes and prospered a once impoverished community. My cultural values have been impacted while here as well. I have experienced different health, social, and spiritual culturally related beliefs while in Cherokee. Though my beliefs and values are deep rooted, the broader understanding I have now of the Cherokee people will only serve my patients better as a future nurse, and myself better as a person in this world. When looking back at my first blog and seeing what my aspirations where from coming to North Carolina, I have accomplished all that I wished too from this trip and I could not be more thankful. 

Below are pictures throughout this journey and the wonderful times we had together <3

Kayla and Victoria of Cherokee Indian Hospital: Tributes to the community.

 Replica of a traditional Cherokee Council House

                                                

       Deanna and I's engagement photo at the Biltmore Estate!

 Tour of the Indian Village


















                Depiction of Jerry Wolfe: Named most Beloved Man

 Kituwah: This is the mound where the first Cherokee was place on Earth by the Creator

        My wonderful instructor and I!

 Friends!!

              Mission Children's Hospital

 Beautiful mornings

                                                                                                                        NICU



                                                                                                    

 Amphitheater where we watched "Unto These Hills": a depiction of the historical events of the Cherokee people












                                                                 
                                                                      Just being silly

Morning runs in the mountains <3

   Lunch at the Sassy Sunflower

 Traditional Cherokee sculpture

















                           Never forget.... "It Belongs to You"