June 7/8

I thought today was very interesting and a total learning experience for me. I really didn’t know what to expect as it was very new and different. I didn’t know if going to the Cherokee Hospital would be welcoming of us students or would they block us out. Would they look at us like were aliens or would they open up about their way of doing stuff here at the hospital and what their culture entails in healthcare. Well thank goodness for open minded people because they were very welcoming. My experience was they were open to answering any questions I had, explaining how they do things here at the Cherokee Hospital, I got see firsthand how they handle certain cases (well the ones I was involved in of course) answered any questions I had about healthcare or their culture. The experience was amazing and I am so glad I got the opportunity to meet with the people I did. During my rotation I got to visit with a PA, LPN/graduated RN, Dr, dietician, nurses who work with the diabetes cases, Behavioral Health case manager, child specialist case manager, and CNA. I am blessed of what I saw and how they were open to speaking with me.

It was an amazing day but like I said I had learned a lot. Here on the Qualla Boundary,  there are not a bunch of ethic committees, hospital boards, or a bunch of hoops to jump through to determine who actually runs the healthcare system. There is one and only one group who makes all the decisions for the hospital and that is the tribe leaders. They vote on things that are needed for the hospital or situations that need taken care of and that is that. There are several members of the healthcare team like other healthcare teams but what makes Cherokee Hospital different from others is the team work they have and it shows. I saw firsthand of how well this team works together and all I can say is WOW! It is amazing what they do for the pt/customer and how well they get things done together. What is neat is that this hospital holds everyone from the pharmacist to case manager to radiology to dental visits. A pt/customer needs help or needs something/to be seen and they work it out for the pt/customers benefit and how quickly it gets figured out is amazing as well. During a checkup, the PA saw that a pt/customer was due for a mammogram and dental checkup so the PA and nurse made arrangements for the pt/customer right then and there. It was so cool and I hope our healthcare system follows in the same footsteps.

Some of the similarities and difference I noticed besides the excellent team work and the healthcare model is behavioral health. It’s something that is handled well here for the fact that there is a need for help and they recognize that. It’s a big issue and here they get help for the pt/customer. Programs have been around for a while unlike back home where it’s starting to show that there is a need for help and more programs. Another thing I noticed is the amount of work this team puts into helping and preventing measures for the pt/customer unlike back home. Here everyone is on the same page about things but back home you have numerous doctors and ideas and tons of meds for one pt. I thought it was it was interesting how in the same office is a pharmacist. The pharmacist goes beyond what I am used to. Here they don’t just prescribe meds they work with the pt/customer and really focus on the meds and treatment they need to make sure they are actually needed to get better. I also thought it was interesting how people here are just as stubborn about getting their annual vaccines as people back home but it is not common at all for parents to not immunize their children.  They also have and give the same meds we do back home for treatment. There are however different forms of medicines practiced in this culture. There is acupuncture and yoga and remedies like yaloroot for sore throats. I’m sure there are a ton more but unfortunately those are kept sacred for that culture only. They won’t share or talk about it and I don’t blame them. Childbearing practices for the Cherokee culture are family centered. The mother and most likely the grandmother are the main caretakers of the children but overall the family consistently takes care of the children. It really is true that it takes a village to raise a child because this culture does prove that. Now there are instances where it’s not always perfect and there are challenges for families and children being raised. What I thought was interesting though is that if there is an adoption to be done a child can only being adopted by someone else of the tribe, no one else. Children can be fostered by outsiders but never adopted.

In this culture you hear a lot about who is highly respected and who has authority. The elders in general are all highly respected and have the highest authority than anyone else in the culture community. Women are highly respected because they run the home, grandmothers are highly respected because they are the caretakers/overseers for everyone in the family because they are full of wisdom and life experience. To make any kind of big decisions is done by the grandmother as well for the very same reason as listed above. For major things, the tribal council has the final say. I observed or heard of both the mother of bringing in the children to the office, the father bringing in the children, and the grandmother caring for the children. There are all sorts of family structures in this community from mom and dad family, unmarried couples family, single parents family, grandparents acting as parents family, foster parents, adoptive parents, or grandma/grandpa/mom/dad as a family unit.

Resilience in children I would think is a tough subject. The actual word means the ability to recover quickly from difficulties. Children have proven to be able to recover more quickly than adults. I do believe that. But it is different for every child and situation. There are times where a child goes through a difficult time and come out stronger than ever from the situation. I believe they just have this ability in already built into their DNA to survive and strive for better. Other children don’t have the structure to achieve greatness and have a harder time throughout life. Some children make it because they are saved and have a great support system and have someone to believe in them, give them faith and hope that they can do it. Some children are saved but if they don’t constantly have the help and support to get passed issues then they will have a hard time as well. Overall, I believe children are very vulnerable to life and each situation is different for every single child. Just because one kid makes it through a tough time doesn’t mean another kid would have the same outcome. And that’s what makes it hard for the future generations because of past issues and it isn’t just the Cherokee culture, it’s all children all over the world. I really believe DNA has a lot to do with resilience but so does having a consistent and nurturing support system throughout life not just as a child.