Nursing Education in Indian Country: Salish Kootenai College offers a growing nursing program for the Flathead Reservation

Nov 15th, 1991 | By | Category: 3-3: Math, Science and Medicine, Features
By Jacque Dolberry
TWO NURSING STUDENTS

Students Paul Begay (left) and Marion Shield practice taking blood pressures

Salish Kootenai College, on the Flathead Reservation in western Montana, is successfully preparing Indian regis­tered nurses to provide health care to the Indian popula­tion of Montana and the northwest mountain states. Students graduate with an associate of science degree in nursing and are eligible to take the licensing exam for registered nurses.

In the three years since admitting the first class of students in 1989, the number of Indian students enrolled in nursing classes has increased from four to twenty. Total enrollment of Indian students in first and second year nursing classes at Salish Kootenai College is 43 percent compared to one per­cent in nursing schools nationally. Twenty-six Indian students are taking pre-nursing classes on the Salish Kootenai College campus. Approximately 25 are completing prerequisite course work at other tribal colleges.

The nursing student body represents all seven Montana reservations. While the typical student is a single parent, the number of males, grandmothers and young adults is rising. Qualified licensed practical nurses may challenge selected course work and be admitted to the nursing program with advanced standing.

A unique recruitment and retention program reflects the academic, personal and socio-cultural needs of Indian students and their families. The Nursing Department philosophy and curriculum incorporates Indian and western beliefs about the person, environment and health. Students are encouraged to maintain and strengthen tribal identity and traditions. This program differs from most traditional nursing programs in the United States where few allowances are made for the needs of students, and patients, from different cultures.

At Salish Kootenai College, faculty and students form a partnership to meet the educational outcomes of the curriculum and each student is assessed carefully before developing a curriculum plan. Students must be well prepared in science, mathematics, reading and English skills. Since many students have not attended school recently, or did not take high school science or math, they may require at least a year of specially designed courses to improve their skills in these areas. While improving basic academic and study skills, general education requirements may be taken concurrently. The college’s academic skills lab and science classes provide students with the background to successfully complete college chemistry, physiology and microbiology. An elective long-term care/home health aide class, open to pre-nursing stu­dents, gives students a jump start on nursing and job skills.

Because of small class size, attention can be directed toward a variety of student learning styles. Five master’s degree nurs­ing faculty and a lab resource coordinator tailor teaching strategies for the individual and for small groups. Students develop critical thinking skills working in the audio-visual lab using videos, audio tapes and simulations on computer soft­ware. The college practice lab replicates hospital rooms so that the students can demonstrate proficiency in nursing skills prior to caring for clients in the hospital.

Clinical practicum begins in the first quarter of the nurs­ing program. Clinical labs are scheduled days and evenings. Reservation clinical sites include the tribal health center, long-term care, day care and elder care centers, physician’s offices and clinics. This introduction to the “cul­ture of nursing” requires a heavy work load, travel and an abili­ty to juggle the demands of school and family. Students travel to the towns of Kalispell and Missoula 65 miles away to care for clients in the hospital. This responsibility necessitates travel two times per week, usually with an overnight stay. Students stay in motels or with relatives and friends.

A favorite on-campus activity occurs each spring quarter at the Health Fair when some 200 members of the college stu­dent body and staff receive health screening and wellness information from nursing students.

From these experiences, nursing students and families expe­rience profound changes in their lives. However, the support network at Salish Kootenai College is unique among nursing programs. Integral to the recruitment retention model are the nurse recruiter, the mentor, and the peer mentors. In written comments from students completing their first quarter of nurs­ing, many spoke highly of the instruction and personal atten­tion offered at the college.

“The college is more on a one-to-one basis…. When I first came here, I didn’t know anybody…but everyone chipped in and helped me, and it has been that way ever since,” said one. Added another: “My family said, ‘If you’ve just got two more years, then why don’t you just go do it?’ I didn’t want to go to a university because I was scared of failing and the classes are so large there. They don’t know if you are coming or going…. Here, in this program, they take the time to see if you are in class. They take the time to help you and understand your problems and help you through. They’re not here to fail you; they want you to get your degree. It’s not easy but it made me try even harder.”

Other students praised the emphasis on traditional culture. “They offer a lot of cultural things and that’s what I think I really like about it. At other places I haven’t been able to drum or sing or Indian dance. So I think the college really helps you keep your culture.”

As graduates, the nurses serve as role models for their fami­lies, communities and other health professionals. A number of Indian registered nurses from Salish Kootenai College are working for the Indian Health Service, facilities serving Indian populations or are attending four-year colleges, pursu­ing bachelor’s degrees in nursing.

Funding for the college’s recruitment/retention model has been provided by grants from the W.K. Kellogg Foundation, the American Association of Junior and Community Colleges/Metropolitan Life Insurance Company, the Indian Health Service, the Office of Indian Vocational Education and the Tribal Controlled Community College Assistance Act.

Salish Kootenai College invites Indian pre-nursing stu­dents and nursing educators to the Second Annual National Indian Nursing Student Conference from April 2-5, 1992 on the college campus. The conference is sponsored in conjunc­tion with the Indian Health Service. Workshops for students include career opportunities in the nursing profession as well as advice on preparing for and surviving nursing school. Nursing educators will be introduced to recruitment. Keynote speakers will address the role of Indian nurse leadership in health care delivery. For more information, contact the Nursing Department, Salish Kootenai College, Box 117, Pablo, MT 59855, (406) 675-4800.

Jacque Dolberry is the director of nursing at Salish Kootenai College. She is a registered nurse with an M.S. degree in nursing from the University of Arizona and a D.S. degree in nursing from Arizona State University.

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