What's crazy is there are things that I am still processing from this trip. Having a first-person perspective on the way of living down in the Appalachia area makes me think a lot about how I will use what I've learned in my future. One of the things I at least did while I was down there was simply talk to some of the people at Open Door Ministries. Like I said in my previous post, a lot of visitors there were struggling with issues in mental health, and just having someone there that will listen made them feel so much better about everything they had going on.
Looking at this trip through a different lens reveals a different perspective of what my personal impact on those communities was while on the trip. I highly believe that immersing myself in the Cherokee culture, meeting new people in the Appalachia communities, and continuously learning about the Northwestern Carolina areas will positively change how I treat patients from other cultures from now on, therefore hopefully improving the health of those patients. Currently, I feel that what needs to change in that area is the amount of psychological health available because of the high number of individuals that struggle with a mental illness and just need that basic psychological help on top of the physiological help. To help make this change in rural communities, I will continue to take the opportunity to learn more about rural cultures and find ways that I can contribute my nursing knowledge to these areas that have lack of access to healthcare.
Monday, June 10, 2019
Friday, June 7, 2019
Day 7: Open Door Ministries
For our last full day we have here in the Appalachia area, we spent a good portion of our day at Open Door Ministries, which is an organization that with community involvement and support, they are able to feed, educate, and offer living assistance to those in need. We were of course there to help out in the kitchen and thrift store to serve those that visited today, but also to take a look at the different health issues going on in this population and how Open Door Ministries helps improve the health in those that face health disparities. As soon as we got there, I immediately hopped in with a lot of the task-y stuff - like organizing boxes, drying and putting away dishes, and making coffee for the visitors. Later on after doing a few more tasks, I was able to go out and start talking to different people and get to know more about the visitors, more specifically the health-oriented aspect.
You would expect that the problems I noticed in most of these individuals that are in high financial need to have more physical issues going on, such as heart or lung disease; but actually, almost all of the visitors today were struggling with some sort of psychological issue, all the way from things like depression to schizophrenia. There were also a shocking number that easily discussed their struggle with drug abuse or other addictions. What is amazing is how much Open Door Ministries is actually working in these people that are struggling. A large number of the visitors feel they are finally being heard by someone, and Open Door is also very faith-based, so seeing how they restore hope and self-worth to the people that come through the doors, as they encounter the love and delivering power of Jesus Christ is just absolutely amazing. There are also several other places available in the community that are open specifically for mental and behavior health, including the recovery-driven company of Meridian Behavioral Health. Open Door Ministries even has services to pay for prescriptions that are written to patients of Meridian, which helps a lot of them stay on track with recovering.
With mental health issues becoming a growing problem in the United States, I was very glad to see how many companies, services, and people there are in communities like this in these areas. There of course could be a lot more people on board with things like this, but just like Tom from Open Door said: "if you want change, it always starts with a spark."
You would expect that the problems I noticed in most of these individuals that are in high financial need to have more physical issues going on, such as heart or lung disease; but actually, almost all of the visitors today were struggling with some sort of psychological issue, all the way from things like depression to schizophrenia. There were also a shocking number that easily discussed their struggle with drug abuse or other addictions. What is amazing is how much Open Door Ministries is actually working in these people that are struggling. A large number of the visitors feel they are finally being heard by someone, and Open Door is also very faith-based, so seeing how they restore hope and self-worth to the people that come through the doors, as they encounter the love and delivering power of Jesus Christ is just absolutely amazing. There are also several other places available in the community that are open specifically for mental and behavior health, including the recovery-driven company of Meridian Behavioral Health. Open Door Ministries even has services to pay for prescriptions that are written to patients of Meridian, which helps a lot of them stay on track with recovering.
With mental health issues becoming a growing problem in the United States, I was very glad to see how many companies, services, and people there are in communities like this in these areas. There of course could be a lot more people on board with things like this, but just like Tom from Open Door said: "if you want change, it always starts with a spark."
Thursday, June 6, 2019
Day 6: Mission Hospital
Overall, today was a fantastic day. We got a full tour of Mission Hospital, which is a very large hospital located in Asheville, NC (approx. 1.5 hours from Cherokee), shopped around a little bit in downtown Asheville, including for the soup kitchen we are visiting tomorrow, then hiked up Clingman's Dome in Bryson City.
The tour of Mission Hospital was fantastic. They have about 700 beds, which is even a little larger than the hospitals we have in the area I'm from; but there is also a huge difference in the area of coverage for just one facility, because Mission covers several different counties in the Northwestern portion of North Carolina, whereas there's more than 4 hospitals located in just the one urban city I live in, and several others located in other cities nearby. Comparing to Swain Hospital (the other facility our group toured the other day) the biggest difference is of course the amount of resources and staffing at Mission Hospital. Swain County hospital only keeps a few of their patients because they have little to no resources, then sends them off to Mission Hospital via helicopter. The reason they life-flight the patients to Mission is because it is much faster compared to the 1.5 hour drive there that most people have to do, or even farther depending on which hospital is closest in certain situations. Therefore, Mission Hospital is the go-to, so they don't send off anyone to other hospitals, especially since they have all of the resources you could think of that are basic to large, Level I trauma centers. They also use certain workflows that they have created themselves and found to be effective, or sometimes adopted a technique from another company that was useful in providing care. One of the ways they said to improve efficiency in care that really stood out to me is whenever they have a trauma occur in the ED, all personnel has to wear a large sticker that indicates what role they have in the trauma, then they have certain positioning that they have to be standing in. They have found this to better the workflow and communication of a trauma. I'm not sure if our trauma centers have a technique like this back home, but I do believe that companies should take a look at hospitals like Mission if they are wondering if there is anything they can intervene with to improve a process.
Pictured: My instructor and I with our carts full of the groceries we're donating tomorrow and a picture of us on top of Clingman's Dome (Me, Brenda, Amy, Hannah, Kendi, Brittany).
The tour of Mission Hospital was fantastic. They have about 700 beds, which is even a little larger than the hospitals we have in the area I'm from; but there is also a huge difference in the area of coverage for just one facility, because Mission covers several different counties in the Northwestern portion of North Carolina, whereas there's more than 4 hospitals located in just the one urban city I live in, and several others located in other cities nearby. Comparing to Swain Hospital (the other facility our group toured the other day) the biggest difference is of course the amount of resources and staffing at Mission Hospital. Swain County hospital only keeps a few of their patients because they have little to no resources, then sends them off to Mission Hospital via helicopter. The reason they life-flight the patients to Mission is because it is much faster compared to the 1.5 hour drive there that most people have to do, or even farther depending on which hospital is closest in certain situations. Therefore, Mission Hospital is the go-to, so they don't send off anyone to other hospitals, especially since they have all of the resources you could think of that are basic to large, Level I trauma centers. They also use certain workflows that they have created themselves and found to be effective, or sometimes adopted a technique from another company that was useful in providing care. One of the ways they said to improve efficiency in care that really stood out to me is whenever they have a trauma occur in the ED, all personnel has to wear a large sticker that indicates what role they have in the trauma, then they have certain positioning that they have to be standing in. They have found this to better the workflow and communication of a trauma. I'm not sure if our trauma centers have a technique like this back home, but I do believe that companies should take a look at hospitals like Mission if they are wondering if there is anything they can intervene with to improve a process.
Pictured: My instructor and I with our carts full of the groceries we're donating tomorrow and a picture of us on top of Clingman's Dome (Me, Brenda, Amy, Hannah, Kendi, Brittany).
Wednesday, June 5, 2019
Day 5: Wilderness First Aid Course
For the past couple days our group has been in training for Wilderness First Aid, and we have officially completed it today. This was definitely one of the best classes I have ever taken, because I now feel ultimately prepared for almost any situation if I need to help save someone while out in the wild. The biggest takeaway I gained from the course was that there are so many resources around us that we don't even know in the woods, and even in urban areas. On top of that, there's also different assessment and positioning techniques that I learned to do when using Wilderness First Aid that will help me a lot when taking care of different patients back home. For example, when you need to quickly assess a patient's circulation and there's a reason you don't want to turn them on their back, you can quickly move your hands behind the patient's back and legs, then look on your gloves for any blood. Another example is that if you want to keep a patient's spine straight but need to turn them on their side, you can position their arm and hand in a certain way so that the spine does stay completely straight. These are just a few of the several tips and tricks that I learned in the past few days that I can use while taking care of patients in the urban area I live in.
One other thing I learned in the past few days is what the lack of access to healthcare does to a community. With the lack of access to healthcare that these patients have, it unfortunately tends to decrease the patient's want to improve and look out for their health. This is also because of the lack of knowledge they have toward health and also without the access to healthcare, they're also unable to treat the acute issues they have.
One other thing I learned in the past few days is what the lack of access to healthcare does to a community. With the lack of access to healthcare that these patients have, it unfortunately tends to decrease the patient's want to improve and look out for their health. This is also because of the lack of knowledge they have toward health and also without the access to healthcare, they're also unable to treat the acute issues they have.
Tuesday, June 4, 2019
Day 3: Hospital & Museum
The main points on our itinerary today was that we visited the Swain County Hospital and went to the Museum of the Cherokee Indian. My very first impression of the Cherokee environment is that it is honestly a little more up-scale than I expected. Even though there are plenty of rougher areas, there were a lot of nice neighborhoods and houses that we saw on our way to the cabin and hospital. The people downtown are incredibly friendly and I know this sounds kind of odd, but I also noticed that people seem to drive a little more safer here than people in Illinois.
What I found most interesting as I learned about the Cherokee history walking through the museum is honestly their health beliefs. There was this nice little presentation about how they never had disease or any alteration to their bodies until the people began to ran out of food, so they had to start killing animals. Once they started killing animals, the animals joined up and decided that for every animal that the people kill, they will set out a disease. Once people started falling ill, the plants noticed, joined up, and decided that for every illness, the plants will set out a cure for that illness in order to bring peace and harmony to the world. I found this story incredibly fascinating, and sent me down this whole thought process of different illnesses that we are still trying to find the associated plant for - such as cancer and Alzheimer's disease. So, I suppose that's a thought I can continue on if I somehow end up doing any research.
Speaking of health, I want to talk a little about our visit to Swain County hospital. This hospital has 48 beds, and they only use 25 of them. Compared to the hospitals we're used to, where we have ~400 beds, that is considered very small. What I did find great is how they recognize the various issues they have in the rural communities and the great strides they take to improve the community's health. For example, several years ago, Duke Lifepoint began to own Swain County Hospital to give them the capitol they needed to continue helping their community. Several of the executives also talked about how big of a problem transportation becomes in the area, because then there really is no way for their patients to get to the pharmacy or to their primary care provider.
Another part of Swain County Hospital that I found amazing was the amount of services they have for such a rural community. They have a lot of primary care attached to the hospital itself, and on the floor they have physical therapy and occupational therapy. Also, since they have joined with Duke Lifepoint, when a patient is discharged, their sister hospital in Harris has a discharge team that takes care of all of the discharge planning and sets up Home Health for the patients. So funny enough, just like everything else in a smaller community, so much more can happen when everyone comes together. There are of course always shortages in nurses, assistants, first responders, and providers, but these people know how to make it work with what they have. One service that they mentioned is incredibly difficult at the moment is mental health, and that it is actually a growing issue in all of North Carolina. This could be due to a multitude of things out here in rural areas, like the lack of social interaction, addiction, or family history. On the bright side, it seems that a lot of healthcare works acknowledge that this is an issue, and are on track with finding a way to be able to get help to those that need it.
What I found most interesting as I learned about the Cherokee history walking through the museum is honestly their health beliefs. There was this nice little presentation about how they never had disease or any alteration to their bodies until the people began to ran out of food, so they had to start killing animals. Once they started killing animals, the animals joined up and decided that for every animal that the people kill, they will set out a disease. Once people started falling ill, the plants noticed, joined up, and decided that for every illness, the plants will set out a cure for that illness in order to bring peace and harmony to the world. I found this story incredibly fascinating, and sent me down this whole thought process of different illnesses that we are still trying to find the associated plant for - such as cancer and Alzheimer's disease. So, I suppose that's a thought I can continue on if I somehow end up doing any research.
Speaking of health, I want to talk a little about our visit to Swain County hospital. This hospital has 48 beds, and they only use 25 of them. Compared to the hospitals we're used to, where we have ~400 beds, that is considered very small. What I did find great is how they recognize the various issues they have in the rural communities and the great strides they take to improve the community's health. For example, several years ago, Duke Lifepoint began to own Swain County Hospital to give them the capitol they needed to continue helping their community. Several of the executives also talked about how big of a problem transportation becomes in the area, because then there really is no way for their patients to get to the pharmacy or to their primary care provider.
Another part of Swain County Hospital that I found amazing was the amount of services they have for such a rural community. They have a lot of primary care attached to the hospital itself, and on the floor they have physical therapy and occupational therapy. Also, since they have joined with Duke Lifepoint, when a patient is discharged, their sister hospital in Harris has a discharge team that takes care of all of the discharge planning and sets up Home Health for the patients. So funny enough, just like everything else in a smaller community, so much more can happen when everyone comes together. There are of course always shortages in nurses, assistants, first responders, and providers, but these people know how to make it work with what they have. One service that they mentioned is incredibly difficult at the moment is mental health, and that it is actually a growing issue in all of North Carolina. This could be due to a multitude of things out here in rural areas, like the lack of social interaction, addiction, or family history. On the bright side, it seems that a lot of healthcare works acknowledge that this is an issue, and are on track with finding a way to be able to get help to those that need it.
Day 2: Museum of Appalacia
As we are making our way south to North Carolina, one of the stops we made to help enhance our learning experience was to visit the Museum of Appalachia. The museum had SO many things that are memorable to the Appalachian culture, everything from farming tools to 34.5” wide sawmill blades, and a shocking amount of history in medicine. What I found most interesting was that the museum does not show anything about the history of nursing. I discussed this with my instructor, and we believe this may be because nursing wasn’t known to really be a career til about the 1940s, and even then nursing wasn’t as prestigious as it is today.
Another part of the museum that caught my attention was how medicine was practiced in these communities back before hospitals began to grow. Dr. Andy Osborne of Blackwater, Virginia would travel extensive distances by horse to visit his patients, and would even fall asleep in the saddle as he would be returning home. Luckily, his horse was so well-trained that it would know the trail back home then would nudge Dr. Osborne awake once they arrived. There were several other doctors that were displayed in the museum along with their tools and kits, and there was one commonality I noticed all of them: they would all travel distances to care for the ill.
As I was reading the history of these physicians and how they would go visit the patients’ homes, I began to ponder more about how this relates closely to the lack of access to healthcare that now exists many decades later. Over the years, hospitals were planted, the nursing profession began and grow, health insurance starting to take place rather than paying in cash, and health policies were initiated. Therefore, I believe what happened is healthcare became centralized to hospitals, decreasing the number of individuals getting any sort of medical care, which then caused the amount of disparities that are occurring in these rural cultures now.
Along with healthcare becoming centralized only into certain areas, I have noticed that the biggest difference between central Illinois and these rural areas is the amount of technology that they have and use. Right at our fingertips we have all of the knowledge we could ever want about our bodies and what we should do about it, of course also (most of the time) knowing when we should go to the ER, schedule a visit with our doctor, or just buy over the counter medicine. Here in the Appalachians, not only is it common for the ill to not be able to reach proper treatment, but it becomes a little more difficult to know where to go and how to get the help they need.
Something that the Cherokee does have that I personally have a huge respect for is how much they adhere to their core values. It seems that the Cherokee highly value character, honesty, respect, trust, courage, and many other personal qualities that are foundational to who we are. I have high respect that they adhere to these traits that they look for in people because these are things that seem to be proven in more than just one situation, whereas in our urban culture, it appears that people make very quick assumptions just based off of one instance, which can cause trouble.
Overall, I find it so wild how quickly we can learn about different cultures, and I am already starting to see my mindset change on why we would accommodate different belief systems while they are being cared for by us. I’m definitely excited to see more of what sort of treatment that the Cherokees would allow if they were to end up in a hospital like UnityPoint, or of course what the Cherokees do not allow. I hope that once I finish this course, I would know exactly how to approach someone that is Cherokee if I end up being a nurse for one someday and know what questions I would ask them. One thing I also want to point out is that I am incredibly grateful for my academic history in psychology, because it has taught me a lot about how stereotypes, biases, or prejudices take place, and how I can personally set them aside for just about anything. With a large background in that area of psychology and the wisdom I have gained from my professors, I luckily do not have any stereotypes or anything of that sort toward the Cherokee culture, and I can’t wait to continue learning about their way of living as I experience it first-hand.
Another part of the museum that caught my attention was how medicine was practiced in these communities back before hospitals began to grow. Dr. Andy Osborne of Blackwater, Virginia would travel extensive distances by horse to visit his patients, and would even fall asleep in the saddle as he would be returning home. Luckily, his horse was so well-trained that it would know the trail back home then would nudge Dr. Osborne awake once they arrived. There were several other doctors that were displayed in the museum along with their tools and kits, and there was one commonality I noticed all of them: they would all travel distances to care for the ill.
As I was reading the history of these physicians and how they would go visit the patients’ homes, I began to ponder more about how this relates closely to the lack of access to healthcare that now exists many decades later. Over the years, hospitals were planted, the nursing profession began and grow, health insurance starting to take place rather than paying in cash, and health policies were initiated. Therefore, I believe what happened is healthcare became centralized to hospitals, decreasing the number of individuals getting any sort of medical care, which then caused the amount of disparities that are occurring in these rural cultures now.
Along with healthcare becoming centralized only into certain areas, I have noticed that the biggest difference between central Illinois and these rural areas is the amount of technology that they have and use. Right at our fingertips we have all of the knowledge we could ever want about our bodies and what we should do about it, of course also (most of the time) knowing when we should go to the ER, schedule a visit with our doctor, or just buy over the counter medicine. Here in the Appalachians, not only is it common for the ill to not be able to reach proper treatment, but it becomes a little more difficult to know where to go and how to get the help they need.
Something that the Cherokee does have that I personally have a huge respect for is how much they adhere to their core values. It seems that the Cherokee highly value character, honesty, respect, trust, courage, and many other personal qualities that are foundational to who we are. I have high respect that they adhere to these traits that they look for in people because these are things that seem to be proven in more than just one situation, whereas in our urban culture, it appears that people make very quick assumptions just based off of one instance, which can cause trouble.
Overall, I find it so wild how quickly we can learn about different cultures, and I am already starting to see my mindset change on why we would accommodate different belief systems while they are being cared for by us. I’m definitely excited to see more of what sort of treatment that the Cherokees would allow if they were to end up in a hospital like UnityPoint, or of course what the Cherokees do not allow. I hope that once I finish this course, I would know exactly how to approach someone that is Cherokee if I end up being a nurse for one someday and know what questions I would ask them. One thing I also want to point out is that I am incredibly grateful for my academic history in psychology, because it has taught me a lot about how stereotypes, biases, or prejudices take place, and how I can personally set them aside for just about anything. With a large background in that area of psychology and the wisdom I have gained from my professors, I luckily do not have any stereotypes or anything of that sort toward the Cherokee culture, and I can’t wait to continue learning about their way of living as I experience it first-hand.
Saturday, June 1, 2019
Day 1: And We’re Off!
We have officially departed from home! We expect to arrive at our hotel in Tennessee at 4:30 and we continue our journey tomorrow morning to the Museum of Appalachia. Then we check into our cabin in the late afternoon.
What has happened so far: a million pictures together in front of the college, I’ve apparently designated myself as road trip DJ, Amy called Lisa a control freak as she forcefully passed us, and I am one of only 3 people that are awake. It’s been a blast.
Today’s picture: the 4 Ham Fam takes on North Carolina 😎💉
What has happened so far: a million pictures together in front of the college, I’ve apparently designated myself as road trip DJ, Amy called Lisa a control freak as she forcefully passed us, and I am one of only 3 people that are awake. It’s been a blast.
Today’s picture: the 4 Ham Fam takes on North Carolina 😎💉
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As we are making our way south to North Carolina, one of the stops we made to help enhance our learning experience was to visit the Museum o...
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We have officially departed from home! We expect to arrive at our hotel in Tennessee at 4:30 and we continue our journey tomorrow morning to...