"The eyes are the mirror to the soul."

          Tuesday was an overwhelming, emotional, but educational day at Cherokee Indian Hospital (CIH), while Wednesday was a day to recover and spend time in the Cherokee village.  Tuesday morning consisted of several experiences that have left a strong impact on my thoughts of becoming a future nurse.  These complex experiences have left a mark in my heart in that I hope to become a better person to treat my future clients.  I realize the importance of intervening with the family while providing care for their pediatric patient.  There are several times in life where we, or I, have a rough patch and think the world is coming to an end.  The two experiences I witnessed at CIH struck me with emotions that made me realize those bad moments are just a moment in time, not lifelong. 

            The CIH has several departments that help the clients promote adherence to their treatment regimen and simply have a “one-stop” shop for all their needs.  Tuesday afternoon I was able to witness two clients within the prenatal clinic perform periodic pregnancy testing.  The prenatal appointments were very similar to our culture; they consisted of vitals, belly measurement, questions regarding health care behaviors, and risky behaviors.  One element of the prenatal appointment that was different than our culture was questions regarding the use of Complementary Alternative Medicines (CAM).  CAMs can easily interfere with prescriptive medications if not used with caution.  I have found through observation with a few clients is the Cherokee tribe members do not share what CAMs they use.  One nurse explained clients will have a “leather pouch” with their medication herbal mixture, but may not be open to sharing what herbals are mixed within the pouch. This could be a risk if the physician were to prescribe the client medications; however, as a nurse caring for a client using CAMs it is important to educate about side effects that may occur with common CAMs.

            In my previous post I mentioned the Cherokee tribe is concerned with losing their language.  After seeing a reenactment of the Trail of Tears, I have found that tribal members have trouble with resilience and bouncing back from their traumatic past of attending boarding schools.  The tribe members that attended boarding school were not shown the guidance and love necessary to provide for a family.  These members continue to pass down these habits generation to generation, causing a whirling wind of ineffective coping and guidance.  Family is a value that the Cherokee strongly believe in and practice. The long strain of lacking guidance does not provide a structural environment children need while growing up and learning life values. In the Cherokee culture, the woman is commonly the verbal decision maker of the family.  Children may need to gain independence sooner than our culture due to the need to take care of their elderly and family.  This can create issues if the woman was to pass away or become ill, the father will need to learn how to consider the values and beliefs in order to pursue the tribe's beliefs.

CIH is in the process of starting a new program that allows clients who are abusing opiates long term to learn how to take care of themselves in a holistic perspective.  This includes mind, body, spirit, and physical assessment.  One struggle commonly found within this culture is the healing of mind, body, and spirit.  This new program will allow the clients to attend classes for four weeks and wean off the opiates while using healing and touch to better their health.  Healing and touch are examples of CAMs, as well as guided imagery, relaxation, and acupuncture.  These alternatives may help the Cherokee take care of themselves and gain independence without interfering with cultural beliefs against Western medicine.

This trip has allowed me to gain confidence in asking clients questions regarding their culture.  Prior to this trip I felt uncomfortable asking my clients questions regarding their culture; I was always afraid they would be offended.  Each person I have asked questions to regarding the Cherokee culture has been open and willing to share endless stories with me.  This has allowed me to gain confidence and gain reassurance that I have found a career where I belong.