Developing Nurse Leaders. . .in the Indian Way

Developing Nurse Leaders. . .in the Indian Way

Developing Nurse Leaders

Although a small but growing number of programs now exist to prepare minority nurses for leadership roles in health care management, academia and health policy-making, very few–if any–have focused specifically on American Indian and Alaska Native nurses. But that is about to change with the arrival of Pathways to Leadership, an Indian Nurse Leadership curriculum that has been in development for several years.

The project began in June 1997, when a team of four Indian nurse leaders and one non-Indian nurse leader were selected to attend the Third Congress of Minority Nurses in Denver, which was sponsored by the Health Resources and Services Administration (HRSA), Bureau of Health Professions, Division of Nursing. From this conference, the plan to create a leadership development program tailored exclusively to the needs of Indian nurses emerged.

Initially, the proposed curriculum focused on generic leadership behaviors and skills that are not specific to Indian culture. However, the Indian team members identified the need to explore the concept of Indian nurse leadership further and to identify whether the dimensions of the Indian leadership style were different from those of general, mainstream leadership. To help define Indian nurse leadership, the National Alaska Native American Indian Nurses Association (NANAINA) was instrumental in supporting and encouraging the development of three Indian Nurse Leadership modules for the curriculum, along with a model showing the relationship of the different concepts examined in the modules.

As a result, the present Pathways curriculum consists of nine modules. Six of them focus on general nurse leadership topics:

  • Knowing Self
  • Personal and Professional Communication and Mentoring
  • Group Process
  • Decision-Making
  • Change Process
  • Being a Futurist.

They are complemented by three culturally competent modules devoted to the following topics: Being a Leader in the Indian Way, Indian Nursing and Tribal Sovereignty, and Indian Nursing and Indian Health Programs.

The focus of the general leadership curriculum is on personal development of leadership. Native Americans value personal growth and self-actualization, so emphasizing a personal perspective of leadership is compatible with Indian culture and values. In addition, Indian concepts are interlaced appropriately within the generic leadership modules. The two worldviews are compared and contrasted. This provides the Indian nurse with a more bicultural view of Indian and non-Indian health care systems.

Filling a Knowledge Gap

Developing Nurse Leaders

One of our biggest challenges in developing the Indian-specific topics was that knowledge about the concept of Indian nurse leadership is almost nonexistent. A review of the literature revealed limited research in the area. To fill the void, we utilized several sources of information to help us develop the curriculum. These included interviews with Indian leaders, conferences on Indian leadership, historical information on Indian leaders, personal experiences of the team members, directors of Indian health programs, and focus groups with Indian nurses and non-Indian nurses who worked with Indian patients. We also explored the spiritual, traditional and ceremonial Indian ways of knowing.

Armed with these data and insights, we developed the Indian section of the Pathways curriculum. Module 7, Being a Leader in the Indian Way, identifies the facets of Indian nursing and the characteristics and actions of Indian nurse leaders. It presents and explores concepts of Indian nurse leadership such as spirituality, humility and self-actualization. Module 8 focuses on political issues relating to Indian tribes and nations, including tribal sovereignty, self-governance and the application of these concepts to Indian nurse leadership. It also examines the importance of being a spiritual leader.

The last module, Indian Nursing and Indian Health Programs, explores Indian health issues, Indian health ethics and Indian tribal programs. Information from the generic leadership modules is interwoven with the Indian concepts to synergize the nine modules into a complete leadership training program suitable for developing the skills of current and future Native nurse leaders.

Putting All the Pieces in Place

 

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In fall 2002 at the eighth annual NANAINA Summit in Oklahoma City, the Pathways team presented the proposed leadership curriculum to Indian and non-Indian nurses for their evaluation and recommendations. This peer review enabled us to identify gaps in the curriculum. It also helped us realize that we needed to have a framework to guide us in what the curriculum should include and how it should be taught.
To build this guiding framework, we again drew information from a variety of sources. We used data that had been gathered from focus groups of Indian nurse leaders several years earlier at NANAINA Summit IV. We also examined the models of Indian nursing developed by NANAINA members Roxanne Struthers, Sandy Littlejohn and John Lowe.1, 2  Their work provided a valuable starting point for creating our model framework.

 

The guiding framework for Pathways to Leadership–which encompasses both the Indian and generic leadership modules–is based on three themes:

  • Point of reference (being connected) for the Indian nurse leader. Connectedness for the leader focuses on the individual, the family and the tribal community.
  • What an Indian nurse is. Native nurses can be defined by such terms as: spiritual, self-actualized, visionary, quiet presence, humble, wise, experienced, political and recognized. 
  • What an Indian nurse leader does. This includes mentoring, serving as a role model, communicating, listening, mobilizing, inspiring and demonstrating values.

Putting It into Practice

Now that the final stage of developing the Pathways to Leadership curriculum was finished, it was time to “take the show on the road.” In June 2003 the Pathways team organized a gathering for Indian nurse leaders in Phoenix, Ariz., to present the new leadership training curriculum. Two other nurses collaborated with us in implementing this event: the nurse consultant for the Phoenix area of the Indian Health Service, and the director of Arizona State University College of Nursing’s American Indian Students United for Nursing (ASUN) project.

Developing Nursing Leaders

Seventeen Indian nurses attended the weeklong gathering. We presented the curriculum modules over the week at the rate of two per day. Each day began with a prayer or meditation by an Indian elder, followed by opening circles in which all the participants sat together in a circle to share our thoughts and ideas. The Indian cultural tradition of the circle is important, because it means that we will come back to the beginning.

 

Several guest speakers were invited, to serve as examples of leadership and express their views of leadership in relation to the concepts discussed in the modules. For example, one former tribal chief described his three principles of leadership: “be honest to yourself,” “listen to people” and “respect their culture.” One of the Pathways team members served a meal at her home for all of the participants. At the end of the week, the gathering ended with a giveaway (a Cherokee tradition of expressing gratitude). We gave gifts to the participants to show our appreciation to them for attending and for letting us be their teachers. Finally, an ending circle was formed and the closing ceremony was conducted by an Apache healer.

Participants were asked to evaluate the program daily, with a summary evaluation at the end of the gathering. This feedback revealed that the curriculum was well received by the students.

While we are proud of this initial success, at this point Pathways to Leadership is still an ongoing work in progress. The presentation in Phoenix was a pilot project that we hope will set the stage for nationwide implementation. Our goal is to continue to refine the curriculum for expanded use in schools of nursing and with nursing leaders of tribal health programs. 
For more information about the Pathways to Leadership project, please contact Lee Anne Nichols ([email protected]), Martha Baker ([email protected]) or Judy Goforth Parker ([email protected]).

References

  • Lowe, J. and Struthers, R. (2001). “Profession and Society: Conceptual Framework of Nursing in Native American Culture.” Journal of Nursing Scholarship, Vol. 3, No. 3.
  • Struthers, R. and Littlejohn, S. (1999). “The Essence of Native American Nursing.” Journal of Transcultural Nursing, Vol. 10, No. 2.
Developing Nurse Leaders. . .in the Indian Way

Awakening a Passion for Research

I am a recent graduate of the BSN nursing program at New Mexico State University (NMSU) in Las Cruces, N.M. I am also Native American, a member of the Navajo tribe. My family and I live on the Navajo reservation outside of Ganada, Arizona. During the summer of 2001, prior to the start of my senior year, I had the opportunity to spend four weeks in Austin, Texas, working as a research intern with Alexa Stuifbergen, RN, PhD, FAAN, at The University of Texas at Austin School of Nursing’s Center for Health Promotion & Disease Prevention Research in Underserved Populations (CHPR). It is not an exaggeration to say that this experience changed my life.

The CHPR is a program funded by the National Institute of Nursing Research (NINR), one of the National Institutes of Health (NIH). The center’s mission is to improve the health of medically underserved populations–such as racial and ethnic minorities, women, people with disabilities, children/adolescents and the elderly–through research designed to reduce health disparities.

I first learned about the summer research internship opportunity at CHPR from one of my professors at NMSU, Dr. Becky Keele-Smith. She had just returned from a meeting in Washington, D.C., where NINR announced it was providing special grant funding to several research-oriented schools of nursing to enable them to form partnerships with smaller schools that have large numbers of minority students.

The UT Austin School of Nursing was one of the institutions that had applied for one of these grants. It planned to use the money to sponsor a program that would help increase minority undergraduate nursing students’ interest in careers as nurse scientists. An additional goal was to provide research training and development opportunities for junior nursing faculty at minority-serving schools who were interested in researching minority health disparities.

Alt photo text goes here.(L-R): Research interns Nina Ortiz, Denise Griffin, Melanie Long, (standing) and Amber Kozak

As part of NIH’s Research Supplements for Underrepresented Minorities program, NINR awarded the CHPR an administrative supplement grant to partner with New Mexico State University and another minority-serving school, the University of New Mexico. As a result, a group of nursing students from our school was able to travel to Austin and participate in the Summer Research Institute. In addition, two of my professors at NMSU, Dr. Keele-Smith and Dr. Alison Druck, were given the opportunity to “team up” with faculty at UT Austin to develop their research ideas.

When Dr. Keele-Smith asked if I would be interested in working during the summer in Austin doing research, I was very excited. And when I learned that the program was being sponsored by NINR and that my professors would also be collaborating with researchers at UT, I was ready to pack my bags.

The two schools are quite different. The University of Texas at Austin has the highest enrollment of any university in the nation–over 49,000 students. New Mexico State, which is classified as a Hispanic-Serving Institution, has approximately 15,000 students on its main campus. Nearly 50% of NMSU’s students are non-Caucasian (41% Hispanic, 3% Native American, 3% African American and 2% Asian American). It seemed like a wonderful idea for professors and students at NMSU to team up with the large research-oriented nursing school at UT Austin. NMSU is a great school, but its students and faculty can learn a lot from working with established researchers, just as those researchers can learn a lot from working with a school that serves a large number of minority students.

Meeting, Greeting and Learning

There were six undergraduate research interns from NMSU working in Austin that summer. All but one of us were minority students. Each of us was assigned to a faculty mentor at UT, an experienced nurse scientist who helped us understand research from an insider’s perspective.

My days were spent working with Dr. Stuifbergen’s research team on their studies of people with multiple sclerosis and post-polio syndrome. I assisted with data entry and coding narrative data from the research surveys. I even did a data analysis of Dr. Stuifbergen’s study and presented it as my own mini research project at the end of the internship.

The other interns worked on similarly interesting studies, examining minority health issues such as obesity after childbirth in Mexican-American women, sleep patterns of cancer caregivers, and self-care behaviors of children with diabetes.

Besides immersing ourselves in the research process, we spent a day in San Antonio at the annual conference of the National Association of Hispanic Nurses, where we had the opportunity to meet many of the staff from NINR and other branches of the National Institutes of Health. We also got to meet other researchers at UT, some doing research in nursing and some from other disciplines, like sociology, communications and social work.

In addition to our research mentors, we had the staff at CHPR to help coordinate our activities and give us support as we became accustomed to a new town and a new workplace. They helped with travel and transportation arrangements and coordinated housing and food service for the interns. We stayed in dorms and were assigned a CHPR doctoral student who served as a “den mother.” The CHPR staff also organized events and programs for us, such as lunchtime colloquia.

A Researcher Is Born

The Center for Health Promotion was an interesting place, because its mission to eliminate the health disparities of underserved groups is the same as my personal goal as a nurse. It was not surprising that a strong bond developed between the CHPR researchers, the staff and myself.

What was surprising was that I became really interested in the other part of CHPR’s mission: promoting, disseminating and supporting research. I had always thought of research as something that only doctors and lab scientists did. But my experience in Austin that summer changed that idea, both for me and for my fellow interns. We discovered that research is a way of understanding life and exploring ways we can help make things better for people who are truly in need.

Since then, spreading the word about the importance of health promotion research in underserved populations has become my calling in life. When I returned to the reservation after my experience at UT and told my story about what research means to me, I introduced the concept that research can help Native Americans combat problems that are unique to us. However, one person cannot perform all this research alone. Therefore, when I am asked to speak in front of people, I stress the importance of research and give them the confidence that Native Americans can obtain the education and training to do research that will help improve the health of our people.

My research internship at CHPR changed the goals I had set for my nursing career. What I learned in Austin has built a foundation for my future. Our faculty mentors and the staff at CHPR inspired me to give research a chance and to think about pursuing graduate education.

Participating in this internship broadened my horizons. It gave me a chance to meet new people, learn to work with computer programs and databases, experience a place different than home and much more. Most important of all, my research experience at UT Austin helped me discover a lifelong passion that I never knew I had.
 

Careers in the Indian Health Service

It’s probably the best working example of universal health care in America. It’s a system that provides millions of people with a widely comprehensive range of health and wellness services–everything from disease prevention programs to dental and optical services to hospital and ambulatory medical care. Its goal is to “ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to all American Indian and Alaska Native people.”

It is the Indian Health Service (IHS) and it remains the nation’s largest employer of American Indian and Alaska Native nurses. But regardless of race or ethnicity, if you’re a nurse who has a strong desire to experience different cultures, work with medically underserved communities, fight minority health disparities and reap the benefits of a career that offers chances to advance to leadership roles, working for the Indian Health Service may be just the opportunity you’ve been looking for.

The Details

In 1921, Congress passed the Snyder Act, which established the Indian Health Service as the primary federal health care provider and health advocate for Indian people. It’s a role the agency has continued to play for 80-plus years, providing a comprehensive national health delivery system designed to elevate the health status of American Indian and Alaska Native people to the highest possible level and to encourage the maximum participation of tribes in the planning and management of those services.

Although Native tribes are sovereign nations, the IHS is a U.S. government organization operating under the Department of Health and Human Services (HHS) umbrella. Today, it cares for 1.6 million of the nation’s estimated 2.6 million Native Americans from more than 560 federally recognized Indian tribes and Alaska Native corporations coast to coast.

The IHS is an extensive system, divided into 12 regional areas, that encompasses 36 hospitals, 63 health centers, 44 health stations and five residential treatment centers in 35 states. In addition to these facilities, most of which serve American Indians who live on or near reservations, the IHS also has 34 urban Indian health projects that provide a variety of services. Some IHS facilities are managed by the tribes themselves with financial and administrative support from the federal agency. At others, all daily operations are completely managed by IHS.

Nurses hired at tribally operated facilities (“direct hires”) are considered employees of the tribe. If the nurse is recruited by the IHS to work at a federally operated facility, then he or she is a federal employee. In addition, some nurses who work for the IHS do so as officers in the U.S. Public Health Service Commissioned Corps, a federal program under the direction of the U.S. Surgeon General in which nurses work for local, state, federal or international health agencies in a variety of capacities. Generally, nurses in the Commissioned Corps tend to have more experience and education and receive an expanded benefits package.

According to IHS statistics, there are currently more than 2,500 nurses in the organization working in inpatient, outpatient and ambulatory settings. Additionally, the agency employs public health nurses and nurse educators to carry out its numerous health awareness programs, among other duties. Many of these campaigns are created with input from tribal and spiritual leaders to address a particular community’s specific health care and cultural concerns.

Of course, like any large health care system, the Indian Health Service also provides opportunities for experienced clinicians to move into management positions on local, regional and national levels. But it’s the challenge of working with a unique patient population in a specialized environment that many IHS nurses cite as the most rewarding aspect of their career.

 

The Need

Like other health care employers today, the IHS is struggling under the weight of a severe nursing shortage and the increasing financial burdens of doing business in the current economic environment, despite a proposed budget of $2.9 billion for fiscal year 2004.

“We have a 14% nursing vacancy rate right now, compared with the national average of 13%,” says Celissa Stephens, RN, MSN, acting principal nurse consultant and senior recruiter for the IHS national headquarters in Rockville, Maryland.

The reasons for the nurse staffing crisis within the IHS mirror those for the health care industry in general. Fewer young people are choosing nursing as a career, while at the same time, the current RN population continues to inch toward retirement age. But this second factor has had an even bigger impact on the IHS than on private sector nursing employers. “The average age of nurses in the IHS is 48 years old, which is even older than the national average of 43 years,” Stephens explains.

More specifically, the IHS reports that approximately 755 of its 2,500 nurses are 41 years old or older. Of those, 8% were eligible for retirement last year. Even more alarming is that another 20% will be reaching retirement in the next five years.

While skilled, experienced nurses are urgently needed throughout the IHS system, Stephens says some specialties are in more demand than others. “At the present time, the greatest needs are in the areas of emergency, operating room, ICU and obstetrics,” she reports. “We’re also interested in Certified Registered Nurse Anesthetists (CRNAs).” There are also many career opportunities open for advanced practice nurses and Certified Nurse-Midwives.

The People

“Everything you do [as an Indian nurse working for IHS], you can see it making a difference. You’re working toward a goal to improve the health of our families and communities,” says LaVerne Parker, RN, MS, an IHS nurse consultant in the Aberdeen Area of South Dakota and a member of the Turtle Mountain Band of Chippewa Indians.

Indeed, there seems to be a very strong connection between American Indian/Alaska Native nurses and careers in the IHS. The agency reports that approximately 66% of nurses working in the federal system or for tribally operated health care organizations are Native Americans. While this may be partially due to the fact that IHS has Congressional authority to give American Indians and Alaska Natives preference in hiring, working for the IHS also appears to be a traditional career path for many Indian nurses.

For instance, Parker grew up relying on the IHS as her own health care provider. When she became interested in a nursing career, IHS was foremost in her mind. “I always wanted to work with my own people,” she explains.

“There was never any doubt that I would be working for my [Indian] community,” says Lisa Sockabasin, RN, BSN, of her career choice as diabetes nurse coordinator for the North American Indian Center of Boston, an urban IHS facility in Boston, Massachusetts. “I saw so many health disparities among American Indian communities during my experience as a research fellow at Harvard Medical School, including cardiovascular disease, diabetes and cancer. I really wanted to work in preventing morbidity and mortality in our communities.”

While it may be a sense of community that brings Native nurses to IHS facilities, it’s the rewarding work and career advancement opportunities within the system that are keeping them there. Working for an IHS or tribal-run hospital or clinic is different than the “typical” nursing job in a number of ways. First and foremost, the patient population is almost exclusively American Indian or Alaska Native. Therefore, culture plays a very prominent role in health care delivery.

“There are so many different meanings of what good health is and how it’s perceived in so many different cultures,” says Sockabasin, who is half Patsanaquoddy Indian.

Culturally and linguistically, Indian tribes are by no means all alike, even though there may be some common threads among the different groups when it comes to health issues–such as high incidence rates of heart disease and diabetes–as well as general beliefs about health and illness, such as an emphasis on the use of natural remedies.

“You can’t make generalizations about the tribes because they’re all different,” emphasizes Stephens, a member of the Choctaw tribe. “It’s important at the local level that new employees are provided with culturally appropriate orientation to the tribal communities they will serve.”

Language can also impact health care delivery in Indian communities, especially with older patients who may not speak English very well or at all. The majority of IHS settings have an interpreter on staff, or other bilingual staff members who can help with translation. However, caution must be used in this circumstance, because when it comes to health care terms there is little room for misinterpretation.

“Some medical terms, such as cancer, don’t translate into the Navajo language, for example,” Stephens explains. “The term for cancer in Navajo could be described as ‘lood doo na dziiyigii,’ which means ‘a sore that does not heal.’

“Traditional Navajos believe that spoken words are like arrows, and arrows can wound people,” she adds. “Therefore, it would not be appropriate to discuss the patient’s mortality or potential outcomes in the first person. In order to avoid ‘inflicting wounds,’ the care provider must discuss the medical condition in the third person–for example, ‘some people experience x, y and z.’”

The Setting

One of the most distinguishing features of a nursing career with the IHS is where you work. The vast majority of IHS hospitals and clinics are set on or near Indian reservations, which are usually in rural areas. Not only are they small communities, but they’re often located at substantial distances from the nearest town or city, which can be problematic for nurses who have families or are not accustomed to small-town life. For example, there may not be immediate access to employment and social outlets for spouses and children.

“Families have to adopt a certain lifestyle to live in our communities,” notes Stephens. “We need nurses who have a sense of adventure, are willing to accept the challenges of a rural lifestyle and are interested in being involved in the communities they serve. On the other hand, IHS nurses get to experience the [richness of] Native community life and culture. You may not get that opportunity in the private sector.”

Indeed, when HHS Secretary Tommy G. Thompson announced the awarding of $1.7 million in grants to six American Indian and Alaska Native tribes and organizations last fall to assist them in recruiting and retaining health care professionals, he specifically cited location as a contributing factor to the ongoing need for health care personnel. “The national shortages of nurses, physicians, pharmacists and many other health professionals is particularly serious in the remote and isolated areas where many tribal communities are located,” Thompson noted.

The HHS grant recipients were the Maniilaq Association in Alaska ($99,931), the Ketchikan Indian Corporation in Alaska (($91,693), the Seneca Nation of New York ($96,467), the Nisqually Indian Tribe in Washington state ($100,000), the Confederated Tribes and Bands of the Yakima Nation in Washington ($100,000) and the Northwest Portland Area Indian Health Board in Oregon ($92,209).

The Opportunities

Like other health care employers that urgently need more nurses, the IHS is intensifying its recruitment and retention efforts, both within and outside the American Indian and Alaska Native communities it serves.

“Having Native American nurses in the community is probably our biggest retention key,” says Parker. “Many of them have been able to go to nursing school through IHS scholarships and they come back here [to work] and they stay. They are our staple staff.”

Of course, another key to attracting and retaining nursing talent is to offer plenty of professional development opportunities. And the IHS certainly has its share. For example, new RN graduates can compete for a position in the RN Internship Program, which allows them to rotate through a variety of different nursing specialties in a preceptor-like training environment.

Another option is the Public Health Nurse Internship, where nurses with BSN degrees receive specialized training as health educators and advocators. For nurses with at least one year of clinical experience, the IHS offers residency programs in critical care, OR and obstetrics, often with the opportunity to become certified upon completion.

To participate in any of these programs, however, nurses must be willing to move around, because they are only offered at specific IHS facilities. “We have the most difficulty recruiting in obstetrics or the OR because there are so few IHS hospitals in our area that offer those training programs,” states Parker. “We’re trying to develop more programs locally, but for now, we also work with outside hospitals that might provide our nurses with training services.”

Then there are long-term training and continuing education opportunities that help nurses at various career levels pursue academic degrees. For example, American Indian and Alaska Native nurses employed with IHS, tribal or urban facilities can take advantage of long-term training opportunities such as the Section 118 program. In this program, which is sponsored by the IHS Headquarters Division of Nursing, LPNs can pursue either an associate’s or bachelor’s degree in nursing; RNs with associate’s degrees can pursue BSN degrees.

“To date, more than 55 nurses have received advanced training and additional degrees through IHS long-term training programs,” says Stephens. “Currently we have 18 nurses in advanced training. Nurses receive full salary, benefits, books and tuition while pursuing advanced education. That’s a benefit the private sector usually does not offer.”

In addition, financial aid opportunities for third- and fourth-year student nurses are available through COSTEP, the U.S. Public Health Service’s Commissioned Officer Student Training and Extern Program.

But perhaps the single most irresistible benefit for nurses is the IHS Loan Repayment Program. Simply put, this program offers nurses–including tribal direct hires–repayment of up to $20,000 per year toward nursing education loans. In return, the nurses agree to a minimum two-year service contract at an IHS facility, usually one that has a high nursing vacancy rate.

 

The Experience

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Being an Indian Health Service nurse is an opportunity for minority nurses of all races and ethnicities to live a unique personal and professional experience that is simply not available anywhere else. Not only will you encounter a fascinating culture and people, but your expertise as a nurse will be valued and broadened. Within a health care system that offers such a broad spectrum of services, the opportunities to explore different career specialties and gain additional skills are wide open.

“When I worked in the private sector, I didn’t have the ability to move from clinics to ambulatory to inpatient or emergency,” says Parker. “But within the IHS, you can work in a variety of areas and with a variety of cultures.”

You’ll also see how your efforts to care for, educate and advocate for patients can have a ripple effect on the entire community. As Sockabasin explains, “When you work for the IHS, you have the ability to touch a population that is in so much need of good nurses.”

First American Indian Nurse Named to Nursing Hall of Fame

Susie Walking Bear Yellowtail, RN (1903-1981) was a nursing pioneer whose life was filled with groundbreaking accomplishments. And even after her death, she continues to make history: On July 1, she became the first American Indian nurse to be inducted into the American Nursing Association’s prestigious Hall of Fame. 

Born on the Crow Agency reservation in Montana, Susie Walking Bear Yellowtail was the first American Indian registered nurse in the U.S., as well as an activist who fought tirelessly to achieve better health care for Indian people. After graduating from Boston City Hospital School of Nursing in 1923, she returned to Crow Agency to work in the Bureau of Indian Affairs Hospital. The injustices she witnessed there–such as the forced sterilization of Crow women without their consent–galvanized her into a lifelong fight to end abuses in the Indian health care system.

From 1930 to 1960, the Crow/Sioux nurse traveled to reservations throughout the country to assess the problems American Indians faced. One of Yellowtail’s assessments revealed that seriously ill Navajo children were literally dying on the backs of their mothers, who often had to walk 20 miles or more to reach the nearest hospital. To fight these iniquities, she joined state health advisory boards and quickly became well known among national health care policy-makers.

In the 1970s, Yelowtail was appointed to President Nixon’s Council on Indian Health, Education and Welfare and to the federal Indian Health Advisory Committee. These appointments gave her a national platform for advocating for the health needs of her people. She also founded the first professional association for Native American nurses and was instrumental in winning tribal and government funding to help Indians enter the nursing profession. In 1962, Yellowtail received the President’s Award for Outstanding Nursing Health Care.

IHS Receives Research Grants and a New Headquarters

The Indian Health Service (IHS) and the National Institutes of Health (NIH), both agencies of the Department of Health and Human Services, recently agreed to continue their partnership initiative to include American Indians and Alaskan Natives (AIs/ANs) as participants in and beneficiaries of the research and training supported by the NIH.

Shortly after, the IHS and the National Institute of General Medical Sciences (NIGMS), one of the NIH Institutes, announced that they are the recipients of approximately $3 million in grant funds to support AI/AN medical research efforts.

Eight Native American Research Centers for Health (NARCH) programs have been selected to receive grants for proposals submitted during fiscal year 2001: the Northwest Portland Area Health Board, the Alaska Native Tribal Health Consortium, the Inter Tribal Council of Arizona American Indian Research Center for Health, the Five Civilized Tribes, the Black Hills Center for American Indian Health, the White Mountain Apache Tribe, the New Mexico Tribal Healthcare Alliance and the California Indian Health Council.

“These grants are critically important in our efforts to improve the health status of [Native Americans],” says HHS Secretary Tommy G. Thompson. “These funds will help address the underrepresentation of AI/AN researchers and their perspectives in medical research, and will empower tribes to influence research projects relevant to Indian communities.”

 

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“These funds will increase the capacity of tribes and universities to work in partnership to reverse a trend of Indian communities frequently being the subject of research and not benefiting from that research,” adds Michael H. Trujillo, MD, MPH, MS, director of the IHS. “Additional benefits from the NARCH program will be culturally sensitive research, research influenced and sanctioned by tribal communities, and the encouragement of AI/AN youth to consider research, science and public service as career options.”

 

In related news, the IHS recently relocated its headquarters functions to 801 Thompson Avenue in Rockville, Md. after residing at the Parklawn Building in Rockville for the past 31 years. The new IHS headquarters building is newly renovated and contains 50,918 square feet. This headquarters will house all of the Office of the Director functions and most of the programs of the Office of Public Health and the Office of Management Support.

“This building represents a commitment to improve the effectiveness and efficiency of the IHS headquarters staff in support of our mission to provide the highest quality health care services to Indian people,” says Trujillo.