Monthly Archives: August 2019

Today is our last day on the rez. Everyone is tired, perhaps starting to get on each other’s nerves a bit, but still hanging in there. I am still feeling good-we have had an awesome trip, and I have no complaints about anything. We started with a breakfast in the motel restaurant with Mrs. UB. This was not a required participation event, but I was happily surprised that the majority of the group came to meet her and visit. We enjoyed a lively discussion on different topics, and the students walked away with some new insights provided by Mrs. UB. In our discussion, one of the many things that stood out to me was her take on how our society is lacking the commitment of service to others and that there is a strong need to re-emphasize this, especially among youth. In a culture that values generosity and has the expectation of sharing if you are able to, service to others is a necessity. This is one of the many things that draws me to the Lakota and Pine Ridge. With these concepts so simple, why are they so hard to put into practice in our day to day life at home back in IN? I don’t have the answers, but I do have the ongoing goal to find the joy in service—whatever that may look like. The students received some great reminders from Mrs. UB as well about being present and actively listening with their patients. She will be moving to the extended classroom in the fall—Mr. G resigned, which is a huge loss, but Mrs. UB will be an outstanding replacement. I am looking forward to working with her again in the Spring for health teaching!

After dropping some donations off at the school for her classroom and getting photos with her, we turned our attention to a ranger class at the White River Visitors Center in the Badlands. We were extremely pressed for time, with Suzie’s tour of the Kyle IHS Clinic finally being scheduled to overlap with our ranger talk. We had the pleasure of meeting Ranger Matt, who offered a “menu” of ranger talks for the students. We decided on the Medicine Wheel talk, and this was perfect. He was a dynamic speaker and explained the Medicine Wheel in a way that kept my attention completely. Unfortunately, even though we did not want to leave the talk, I had to get Suzie to her tour. We made it to the clinic and decided to tour as a team (a la ‘Stepbrothers’-style). Someone asked me if I was her mother! The tour was fantastic and in-depth, and she was able to meet many of her future co-workers. She will be on a team with a DNP-prepared NP, focusing on int. med, infectious diseases, women’s health, and some behavioral health. This is going to be fantastic, and she will be living my infectious disease dream! After the tour, we raced back to the Visitor’s Center to pick up the students, only to find out that the talk ended 5 minutes after we left to take Suzie to the tour. The students played UNO on the porch of the Visitor’s Center while they were waiting, and even though they likely wanted to complain about this extended and unplanned wait, no one did. After thanking Ranger Matt, we were off to Pine Ridge one more time.

We made our appointment at the OLC Nursing Program and enjoyed our tour and talk with MB and another faculty member. They are down to 3 faculty members which I cannot even imagine. Her very optimistic attitude about this reminded me of when I did home health supervision and the day would end without enough nurses on the schedule for all of the patient visits—it will work out and always does. We had a fun trip to Red Cloud Indian School—normally, this is not necessarily a fun stop, but rather one of solace and peace in the beautiful chapel. We still found this; however, there is a selfie backdrop in the Heritage Center that provided us with a chance for photo posing that caused me to laugh hysterically. For all of the moments of work, seriousness, service, and respect for the culture, a trip to Pine Ridge also involves many laughs with the students, and I enjoy these moments nearly as much as everything else. A Higher Ground coffee shop stop, a trip to Big Bats for gas, and then on to Wounded Knee for our last stop. We made the best of our time here—today and the whole week.

Our week is wrapping up, and with that it means a bit of a slowdown with screenings but still trying to fit in a few more visits and stops around the rez. Tuesday found us at the Singing Horse for most of the day. No matter how many students I bring or their riding experience or lack thereof, Rosie always accommodates us for horseback riding. This is always one of the events that students are most excited for so it is nice to finish up the week with this fun activity.

While half of the students rode, the other half got a beading lesson from A. A. is a patient teacher who never gets frustrated no matter how many times she has to untangle something or help someone to correct a mistake. This is always a great time for us to chat and catch up also—I always enjoy this part of our visit. All of the students finished their bracelets, and many were able to include some fairly complex designs. Very impressive! Along with horses and beadwork, we were able to complete several screenings at the trading post to make this day even more of a success.

After returning to the cabins, we cooked hotdogs, bratwursts, and smores around the fire. The students have enjoyed campfire time most nights during the trip for even further bonding beyond our numerous and long car rides.

There is a term used on the rez for the letdown and fatigue after the pow wow known as a “pow wow hangover”. In past trips, I have honestly felt this, but not this time. There is still so much to see and do that my fatigue thus far has not overtaken my energy level. Monday began with a trip to the historical center at the main Oglala Lakota College campus in Kyle. I am pretty sure that the students were quite excited to find out that we only had to drive across the street and up a hill to get there instead of the usual 30-60+ minute drive. After a somber and reflective time listening to the history of the Lakota, many students verbalized there frustration with this historical mistreatment as well as an understanding of why there is such a mistrust of the governmental-run health care system on the rez. We enjoyed the college grounds and the views from the pow wow arbor where graduation is held before heading to the college bookstore for OLC t-shirts and other souvenirs. The primary purpose of being on the campus was to do screenings at OLC Head Start Administration for the staff who had an all-day orientation session. We had a room of approximately 40 employees, and I knew from past experience that we would be quite busy. We set up as three teams for screenings and after some initial equipment and technology glitches that were quickly resolved (or as quickly as I could get them fixed), the students were screening smoothly with their best teamwork to date. We saw many repeat screening participants and had many quite positive interactions. We did have one employee with a blood sugar of over 400 who had not previously been diagnosed with diabetes but had a family history. The students provided education, and I gave her very specific instructions about following up ASAP with her provider. I will plan to follow up with her next week to make sure that she was able to get an appointment. After an intense and busy few hours, we moved on for another brief siesta before heading to the main part of Badlands National Park.

The park was super busy, but still an outstanding visit. We did a hike through the rocks to the edge of the cliffs, and at one point I told Suzie that if we got lost she had to wait for me, even if it got dark. We successfully made it back to the van with the rest of the group though—thank goodness. We never saw any buffalo, but after turning down an unpaved road, came across a herd of bighorn sheep with lots and lots of tiny babies. I have never seen these before during any of my trips so it was quite thrilling. We got out and took photos as close as the sheep would allow us to get. I’m pretty sure that is the students could have caught a baby that it would have ended up in the van. A bit further down the road, we stopped at one of the many prairie dog colonies. These prairie dogs are apparently used to people and allowed us to get quite close to them for photos. After turning around to try to find an overlook to watch the sunset, we saw more prairie dogs and upon the advice of one the students decided to try to feed them popcorn. This began initially as popcorn and pretzels being thrown from the van to the prairie dogs and progressed to the students getting closer than I would have liked to offer their popcorn. We had previously discussed that prairie dogs carry the plague, but this was not a deterrent. Apparently, I have lost control of this trip (not really)… Many had what was described as a ‘bucket list’ prairie dog encounter and lots of photos were taken in the process. We had vigorous hand-sanitizing before moving on for the sunset. Ten pm tacos were the end of this busy, busy day.

Sunday was a bit of a later start with our plan to arrive at the Relays at 12 noon. Initially before the trip I was told that there would be no relays which was terribly disappointing. The Relays are absolutely my favorite event—both for spectating and for screening. Upon arrival at the rez, I found out that the relays were on, and this was great news!

We received a warm welcome when paying our entry fee with the promise that we would be announced for our screening tent. With our early arrival, we had our choice of spots for canopy and ended up with a prime spectating spot right by the starting line. As promised the announcer let the crowd know that we were there and available for free screenings and free hygiene supplies. Very quickly we began to have business with many repeat screenings from past years. It’s hard to describe what makes this environment different for screenings—it is more relaxed, people are more willing to chat, and overall, it is just more open. Also, thankfully, the temp was cooler than 95 with clouds and a nice breeze.

Before we knew it, two hours plus had passed, and the races were on. One of our first screening participants parked next to us was the family member of one of the relay racing teams and had a grandson that we had watched a few years ago (when he was 2!) in the pony races. The grandson, P., was in the pony races again—he was fully dressed in racing regalia and his dad lead him during the race again. This was quite the exciting pony race, with P.’s dad falling down amongst the ponies during the race, and P. finishing second on his own in full meltdown crying. Poor baby-he probably thought that his dad had been trampled. Everyone was fine though—no injuries but just the type of excitement that we are used to at the relays!

During a lull in the activity, Suzie and I and some of the students went to the concession stand in the center infield area of the track to seek out snow cones. During this trip away from the tent, we ended up preoccupied by a month-old pony that was absolutely precious. We took so long that a race was run and completed. I happened to look up and see the majority of my students sprinting down the track—a rider in this race fell off his horse and was stepped on at the end of the race. I told Suzie that we had to go, and we walked quickly (sorry, no sprinting from me at this point). Side note: There is usually an ambulance present throughout the relays, but for some reason there was not one present this year. The students and relay officials/organizers were gathered around the rider who was screaming in pain. They had already cleaned and dressed his leg wound and done an initial survey. There was no neck injury or other injuries beyond the leg. This rider, a young Lakota man, insisted upon standing up—screaming, “I’m an f*&3@ing cowboy”. He was helped to standing and supported to be non-weight bearing and carried to a four-wheeler. It was unclear if his leg was fractured or only the wound with soft tissue injury, but it was treated like his leg was broken. After being taken off to wait for the ambulance to arrive, the students received big thank you from the relays announcer and clapping and car horn honking from the relays audience. I am very proud of their actions—they acted quickly, appropriately, and as a team. What an outstanding representation of the school and the profession of nursing. We had a visit from one of the relays officials after this incident telling us that we needed to be on stand-by in case anything else happened injury-wise since the ambulance was not present.  Thank God there were no further injuries, even though the relays were some of the wildest that I have seen. Just absolute chaos and craziness.

Also, during the races, two young boys came around selling raffle tickets to try to raise money to go to compete in a horse race in Minnesota. Jordan bought $5 worth of tickets from them, and toward the end of the races, we were quite surprised when his winning ticket was drawn. He won a beautiful star quilt in white and blue tones that almost looks like a snowflake and some relay team t-shirts and a hoodie. What an end to the day at the races!

Saturday saw a return to Pine Ridge for us with an earlier start to ensure that we could make it before the road closed for the pow wow parade.  We returned to our spot along the sidewalk across from the pow wow grounds.  While yesterday was a trickle, today was a steady stream.  Pine Ridge turns out for the parade and that benefited us greatly as far as screening participants.

The students now work as a team fairly seamlessly–they are comfortable approaching people and inviting them to our tent.  They also pair up without issue and trade off so that everyone gets a chance to screen.  The weather today was HOT and dry with no breeze to speak of so our only issue was our incredibly sensitive cholesterol monitors.  They are not meant for this type of environment, but we make it work by keeping them in the shade and putting them on ice in between screenings.  We have seen all ages during our screening time–elderly to young adult with lots of children for the students to interact with.  Our kids bag has bubbles, frisbees, coloring books, and crayons, and the bubbles are always a hit.  With lots of screenings, kids galore, and throw in a cute puppy at the tent next to us, and you have a great screening environment, even with the heat.

While the big excitement during a previous trip was a high speed chase that we witnessed in Pine Ridge, this year there was a car fire on the pow wow grounds.  Nothing to see beyond a lot of smoke, and thank goodness everyone got out safely.

With our location this year, we were right at the end of the parade route so once the parade started, the students and alum were just like the kids with their empty bags waiting for candy to be thrown at them.  They ended up with two hospital bath basins full of candy.  I stayed in the shade of the tent, and by doing so missed out on getting sprayed by the fire truck like a sprinkler.  Oh well, there’s always next year.

We also met a group from IHS that were staffing the mobile clinic at the pow wow.  This was terribly exciting for me, and they were so kind and friendly.  We met an ED nurse, a flight nurse, and the supervisor of outpatient services.  We exchanged contact information, and the supervisor of outpatient services told me to contact her for tours and other experiences with IHS.  We were also invited to tour the mobile clinic!

After screening for as long as our equipment would hold out, we stopped by the mobile clinic, and the students did a brief tour.  The physician staffing the clinic stated that in past year’s she has seen up to 150 patients over pow wow weekend and that sometimes people will come to see her for a visit and this is the only time that they will see a Dr.  This certainly supports what we have heard from many people–they just don’t go to the doctor or are distrustful of IHS.

We went into the pow wow briefly to get a beverage from my new iced coffee supplier–Pejuta Sapa–or Black Medicine Coffee.  It is a mobile coffee shop truck based in Kyle but at the pow wow this year with the food vendors.  After everyone got something cold, we saw that the dancers were lining up for the afternoon grand entry.  I decided that I was going to seek out our friend S., an elder traditional dancer, from the 2016 trip.  We met him at the pow wow in 2016 and talked to him extensively and then later sent him a note and photos.  I easily picked him out of the crowd–he was in his red regalia talking to two other traditional older traditional dancers.  While he did not remember my name, he remembered the group from 2016 and was surprised that we had come back.  He also stated that he still reads the note that we sent him periodically.  He is doing well and currently helping to care for his wife who recently had some toes amputated.  We took photos with him, and I told him that we would send some to him from this year.  It was great to see him, and I am so happy that he remembered the group.

After another fiesta/siesta, we went to Singing Horse, and I finally got to see A. and baby L.  Also, V. and C. were in the store–I had not seen C. in 5 years since she moved to Rapid, but she remembered us as well.  The students shopped more and then climbed the ridge again for photos.  We drove out to the Red Shirt Table overlook trying to catch the sunset, but I had visited too long at Rosie’s, and we barely missed it.  Doesn’t matter though–the incoming storm clouds and colorful sky against the backdrop of the Badlands provided some of the most beautiful landscape, I have ever seen.  A great way to end this day–chasing sunsets as the students say.

As we arrived on the reservation, there was still so much up in the air as far as plans. One thing that I am always able to schedule ahead of time is our visit to the Oglala Lakota College Nursing Program. We were scheduled to visit at 0930 on Friday, but I got an email from our contact to cancel due to a family member’s health emergency. We quickly regrouped and used this bonus time to sort our donations. We had received 180 pounds of personal hygiene items from Supplies Over Seas (Thank you!) and then the students had gotten other donations as well. After a fun, donation-sorting period, we left for the Children’s Pow Wow in Pine Ridge.

This year was the first year for a separate Children’s Pow Wow so of course, we needed to see the kids! After a grand entry that mesmerized the students, the kids (all the way from toddlers to teenagers) began their specific dances. My favorite is the men’s/guy’s traditional dance. In this dance, the men wear a bustle of feathers, a headpiece with feathers that looks like a long mohawk, and often times a breast plate. In this type of dance which I think (emphasis on the think!) the moves simulate the hunt. The precision of the steps and body movements with the drum often gives the sense that the dancer is in a trance—they seem to be one with the beat of the drum. There was a teenage boy with red regalia that made an instant impression in this dance. He was absolutely amazing to watch. I look forward to seeing him dance in future years—he is already amazing and probably only 14 years old!

I also needed to make contact with my tribal contact that I met last year about where we were going to set up near the pow wow for screenings. He and I have had a back and forth discussion on whether we needed to pay to be a vendor. Since we are not selling anything, paying to be present seems like a stretch, but I do understand that the pow wow takes a lot of planning, manpower, etc. We finally got things worked out, and for the first time were to set up outside the pow wow parking lot. We were with vendors selling Indian Tacos and other food along the sidewalk of the parade route. I had decided that we would begin to screen on Friday if given the opportunity and since we needed to stay in Pine Ridge so that we could go back to the pow wow then why not set up for a couple of hours? Of course, I forgot a few things at the cabin—like our IUS banner, etc. but that is par for the course. There are a lot of things to remember and organize for this trip—I do my best! Anyway, we set up and surprisingly had a steady trickle of interested people. This was a good start for the students to get used to the telemedicine platform, screening flow, and what to expect. Several of the students chose to be our outreach team and walked around talking to people and inviting them over to our tent. The team worked very well together-taking turns, assisting each other, and adapting very quickly to the expectations.

We went back to the pow wow for the main grand entry at 7pm. I had told the students that the evening grand entry was like the children’s grand entry but on steroids. We found an excellent spot to watch, and the grand entry did not disappoint. I love to watch their reactions to this beautiful event and see the awe in their faces. It is such a beautiful expression of the Lakota culture, and it gives me goose bumps every time that I have the privilege to attend and observe. I encourage students to take photos as appropriate, and as with other groups, this group was afraid to ask individual dancers if they could take photos with them. We got over this hurdle when I asked a teenaged female jingle dancer in the most beautiful pink regalia if Becca could take a photo with her. She was very gracious, and this broke the ice. As we got ready to leave, the students got several photos with their favorite dancers. Spirits were high as we headed back to our home for the week.

Where to start with this trip? So much already…another drive, another group, another trip with new experiences. Here I am again-on the reservation with 10 students and an alum. This will be the largest group that I have taken since I’ve been at IUS, and unfortunately, that means moving back to the 15-passenger van. At this point, I feel like I could drive an RV without difficulty!

We left at 11pm on Tuesday night—one alum and 3 students and the van loaded with lots and lots of donations. The other 7 students chose to fly with an arrival on Thursday. A long, long drive with no hiccups beyond my travel credit card not initially working, and we arrived in Kyle around 4. Since the burrito stand was open when we drove in, we started our trip with an Indian Taco of pure deliciousness (this was before we even got to the motel!). A smooth check-in later and a siesta (or fiesta if you are Jordan) was had by all. I probably could have slept from siesta-time at about 5pm until the next morning, but my excitement at arriving overruled the fatigue. We went to Singing Horse to say hello, and I got to see Freida, Andrea, and Rosie briefly. The students climbed the ridge and took photos before we returned to the motel.

The other 7 students arrived in Rapid at 12:15 on Thursday. We didn’t waste our morning before our drive though—we stopped by the Badlands Visitor Center and took photos around the visitor center. The group of 3 and Suzie already have a great vibe. Energetic and enthusiastic for anything—this is my favorite trip mindset, and it is not always possible with students. The other students arrived on time, and we went to Mt Rushmore and Crazy Horse. There was a Theodore Roosevelt actor at Mt Rushmore for the first time, and we enjoyed meeting him and getting photos (there has to be some sort of new draw since Mt Rushmore is generally a drag!). We found out that he was from Indiana and will be coming to the Corydon Historical Center in October for a re-enactment. Such a small world! After eating at a very interesting Mexican restaurant in Rapid, we went to Walmart for the usual divide and conquer shopping trip that ends with trying to cram everything in the van with the luggage and the passengers. Of course, it fit—it always does! We’re off to a great start, and I am looking forward to a productive and fun week.