At the base of the stunning blue and green Mission Mountains and a few miles south of the largest natural freshwater lake in Montana, sits Salish Kootenai College (SKC), the tribal college of the Flathead Indian Reservation. SKC seeks to integrate Native cultural content into classes, programs, and the college environment. Nowhere is this more apparent than in the Salish Kootenai College Nursing Department.
Located in the John Peter Paul Building, a two-story brown building on the far north side of the college’s 128-acre campus, the Nursing Department houses three practice/teaching labs, multiple classrooms, and the program’s staff and faculty. Enter the second floor of the building into the long, cream colored hallway and one will observe a pictorial testimony to the astounding number of nursing students who have graduated from SKC.
Salish Kootenai College offers two nursing programs. The Associate of Science in Nursing (ASN-RN) is a two-year RN program that is designed to provide entry-level skills and knowledge needed to gain licensure and to function as an RN. The Bachelor of Science in Nursing (BSN-RN) is a four-year, online/hybrid program that offers working nurses an opportunity to further their education level and degree while remaining in their home or job. The BSN-RN is an upper level program that focuses on complex practice, clinical leadership, and care for individuals, families, and populations. The college gives tribal preference for all nursing students, opening an educational door to a multi-level approach of culturally congruent care.
What does it mean to be a competent, critically thinking, culturally aware nursing student fluent in anatomy, physiology, chemistry, statistics, and your own tribal culture? It means a winning combination for success. Healthcare professionals at all levels can offer compassionate and culturally respectful care when aware of a particular culture or tribe. Sharing that knowledge, being aware, and offering that extra measure of compassion to the frail population in medical need is a strength of tribal nursing at SKC.
Nursing students begin their course of study with an orientation to the main nursing labs, which involves learning about all aspects of healthcare. The first of the three lab settings offers students an opportunity to apply the theory taught in class to the safety of a simulated laboratory. The specific lab setting can be tailored to incorporate any aspect of tribal custom or need. For example, a patient may have a specific need for a tribal ceremony during an illness, which can be incorporated into actual lab time, simulating the real-life need a tribal member might request. Or perhaps during a birthing event a simulated patient may request specific tribal customs to be included, thus teaching the students how and when to bring culture into a healthcare setting.
Another aspect of culturally aware nursing instruction is anticipating the specific cases that nurses working within a tribal system may encounter. For example, if a student nurse is given a real-life simulation experience of working with a pregnant woman who is giving birth to twins and having complications like requiring blood transfusion(s) or surgery, simulation offers the student nurse an opportunity to understand his/her own reactions to specific events.
To create a simulation scenario for a nursing student, mannequins or “simulators” are utilized to create a realistic medical setting. The life-like simulators resemble a patient a student nurse may encounter, being the size and weight of an average adult male/female or child. Depending on the medical scenario that the student is studying, on any given day student nurses may be working on a simulated mother giving birth to twins, or a simulated adult male who has a health concern, or a simulated child who has experienced a playground fall. Simulators can be computer operated, with the ability to speak, blink eyes, become hypothermic, and exhibit a wide-range of signs and symptoms according to the program tailored to the educational experience that a student needs.
Not until students reach a level in their nursing education in which they are actually interacting with real or simulated patients, do they begin incorporating critical thinking into sound and active medical decision-making. Such experience is essential for students who understand the principles of pediatric medicine, but who have never worked with pediatric clients or populations. Entering a lab fully set up for a variety of scenarios of problems and concerns, assessing a pediatric simulator with full pediatric responses, and initiating care for pediatric patients gives students an insight into their own level of ability and competence.
Registered Nurses are a vital part of the medical world, and the training and education required to advance students requires a combination of intense study, critical thinking, and the ability to absorb scientific knowledge. Add to this the essential element of cultural knowledge and sensitivity and it is clear why Salish Kootenai College’s RN graduates are such an asset to their community and why they make a difference in the communities they serve.
SKC students have the opportunity to work and study within a tribal college that not only promotes cultural sensitivity, but which offers a panorama of cultural insights to each and every one of its students. Student nurses work hard to become professional in their chosen career, and in the college’s Nursing Department that work is done with a cultural focus. The hard work to become a proficient Registered Nurse is reflected in the hard work that the nursing students show every day at Salish Kootenai College—where culture and rigor combine to bring solid success.
Kitt Adams, BSN, RN, a Salish descendant from the Flathead Indian Reservation, has been an active nurse since 1975 and is the nurse recruiter at Salish Kootenai College.