Nursing and the healthcare related fields are avenues of great opportunity for tribal colleges and universities (TCUs). Health sciences are growing and proliferating at a dizzying rate. Today, TCU students who earn nursing or healthcare-related degrees will have good job prospects and the opportunity to return to their tribal communities to help their people.
Salish Kootenai College (SKC), the tribal college of the Confederated Salish and Kootenai Tribes, was one of the first TCUs to offer a nursing degree for its students. The program expanded, and today SKC offers both two and four-year degree programs, as well as an Associate of Arts and certificate dental assistance program. Longtime president and SKC founder, Dr. Joe McDonald, discusses how SKC developed its programs and became one of the state’s leading institutions for nursing and healthcare programing.
Can you tell me a little bit about the nursing program at SKC—it’s main focus, the training it offers, and the opportunities it affords?
Well, there weren’t many nursing programs in Montana. We put it together in the late 80s. The state board hadn’t started or approved a program since 1952 and in 1976 there was one Indian student in nursing in Montana. We didn’t have public health hospitals here. And even if we did, they wouldn’t be staffed with Indian people. We had a few Indians who had gone through nursing programs in the 40s and 50s, but you could count them on one hand. So that was our focus.
It was quite a struggle with the state nursing board. Michael O’Donnell really helped with it—he was a great program director. He even wrote the president [of the United States] about our proposal to start a nursing program. Our tribal chairman joined up and we got approved. Our focus is floor nursing.
Healthcare is changing. There are different aspects to it now—residential and hospital. At the time, the places of training were St. Pats and Community Hospital in Missoula. Mike [O’Donnell] worked with the presidents and hospital CEOs.
Our nurses were older. We had a few men, but mostly older women. The doctors and the people at the hospitals were really impressed with our students. They weren’t 18-year-olds, they were in their 30s and 40s and really focused. They’d do what they had to do. I got many calls from people who were treated by our nurses and were really impressed. They wanted our nurses so our job placement was really good. We trained them from all tribes from all over Montana. They went back and worked with their respective tribes.
Some nurses who served in the state legislature helped us and supported us. There was a big war on at the time over nurses with two-year degrees and those with baccalaureate degrees. There were a lot of good RN’s who had two-year degrees. We were a two-year program and we got support from those nurses on the state board who had two-year degrees.
They didn’t think we could do the [nursing licensure] test afterwards. I contacted a state senator who wrote me back and said he didn’t think we could do the test. I threw the letter away. We had the highest composite score in the state on the test the second year of our program. Nowadays they’re approving them [nursing programs] right and left. There’s such a nurse shortage so they’re cranking them out.
There’s something about our nurses. Being Indian people they’re used to caring for people. They have compassion, plus they’re a little older.
When did SKC establish its four-year nursing program and how did you do it?
Years ago we went to a four-year program. Now we have both a two-year and four-year. This [the four-year program] started this in the late 90s. Our first four-year program was in 92, and that was in social work.
What were your primary concerns when discussions began about launching a nursing program?
The concern of course was that our students came in with a high school background. The nursing program was so rigorous. There was a sequence in courses. If you fail, you’d be out of sequence and would have to wait a year. The instructors had to be very strict. When you’re injecting something in someone’s vein, you need to be damn sure you’re accurate. This isn’t a social science.
Plus there was all the coursework in anatomy, algebra, biology. We wanted them to have a certain number of courses before they’d be accepted into nursing.
We’d have a lot of non-Indians wanting to get into the program. We’d bring in 25 and 18 would complete [the program]. We’d bring in all the qualified Native students, and the best of the non-Native students—the cream of the crop. So there were two different groups of students working together. We trained a lot of non-Indian nurses. Some are now hospital managers.
What do you see as the greatest benefits of the program?
When we started the nursing program, students had to take algebra. All the other students saw that if [the nursing students] could do it so could they. It motivated the other students to take those math and science classes. It had a positive effect on the whole college. The nursing program really made our college. It made everything else fly.
Also our reputation—we really put out some great nurses. It put our college on the map. When I go to the state legislature for money there’s one state legislator who always tells the story about his daughter going through our program and how great it is. Hopefully we’ll offer a master’s program leading to a nurse practitioners degree.
We don’t hurt for faculty. It’s a wonderful area to live in and work in. We get good applicants.
SKC also has a dental department. Can you talk a little bit about that?—it’s main focus, the training it offers, and the opportunities it affords?
It was the same thing, there was such a shortage of dental hygienists. There were no programs. The Kellogg Foundation helped us get started. We also got equipment from the Army so we have all the latest technology.
We have Job Corps in the area. The Job Corps students come in and go through the program and they’re trained to help in dental health clinics. When I go to the tribal dental clinic, the hygienist is a graduate from our program. The dental assistant’s program has been going since the late 1980s. There’s the certificate program which is what IHS requires. It takes 24 months and is 71 credits. The A.A. program, dental assisting technology, is a 91-credit program, but [the students] also get an Associate of Applied Science degree.
How do you envision the future of healthcare programming at TCUs?
It’s the field. It’s a growing field for tribal colleges. It’s the biggest employer in our area. Healthcare provides about 15% of the employment. There are so many fields. So [it’s advantageous for jobs and need. But it’s extensive. We tried to start a medical records technology program, but we couldn’t find an instructor in that field. It’s a big field. And then there’s all the other fields—x-rays, labs—there’s a lot of jobs.
Public health holds up the advancement of Indian people more than anything. There are such strict guidelines and they don’t put any money into it. There are obstacles for everything you want to do. When we did the two-year nursing program, they wouldn’t hire our nurses because they said they had to have a baccalaureate. But if someone is willing to go out into the community and help people, they’re needed.