Promoting Nursing as a Career Choice for Native Americans

Volume 27, No. 4 - Summer 2016
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TRIBAL COLLEGE NURSING PROGRAM GRADUATESBaby Boomers are retiring in the thousands every single day and as this trend continues there are a number of concerns that need to be addressed, particularly shortages of healthcare professionals. What does this mean for the future labor market? It means that we need more doctors, nurses, more hospitals, nursing homes, and many more pharmacies. Without a doubt, all of these different areas will be impacted by the large number of retirees and their current and future needs.

Baby Boomers are individuals who were born between 1946 and 1964. During this period the United States experienced an unprecedented increase in birthrates. Since this generation continues to represent a large portion of our population, it is predicated that a major financial strain will be evident in programs such as Social Security and Medicare. These programs are managed at the federal level. At the state and local levels, we must provide the services that this generation will need in the areas of healthcare and wellbeing.

In addition to these concerns regarding Baby Boomers, the general population of the U.S. is increasing, especially among minority groups such as African Americans, Hispanics, and Native Americans. Furthermore, the number of immigrants is increasing by the tens of thousands every year, and sooner or later their demand for healthcare will also increase (Ewing, 2014). A rise in demand and not enough supply means a shortage of healthcare professionals such as nurses. Many media reports have warned that we might be in a national crisis if this shortage is not addressed sooner rather than later. While this raises eyebrows, and understandably makes us cringe, the reality is that this shortage should create employment opportunities for those groups who have high unemployment rates—such as Native Americans (Al-Asfour, 2015).

A Shortage of Nurses

Visit any of the healthcare facilities across the U.S. and one will notice that many of the nurses are close to retirement age (Carnevale et al., 2015). This means that in a short period they will be in need of healthcare themselves. Even though the U.S. has the largest nursing workforce in the world, based on the size of the country and the growth of population, there is no equilibrium between supply and demand. Carnevale (2015) reported that by 2020 there will be an additional 3.5 million nursing professionals, including 3.2 million RNs and 703,000 LPNs/LVNs. Although the number seems to be very impressive, the demand for nursing professionals will be over 4.14 million. Hence, Carnevale predicted a shortage of 193,000 nurses. This number is a conservative estimate and foresees a major shortage of healthcare professionals. The question is: what actions can or should be taken?

Many reservations and Native communities near reservations have major unemployment rates. For example, the Pine Ridge reservation experiences a high unemployment rate when compared to any state or federal standards (Al-Asfour, 2014). Lawmakers, politicians, and many others have discussed this for years, but the problem remains unresolved. Recently, Senator and presidential hopeful Bernie Sanders visited the reservation and spoke about the unemployment rate, as many others have. Local level efforts, with support at the state and national levels, could both affect the forecasted nursing shortage and affect what has been an eternity of unemployment in Indian County.

The Pine Ridge reservation resides in the second economically poorest county in the nation (Giago, 2012). Accordingly, finding employment for the people should be paramount for local, state, and federal leaders. Even though significant efforts have been made, there are still not enough work opportunities. For example, if a person were to visit the Pine Ridge reservation 35 years ago, that person would have seen only two or three Native American nurses working in the Pine Ridge hospital. Thanks to the Oglala Lakota College (OLC) nursing program, which has graduated many students, the majority of the nurses in the Pine Ridge hospital currently are tribal members. Even with the efforts of OLC, much more is needed.


OLC is one tribal college that is working to address a growing shortage of healthcare professionals and, at the same time, offering career pathways for its students.

Hospitals on many reservations and in nearby communities are in need of nurses and other healthcare professionals. Thus it is important that tribal members consider nursing as a career choice. The nursing profession needs to recruit young and motived people. Finding jobs and careers is the path by which the tribal community can prosper. Since there is a shortage, there is still room for growth and employment in a state like South Dakota.

Nursing Programs at Tribal Colleges and Universities.

Tribal Colleges and Universities (TCUs) need to play a bigger role within the healthcare industry. There are 37 TCUs in the U.S. and only 12 that offer healthcare professional certificates and programs (Horwedel, 2016).

Students who graduate with degrees in healthcare can easily find employment on the reservation or in different hospitals and/or healthcare-related professions across the country. Mainstream healthcare providers have had great opportunities on the reservations. Nevertheless, many individuals who practice traditional medicine can reap benefits from the increased demand in healthcare. TCUs can be leading hubs in the country for educating healers proficient in traditional medicine. Beyond any shadow of a doubt, there will be demand for these individuals who practice traditional medicine.

The demand for nursing allows for mobility. Nurses can look and find a job in virtually any state and the unemployment rate among nurses is one of the lowest in any career (McDonald, 2016). Once a person becomes a nurse, that individual can work in different areas of professional healthcare such as trauma care, patient care, the justice system (as a legal nurse consultant), teaching, writing, and many more. Acquiring a healthcare degree almost guarantees employment, even under tough economic circumstances.

TCUs should use the shortage of healthcare professionals as a major opportunity to offer an education which enables members of the tribal community to find employment. Since TCUs main purpose is to rebuild their communities through education, this is a golden opportunity. TCUs should not only focus on nursing programs, but should take the entire field of healthcare as a path of empowerment for their community members. Only with the right skills can we achieve our dreams of rebuilding the communities that we serve.

Ahmed Al-Asfour, Ph.D., is the chair of the business department at Oglala Lakota College.


Al-Asfour, A. (2014). Training for Tomorrow: Developing a Native Workforce. Tribal College Journal of American Indian Higher Education, 26(2), 24-25.

Carnevale, A.P.,  Smith, N., & Gulish, A. (2015). Nursing Supply and Demand through 2020. Georgetown University Center on Education and the Workforce. Retrieved from

Ewing, W.A. (2014). “Enemy Territory”: Immigration Enforcement in the U.S.-Mexico Borderlands. Journal on Migration and Human Security, 2(3), 198-222. Retrieved from

Giago, T. (2012). The Second Poorest County in America. Huffington Post. Retrieved from

Horwedel, D. (2016). Rx for Indian Country: Tribal College Education. Tribal College Journal of American Indian Higher Education, 27(4), 20-24.

McDonald, J. (2016). Nursing at Tribal Colleges. Retrieved from

2017 AIHEC Student Poetry Slam


On the opening evening of the 2017 AIHEC Student Conference in Rapid City, students from an array of TCUs entertained conference goers with the spoken word at the annual poetry slam. View the video

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