Creating a pathway for rural providers to improve American Indian care

^{The Great Plains Area Indian Health Service map.}

Students at the University of Minnesota School of Nursing now have the opportunity to have clinical experiences at Indian Health Service clinics and hospitals after a collaborative agreement was established between the Great Plains Area Indian Health Service and the University of Minnesota School of Nursing.

The agreement facilitates the clinical learning experiences in 21 Indian Health Service Units and Tribal managed Service Units in North Dakota, South Dakota, Nebraska and Iowa for nursing students in the Bachelor of Science in the Nursing and Doctor of Nursing Practice programs.

The Indian Health Service, an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. Its mission is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level.

Erica Amador, BSN, RN, SANE-A, an enrolled member of the Turtle Mountain Band of Chippewa and chief nurse executive for the Pine Ridge Service Unit, approached the school about partnering after learning of the school’s Doctoral Education Pathway for American Indian/Alaska Native Nurses, which supports AI/AN nurses in completing a doctoral degree at the University of Minnesota.

“I thought that it would be a good pathway to spread the word about our agency and the opportunities available in this unique location and unique population,” says Amador.

As chief nurse executive for Pine Ridge, she oversees the administration of nursing services for the hospital and three clinics that serve 26,000 active patients in South Dakota. “We have a significant nurse vacancy rate because of our rural location so my goal was to build a pathway to attract students to learn here and discover the opportunities for them here after they graduate.”

While the agreement includes all of Great Plains Area, it’s expected that many of the clinical experiences will occur at Pine Ridge.

“It’s a great opportunity for students to learn about the culture of the community and to experience a very rural part of South Dakota. It’s a win-win for each of us,” says Misty Wilkie, PhD, RN, FAAN, Turtle Mountain Band of Chippewa/Métis and director of the Doctoral Education Pathway for AI/AN Nurses at the School of Nursing.

Since signing the agreement with Great Plains Area, the school has established new agreements with Oklahoma City Area IHS, Phoenix Area IHS, Navajo Area IHS and Albuquerque Area IHS.

Many of the opportunities at Pine Ridge are appropriate for DNP students in the nurse practitioner, nurse-midwifery and nurse anesthesia programs.

“We have a very busy emergency room that sees 80-110 patients a day with a high acuity of injuries and illness. It’s an interesting place to be where there are a lot of patient contacts,” says Amador. “Students will see how higher acuity patients are cared for in a rural setting, which is different than an urban setting where a variety of services are available at the same location. It’s different experience.”

Whether students decide to provide health care within Indian Health Service after graduation or not, they’ll be better prepared to care for American Indian patients regardless of their location. “Given that 70% of Native Americans live off of the reservation, whether they come to work on a reservation or not, they are going to care for Native Americans. Students coming here to do an immersion experience will add so much to their knowledge and comfort with our population. That’s really exciting,” says Amador.

Already, Amador is serving as a preceptor for a DNP student in the health innovation and leadership specialty and as a board member for the School of Nursing Center for Indigenous People, Health and Nursing of North America.

“I’m really excited about the whole experience with the School of Nursing. I’m proud of the University for the Pathway Program and assisting Native health care providers in reaching that doctoral level. It’s going to lend improvement to access and inclusion of Native nurses at higher administrative levels.”