Nursing Schools and Programs
Students can choose from the more than 600 nursing schools that are members of the American Association of Colleges of Nursing. They are listed on the association’s website. Registered nurses (RNs) who want to earn their bachelor’s degree can explore more than 620 RN to BSN programs on the website, including more than 340 offered at least partially online. In addition there are 149 programs available nationwide to transition RNs with diplomas and associate degrees to the master's degree level.
Bette Keltner Jacobs, Cherokee, PhD, RN, Dean of Georgetown School of Nursing and Health Studies says that American Indian people who want to move into positions of high influence and high impact should consider premier institutions such as Georgetown. Graduate degrees are highly recommended.
Students who want to begin their education close to home or in a home-like atmosphere might want to explore schools, such as the following, that have programs that actively recruit American Indians and Alaskan Natives and support them during their education. Although the schools tend to focus on indigenous people in the state in which the school is located, students from tribes outside of the schools’ states are also welcome.
Below are descriptions of programs at the University of Oklahoma, Arizona State University, Montana State University, the University of Alaska, and Northern Arizona State University
University of Oklahoma
Nursing students doing health education in a school
The American Indian Nursing Student Success Program at the University of Oklahoma College of Nursing recruits students into the OU College of Nursing and supports them throughout the baccalaureate program. Program director Beverly Patchell, Cherokee, RN, MS, CNS says that a major focus is helping students learn to study and deal with test anxiety. “We have excellent students with good grade points. Only 120 of the 1200 applicants to the nursing school are accepted each year, so our students have gone through a very competitive process. Many Native people have been traumatized early in their education and feel they can’t learn math and science. They also can have trouble adjusting to the curriculum that is so focused in the head, meaning it is very intellectual. To help students learn we use things like the Cercone program that includes music and color. We also use the HeartMath program. When I recruit students, the Elders in the communities tell me they don’t want their children to go on to higher education because they will loose their heart. One of the benefits of the HeartMath program is that it provides grounding in the heart. These programs have been very helpful to students. Unofficially, I think that, on average, the HeartMath programs improve students’ scores by 17 points.”
The students’ clinical experiences include supervised, hands-on care of Indian people in clinics and hospitals in Oklahoma City and in tribal clinics outside the city, some of which have multi-million dollar budgets and serve thousands of people. As part of a leadership course, Patchell took some students to the Cherokee Nation Home Health Services in Tahlequah. Patchell says, “The students didn’t want to be in a hospital learning how to be a charge nurse. They wanted to see Indian people in leadership positions in a complex organization that relates to the Cherokee Nation, the state, and the federal government.”
Networking and a limited number of scholarships are among the other features of the Success Program at OU. Social support includes meetings with tribal Elders, medicine people and American Indian role models.
Arizona State University
American-Indian Students United in Nursing (ASUN) was established at Arizona State University College of Nursing & Healthcare Innovation in 1990. ASUN students participate in all of the courses and activities of the nursing school. In addition, ASUN provides a variety of services and activities. Program Director, Bev Warne, Oglala Lakota, MS, RN, says. “We think of the medicine wheel and try to support our students physically, mentally, emotionally and spiritually. Native students who are in the pre-nursing program can have tutoring for all required courses. Our ASUN graduates provide tutoring for students in the professional nursing program. They want to give back.
“We have an Elder Nurse Program with two nurses who worked for many decades in the IHS. Niela Redford, Choctaw, RN, BSN. MAOM (Master of Arts in Organization Management), comes to the school every Friday morning to listen to and talk with the students. Judy Black Feather, Ottawa, RN, BSN, MPH, also serves as an Elder and mentor.
“Rachel Carroll, a Northern Cheyenne traditional healer, is an important part of our program. Every month she conducts talking circles with our students. For reading day before finals week, she gives an inspiring talk about how nurses are healers. Then she does a blessing for each student. The smell of sage is very comforting. It grounds the students. Rachael also offers a sweat lodge ceremony at the end of each semester.
“Students feel part not only of the ASUN family but also of the Native American Nurses Association (NANA) family. For example, the association and ASUN co-sponsor a nurse’s day luncheon at which we recognize the students, and veteran nurses give messages of encouragement to the students. NANA and ASUN also co-sponsor a welcome-back-gathering for nursing and pre-nursing students. Families are welcome at this and other events in keeping with our values as Native people.”
With more than 20 tribes in Arizona, all of the students at ASU have many opportunities to take care of American Indian patients.
Warne encourages bachelor level students to begin thinking about entering a master’s program. When students graduate, she tells them, “Keep connected with your roots and your school. Mentor others. Get back into school as soon as possible because with a master’s or doctoral degree you can have even more of an impact.”
Montana State University
The Caring for Our Own Program (CO-OP) is a Reservation/University Partnership. CO-OP works with a state-wide advisory board with members from each reservation who represent the education and health sectors. The advisory board acts as a liaison between the reservation communities and CO-OP. Board members identify perspective nursing students as well as effective outreach strategies to use in their respective communities.
CO-OP creates a community away from home through an orientation program, culturally-sensitive advising, group tutoring, leadership training experiences, and other strategies that create strong support networks for students. In addition to the regular nursing curriculum, CO-OP students participate in weekly seminars addressing critical issues in Native health care. As part of the seminars, students plan and implement service learning projects aimed at improving the health of Native communities through education and action campaigns. Some examples of recent student projects include oral hygiene and physical activity education for preschool-aged children; STD screening and risk assessment for college-aged Native American students; tobacco prevention education and action PSAs done in collaboration with middle school-aged children; and family dietary health education that includes the effects of diet on behavior. These projects provide a sense of connection to Native communities while providing a hands-on learning experience.
Twila Old Coyote, Crow, MEd, Assistant Director of CO-OP, says that CO-OP is celebrating 10 years of work. In that time, 43 students have graduated and returned to their home communities providing culturally-sensitive and clinically-excellent health care to their own people. In the last four years, 22 students have earned their BSN’s and eight have started the master’s program. Currently there are 35 undergraduate students and 5 graduates students.
Casaja Fritzler, Crow, says that CO-OP helped her get through school. She has returned to her community and is working as a nurse on the Crow Reservation. See her story in the Bozeman Daily Chronicle.
University of Alaska
The RRANN program (Recruitment and Retention of Alaska Natives into Nursing) at the University of Alaska School of Nursing in Anchorage began in 1998. In their outreach program, RRANN staff try to identify students who would like to become nurses and help them think through what they will need before coming to the Anchorage campus, including funding and housing.
RRANN coordinator, Randi Madison, Inupiaq, says, “Many Alaskan Native students come from small villages. Anchorage can feel overwhelming, so particularly in their first year, we encourage students to stay in the Nightingale Wing of the on-campus residence hall, which is set aside for nursing students. Living in this community helps students build relationships with each other.”
All pre-nursing students meet weekly in the Nightingale Wing where they have sessions on various topics or just relax together. Nursing students in the 4 semester diploma program or the 5 semester bachelor’s program meet together once a month. Madison notes, “We offer a variety of things particularly stress management and time management because the students are incredibly busy with school and often also with families. Students share advice. We encourage students in both groups to bring family members with them.
“Some students drop out of school, not because they can’t handle the classes, but rather because it can be very difficult to navigate the system. We try to prevent this by building relationships with students so they will feel comfortable and come to us if they run into problems. We do a lot of advocacy for our students. We also make sure that they get the academic support that they need.”
Bachelor and associate degrees in nursing are offered at the Anchorage campus. In addition the associate degree is offered at 9 of the university’s other campuses across the state. Madison says, “RRANN has recently received funding for facilitators on the Bethel and Sitka campuses. The facilitators motivate local people to consider careers in nursing. Some of their recruits may to go to Anchorage but students can also choose to earn an RN through an associate program and then participate in the RN-to-BSN program. The lectures in the RN-to-BSN program are offered on-line. Clinicals are arranged at hospitals nearest the students’ campus of study. RNs with family and other obligations can earn their bachelors degree one course at a time while they continue to work.”
RRANN funded 67 pre-nursing and nursing students across the state in the spring semester of 2007. There have been 66 graduates. Most stay in Alaska. Some return to their home village if it’s large enough to support a nurse.
Northern Arizona State University
The programs described above supplement nursing programs, providing, Native students with support and enrichment. The American Indian Program at Northern Arizona University School of Nursing is a complete program. In 1995, it became the first reservation-based, baccalaureate nursing program in the United States. All students can apply to NSU’s main program in Flagstaff. Only Native students are eligible for the American Indian Program on the Navajo Nation. In the first years of the program most of the students were from the Navajo Nation. Now students from other tribes are also joining the program.
Karine Crow, Cherokee, PhD, RN, Director of the American Indian Program, says, “Students in the American Indian Program have the same teachers and the same course content as the Flagstaff Program.” Students in their first two years of the nursing program go to a site, such as Fort Defiance or Chinle, for courses taught via interactive television and the Internet. Beginning in the first year, for all but two courses, students use simulations, manikins, and other strategies in the clinical lab at St. Michael’s to learn specific clinical skills. When they pass the clinical lab exam, they practice their new skills, under supervision, in Indian Health Service facilities. In the last 8 weeks of the 3-year program, students have their first clinical experience off the reservation in a high-level trauma center. Crow explains, “Students have very good experiences on the reservation, but we want to make sure that they have all had access to all levels and types of care.”
Challenges can occur in both indigenous and non-indigenous communities when a few members become the first generation to earn degrees in higher education. This can be particularly true when education has previously been used in hurtful ways. Crow says, “Particularly if the student is from a group culture, while the student is in school, it can be hard for the community to understand why the student is not spending time with them and fulfilling their roles within the family and community. Sometimes people leave to attain their education but can have problems returning and being accepted back home.
“Studies show that if students learn within their framework, it is easier for them to integrate their culture while they are learning. To help our students with integration, two medicine people who have master’s degrees, do traditional ceremonies and also show our students how to build a bridge between traditional and western medicine. One medicine person is a midwife with a master’s degree in nursing and a master’s degree in public health. The other medicine person has a master’s degree in education. In addition, every spring a successful Native graduate of our program offers an elective course in Navajo medical terminology.
“Having students learn in their own communities provides an opportunity for communities to grow with the students. Even though sometimes it’s hard for the community to allow members to change their roles, the community benefits from students’ new knowledge and skills. Since nurses are desperately needed, graduates quickly become leaders who are role models and mentors for the younger generation.”
Two other programs that support American Indian students are the Wokunze Project at the South Dakota State University College of Nursing and the Recruitment/Retention of American Indians in Nursing (RAIN) Program at the University of North Dakota College of Nursing, which has been active since 1990.
This article was originally published in the Summer 2007 issue of Winds of Change. (The cover artist is Bunky Echo-Hawk, Yakama/Pawnee.)