Health care on the reserve
The Kiska Waptan Nakoda First Nation has endured incessant hardship since settling the Kootenay Plains more than 100 years ago.
but over the years, flooding, poverty and politics failed to drive the people from their homes on the Big Horn reserve.
Illness and old age are proving to be more tenacious obstacles to the community.
Joyce Ritchie had no experience working outside a hospital before she took a job as a home care nurse on the reserve six years ago.
Helping elders like Rosie Crawler, 76, remain healthy enough to stay there has taught her the importance of working with people in their own environment.
Based in Rocky, Ritchie has visited Crawler once a week for the past six years to monitor her diabetes, blood pressure and medications.
No sooner has Ritchie arrived for her latest visit than Crawler’s granddaughter, Denean, hands her a slip of paper penciled with test results from the previous night.
Crawler, 76, had a bad case of the shakes after driving home in a hailstorm. It might have been nerves or, worse, her diabetes.
“Good for you,” says Ritchie, who reviews the results before checking Crawler’s blood sugar level for herself. “You’ve got to keep on track of them.”
Tests complete, the conversation turns to Big Horn’s upcoming powwow — and Crawler’s odds of snaggin’ a boyfriend.
“Do you want me to bring you some condoms?” Ritchie asks half-jokingly, drawing a hearty laugh from the Stoney elder.
Ritchie’s caring and compassion has earned her the respect of her peers and members of the small First Nations community, located 160 km west of Red Deer.
That respect led to Ritchie receiving a National Award of Excellence in Nursing for First Nations and Inuit communities earlier this year at a ceremony in Ottawa.
The award recognizes nursing excellence and the key role nurses play in improving the health of First Nations people.
Recipients receive a certificate, a crystal sculpture and a $2,500 non-cash award for professional development.
There are more than 232,000 registered nurses in Canada. About 1,200 work in First Nations and Inuit communities.
Dawnna-Lee Nielsen, nurse in charge at the reserve, nominated Ritchie for the award. She says Ritchie is a valuable asset to the community and other nurses.
Her close ties to physicians and other health professionals in Rocky Mountain House is also a big plus.
“Joyce is someone you can count on to make sure the work is done. And not just done, but done really well,” says Nielsen.
Ritchie says she didn’t give much thought to the nomination because there are so many qualified nurses in Canada.
That is, until the Office of Nursing Services left a message on her answering machine.
“I thought, ‘Oh no! What did I do?’” says Ritchie with a laugh.
Born in the United States, Ritchie and her husband, Doug, moved to Nordegg in 1978. They ran Frontier Lodge, a Christian wilderness camp, until 2002.
Ritchie also worked at the hospital in Rocky Mountain House and was involved with Nordegg ambulance, which also served the reserve.
“I don’t think there is a house I haven’t been in out here,” she says with a laugh.
Ritchie was teaching a personal care attendant course on the reserve in 2003 when the federal government launched its home care program.
The nurse in charge at the time persuaded her to apply for the casual position, which became a regular part-time position a year later.
“I’m surprised I ended up here, because I’m very much an acute care nurse. That was my passion,” says Ritchie. “But I love doing home care because it’s so different.”
Ritchie says the home care program’s goal is to encourage members of the First Nation to take responsibility for their own health.
One component of that is to help elders stay in their homes as long as feasibly possible.
That’s really important on a remote reserve such as Big Horn since there is a good chance that elders who require long-term care will end up in Rocky Mountain House or, worse, Red Deer, far from their families.
Aboriginal families are so integrated that Ritchie often treats three generations during one visit.
While Ritchie is monitoring an elder’s diabetes, another family member might mention that he has a sore throat. Then Ritchie might check whether an infant’s immunizations are up to date and remind the parents to take it to the clinic.
Ritchie says she tries to take advantage of “teachable moments” to advance health promotion and prevention.
“One time I was there I had a young teenager come in and we started chatting about sexual health,” says Ritchie. “By the time you’re done (one visit), you’ve covered the whole gamut.”
Ritchie still works part-time at the Rocky Mountain Hospital and Care Center. In her spare time, she is wrapping up work on a nursing program at the University of Alberta. Her goal is to graduate in the spring of 2009.
“I was just the only one in my family without a degree. I had to fix that,” Ritchie says, laughing.
Ritchie says she visiting her clients on the reserve gives her a better understanding of what will work if they end up in the hospital.
There is no point sending a patient home from the hospital in a wheelchair if their home is not equipped with a ramp. Likewise, its simply not feasible for a client to drive to Rocky Mountain House twice daily so a nurse can give them medication.
Other variables that affect aboriginal health include the price of gas, the weather, culture and language. Even access to healthy food is a problem, since the nearest grocery store is in Rocky Mountain House, says Ritchie.
“Right now what they often do is look at their gas tank to decide whether or not they can take a child (to the hospital).”
But the experience has gone far beyond health care for Ritchie, who says she has learned something about the First Nation and its culture.
The elders are incredible teachers, she says, and she loves when they tell their traditional stories.
“They are incredible survivors,” says Ritchie. “Our job is to encourage them along and point out that this is really a strength that they have.”
Contact Cameron Kennedy at ckennedy@reddeeradvocate.com.
COMMENTS
Let's keep comments:
We ask that all participants own their words by logging in with their Facebook account. It's a simple process that will take seconds and helps keep our comments free of trolls, cranks, and “drive-by” commenters.
We reserve the right to remove comments from anyone using screen names, pseudonyms or false identities. Please see our FAQ if you have questions or concerns about using Facebook to comment.