Healthcare heroes are motivated by a number of reasons to put in long hours in grueling conditions. That’s especially true of those who leave their everyday world behind to work at a remote Tribal or Indian Health Service (IHS) medical facility. It’s an experience that’s profoundly rewarding, but also vastly different from serving patients in a tier one medical center. In some tribal communities, up to 35% of residences lack running water and electricity; many clinical environments are resource challenged. But most report it’s a gratifying opportunity to transform healthcare communities on a generational level – as well as to practice more hands-on care than is typical in most hospitals.
That’s the case with Dana Wade, a passionate advocate for Indigenous health and a clinical veteran of 19 years. Driven by altruism, and originally inspired by a family member who was a nurse, Dana knew she wanted to help the underserved. Today her work as a respiratory therapist with Tribal Health has made a remarkable impact in the lives of many patients.
A large part of Dana’s motivation: her Native American family members. “One reason I hold this so close to my heart is that my grandson and daughter are Cherokee,” she says. “They feel the care at their local facilities isn’t up to standard, that there isn’t the same quality of physicians. That’s part of where I get my passion for the reservations.”
Helping Those Who Help Others
Dana has served on several Critical Care Response Team (CCRT) deployments, which provide both clinical education and patient care. Through elbow-to-elbow training, reference guides, protocols, care checklists, and mock simulations, CCRT teams increase staff competencies in treating critically ill patients. Facility staff are trained to perform intubations, administer COVID-19 medications, assess and treat hypoxia, manage patients on ventilators, and administer Monoclonal Antibody Therapies. The result: patients receive top-notch care – not just while the visiting team is in residence, but after they leave.
As a respiratory therapist, Dana plays a pivotal role. In addition to providing direct patient care, she helps staff built greater confidence and expand their clinical skillset. Transfers are reduced; patients get to receive care and recover in their own communities. Families develop deeper trust in their local healthcare resources while the hospital improves its quality initiative metrics.
“I’m particularly drawn to helping others who help others,” Dana says.
A Respiratory Therapist at Tribal Facilities: Life, Death, and Surprises
While Dana finds working with Tribal facilities rewarding, she admits it’s a career path that is full of surprises, with each deployment bringing new experiences. “It’s an adventure – a journey that demands flexibility and an open attitude.”
On the one hand, she recalls, working with COVID patients has been a “wrenching” experience. “You think they’re going to be ok but then you come back and they’re deteriorating and you’ve putting them on a ventilator,” she says. “We saw an entire family of six get seriously ill. That was hard.”
But those emotionally difficult experiences have been tempered with moments of joy and transformation. One of Dana’s most memorable experiences as a respiratory therapist was saving the life of an 18-month-old baby. Walking into the facility one morning, she found the staff exiting a room where the little patient was struggling to breathe. “The baby’s oxygen was dropping from 80s to 70s. I noticed no chest rise and ordered an x-ray,” she recalled. The result: Dana was able to re-intubate her and stabilize the baby until she was transferred by flight to another hospital. While this may sound like an episode of a TV hospital drama, it’s a very real example of the differences Tribal Health staff can make in Indigenous communities.
Advice for Working at Tribal Facilities
Any healthcare professional who’s served patients in an Indian Health Service or Tribal facility can tell you that it’s a unique experience. To help respiratory therapists and others succeed in their assignments, Dana shared some advice:
- Be open. “You’ll be working with staff from Indian Health Service, so be ready to change your approach,” she says. “Staff can be grateful to have you there or they can have misconceptions of why you’re there. You can get your point across better if you’re humble.”
- Understand where staff are coming from. “The people you work with need a lot of things, from knowledge to equipment. They don’t lack intellect; they make do with what they have.”
- Educate yourself in advance. “Learn the local culture,” Dana advises. She also recommends that staff pack generously, as there won’t be many shopping resources. “Also, expect surprises, as well as a lack of the kind of equipment you’re used to.”
- Adopt a collaborative attitude. “You don’t want to be the person with the clipboard in the back of the room, overseeing everything,” she says. “Remember that you’re there to collaborate, not control.”
Creating a Lasting Impact
Ultimately, Dana says, “The best part is knowing your knowledge is helping others.” It’s a legacy that goes beyond one assignment to drive generational change in Native American populations across the country. For clinicians who want to play a hands-on role in solving healthcare disparities, it’s hard to think of a more gratifying career path.
