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Dan Thomas talks with Karen Brewster on September 14, 2005 in his office at the Norton Sound Health Corporation Health Aide Training Center in Nome, Alaska about...
1) His personal history and how he became interested in and pursued a medical career.
Community Health Aide Training Center\ Nome\ training -- physician assistant\ training center-- statewide\ job -- curriculum coordinator\ meetings -- health aides\ meetings -- statewide\ parents -- teachers\ Shishmaref\ high school -- Nome\ Washington -- region of\ parents -- fishermen\ health services\ nursing school -- Anchorage Community College\ challenge -- intellectual\ PA school -- Seattle\ Unalakleet -- clinic\ mid-level provider\ Nome -- health aide trainer|
2) His role as curriculum coordinator for statewide health aide training and some thoughts about the challenges health aides face during training and work.
curriculum coordinator -- role of\ health aides -- interaction with\ duties -- administrative\ groups -- size of\ patients -- visits with\ training -- program\ sessions -- basic training\ expectations -- level of\ body systems\ problems -- common\ problems -- emergency\ treatments\ skills -- laboratory\ skills -- examination\ sessions -- schedule of\ needs -- regional\ health aide -- hiring\ pay role\ training -- salary\ health aides -- selection of\ health aides -- challengs\ challenges -- academic\ health aides -- characteristics\ caregivers\ village -- service\ health aides -- supply of\ health aides -- turn over\ health aides -- stability\ villages -- differences\ villages -- size of\ trauma\ health aides -- schedule\ health aides -- on-call\ relatives -- caring for\ health aides -- shortages of\ villages -- challenges of|
3) A little bit about health aide training, and how the demographics of the health aides have changed over the years.
facility -- training\ health aides -- training\ health aides -- preparation\ self confidence\ burn out\ challenges\ program -- feedback on\ complaints\ training -- rigorous workload\ exhaustion -- mental\ personal lives -- stress of\ training -- stress of\ homesickness\ standards -- maintenance of\ health aides -- turn over\ health aides -- pioneer\ careers -- length of\ health aides -- retirement\ health aides -- new\ continuity -- lesser\ health aides -- age of\ demographic -- changes\ strength -- academic|
4) The presence of mid-level care providers in villages becoming more common and the benefits of this change.
Unalakleet -- work\ jobs -- favorite\ health aides -- quality of\ clinics -- numerous\ job -- primary provider\ work -- rewarding\ care -- continuity of\ providers -- mid-level\ health aide -- job\ reports -- immediate\ reports -- phone\ health aides -- schedule\ health aides -- on-call\ mid level -- on second call\ emergencies\ on-call -- anxiety\ doctors -- contact with\ Norton Sound Health Corporation\ funding -- grant\ concept -- expansion of\ Davalos, Dave\ Stebbins\ St. Michael\ doctor -- workload\ Unalakleet\ care -- quality of\ care -- promptness of\ evaluation -- detail of\ Unalakleet -- population of\ region -- villages\ Gambell -- population size\ Savoonga -- population size\ Shishmaref -- population size|
5) Doctor - health aide relations and the importance of the Community Health Aide Manual (CHAM).
doctors -- relationship\ health aides -- relationship\ Nome -- medical staff\ staff -- stability of\ health aides -- reliability of\ trust\ patient -- history\ exams\ gut feelings\ training -- professional\ training -- lack of\ training -- structure of\ manual -- use of\ manual -- complaint\ manual -- question list\ body parts -- examination of\ manual -- use of\ work-up -- details|
6) The importance of the Community Health Aide Manual and why some health aides do not use it in the way it is intended.
manual -- revision of\ Curda, Linda\ manual -- reviewing\ manual -- changes to\ training center -- directors\ training center -- input\ manual -- problems\ manual -- complexity\ manual -- sections\ manual -- use of\ manual -- ease of use\ manual -- comments on\ health aides -- comments\ diagnosis -- complexity\ manual -- requirement\ requirement -- legal\ standards -- professional\ lawsuits\ Nome -- training center\ training -- field|
7) The new headquarters for the Nome training center, and how health aides are selected.
Nome -- training center\ training center -- established\ training -- state wide program\ funding\ mid-level trainers -- hiring of\ building -- rental of\ staff -- training\ staff -- supervising health aides\ building -- new\ facility -- prototype\ clinic -- construction\ corporation\ design -- problems\ trauma room\ exam room\ laboratory\ medication room\ offices\ classrooms\ context -- village clinic\ health aides -- women\ health aides -- men\ staff -- fluctuations\ village\ men -- choice\ exceptions\ men -- increase in\ health aides -- early\ health aides -- selection of\ village council -- opinion of\ job -- advertisement of\ job -- application for\ Village Health Services Department -- review of applicants\ tests -- reading\ tests -- math\ health aides -- employment\ Norton Sound Health Corporation\ village Council -- board of directors|
8) The administrative and technological evolution of the health aide program.
health aide program -- development of\ health aide program -- administration\ health aide program -- changes\ Norton Sound Health Corporation\ Indian Health Service\ Alaska Native Land Claims Settlement Act\ Nome hospital -- purchase of\ villages -- clinics\ Shishmaref\ technology -- changes\ communication -- changes\ communication -- radio\ clinics -- lack of\ communication -- telemedicine\ doctors\ health aides\ telemedicine -- use of\ telemedicine -- advantages of\ telemedicine -- photographs\ equipment -- otoscope\ trauma\ rashes\ eardrums\ video -- live\ telemedicine -- confidence in\ villages -- travel to\ telemedicine -- training for\ telemedicine -- promotion of\ computers -- use of\ computers -- culture of|
9) Using computer systems to do patient registration and billing, and how health care provided by health aides is funded.
computerization -- beginning of\ Unalakleet\ billing\ patient -- registration\ Medicaid\ health aide program\ federal certification board\ legislation\ billing -- third party\ money -- dwindling\ health care -- free\ Indian Health Service\ money -- limited\ Norton Sound Health Corporation\ Indian Health Service -- funding\ State of Alaska -- funding\ travel -- funding\ bankruptcy\ care -- denial of\ Medicare|
10) Training health aides to work with doctors, and also how doctor learn to work with health aides.
health aides\ doctors\ work -- together\ health aides -- training\ doctors -- training\ villages -- working in\ priorities\ learning -- context\ traffic -- medical\ telephone\ manual -- new\ manual -- doctor's use of\ doctors -- time\ documentation\ patients\ training -- cross-cultural\ Norton Sound Health Corporation\ career -- counseling\ college\ training -- counselor\ counselors -- village based\ problems -- mental health\ problems -- substance abuse\ college -- Bellingham\ pre-med\ nursing school\ supervisor\ trainer -- health aides\ trainer -- field\ basic training -- follow up\ emergency skills -- review of\ skills -- back boarding\ skills -- IVs\ treatment -- sutures\ charting\ administration\ medication -- ordering\ clinic -- travel clerk|
11) The need for rules and regulations to guide health aides, the importance of the community health aide manual (CHAM), and some comments on the satisfaction he derives from his job.
schedule\ villages -- visits to\ supervision -- direct\ supervision -- amount of\ support -- need for\ support -- field\ program -- changes\ regulations -- concern with\ quality -- control\ health aides\ habits -- shortcuts\ rules -- necessity of\ manual -- complexity of\ manual -- use of\ manual -- training with\ health care -- field of\ health aides -- working with\ job -- satisfaction\ people -- helping|
12) How the scarcity of health aides affects the functioning of clinics and ways to cope with it, now and historically.
state -- regions\ population\ residents -- local\ residents -- long-term\ Native\ non-Native\ health aides -- scarcity of\ clinics -- closure of\ health aides -- temporary\ volunteers\ practioners -- mid-level\ health aides -- schedule\ health aides -- relief\ health aides -- back-up\ vacations\ family -- emergencies\ sickness\ training\ health aides -- alternate\ health aides -- primary\ village council\ Norton Sound Health Corporation|
13) The system of certification and credentials for community health aides.
health aides -- certification\ health aides -- system\ Alaska -- rural\ health care -- provision of\ system -- effectiveness of\ Alaska Health Aide Program -- model\ manual -- regard for\ training -- regard for\ federal certification board\ community health practitioner\ certification -- levels of\ Medicaid -- billing for\ training centers -- credentials\ credentials -- renewal of\ renewal -- requirements for\ continuing medical education -- hours of\ certification -- levels of\ certification -- costs of\ certification -- paperwork\ incentive -- monetary\ billing\ recertification -- requirements|
14) Possible reasons why not many health aides go on to become RNs, PAs, mid-level care providers or even doctors.
health aide -- training\ physician's assistants\ nurses\ health aides -- career\ family\ children\ medex program -- Seattle\ college courses -- pre-requisites\ courses -- distance learning\ PA program -- duration of\ health aide -- RN\ work -- location of\ career -- choices\ responsibility -- level of\ schedule -- on -call\ job -- pressure\ health aides -- excellence of|
15) The traits of a good and successful community health aide.
health aide -- characteristics of\ health aides -- success of\ applicants -- reasons\ job -- need for\ health aide -- avocation\ motivation\ growth\ care provider\ nurturer\ technical skills\ people -- working with\ stress -- management of\ pressure\ circumstances -- tragic\ stress -- emotional\ ability -- intellectual\ mathematics\ medication -- safety\ responsibilities -- family\ health aides -- calling\ health aides -- selection of\ volunteerism\ community|
16) Cross-cultural concerns like languages and traditional medicine and some final comments about the training program.
language -- Native\ language -- English\ St. Lawrence Island\ Siberian Yupik\ bilingualism\ elders\ youth\ training\ Native language -- dominance of\ languages -- fluency in\ medical terminology -- learning of\ training -- intensity of\ skills -- academic\ health aides -- education of\ traditional healers -- role of\ Norton Sound Health Corporation -- program\ native healers -- apprentices\ Kotzebue\ medicine -- western\ balance\ midwives -- acceptance of\ midwives -- replacement of\ bone doctors\ dancing\ missionaries -- role of\ IRA village council -- governing body\ training centers -- success of\ improvement\ training -- field\ funding -- lack of\ staff -- lack of\ training centers -- location of\ Anchorage\ Sitka\ Bethel\ new program -- distance learning\ distance learning -- challenges of\ distance learning -- methods|
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