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Jessie Jim talks with Karen Brewster on May 31, 2006 in Juneau, Alaska about...
1) Her birthplace, family, and personal background.
birthplace -- Angoon\ Mt. Edgecumbe -- high school\ Mt. Edgecumbe -- boarding school\ graduation -- date of\ practical nurse (PN) -- training\ Licensed Practical Nurse (LPN)\ Mt. Edgecumbe Hospital -- employment\ marriage\ husband -- first\ husband -- death\ Angoon -- returned to\ birth-date\ LPN training -- date of\ maiden name -- Gamble, Jessie\ parents -- name of\ Gamble, Johnny -- father\ Gamble, Nadja -- mother\ siblings -- number of |
2) Why she became a nurse and then a health aide.
nurse -- becoming\ friend\ encouragement\ practical nurse -- training\ Mt. Edgecumbe\ Licensed Practical Nurse -- employment\ practical nurse -- differences in\ Angoon -- returned to\ Lane, Frank -- first husband\ Point Hope\ marriage -- second husband\ Charley, Jim Jr. -- second husband\ health aide -- Angoon\ Johnson, Barbara -- health aide\ Johnson, Barbara -- encouraged her\ job -- income\ income -- desire for\ salary -- amount\ job -- starting date\ employer\ government -- federal\ taxes -- withholding\ Indian Health Service|
3) Differences between working as a nurse and a health aide, the evolution of the Angoon health clinic, and how long she worked as a health aide.
knowledge -- previous\ work -- differences\ health aide\ Licensed Practical Nurse (LPN)\ work -- hospital\ work -- in the field\ hospital -- structured\ health aide -- independent\ decision-making\ doctor -- supervision from\ locations -- separate\ communications -- radio\ radio -- location\ Angoon\ clinic -- lack of\ school -- use of\ clinic -- relocation\ Johnson, Barbara\ home -- use of\ work -- strike\ building -- new\ clinic -- construction\ Pauncho, Paula\ fundraising -- grants\ clinic -- maintenance\ clinic -- new\ retirement -- date of\ health aide -- length of employment\ job -- satisfaction\ people -- caring for\ commitment\ quitting -- wanting to\ job -- demanding\ salary -- insufficient|
4) The pressures and expectations of being a health aide, especially when a patient dies.
health aide -- job\ job -- demanding\ pressures\ stress\ job -- hardship\ patient -- death of\ death -- impact of\ people -- working with\ health aide -- quitting\ child -- illness\ child -- death of\ patient -- treatment\ clinical director\ treatment -- CPR\ treatment -- IV\ patient -- transportation\ helicopter\ health aide -- impact on\ community -- reactions from\ health aides -- image of\ health aide -- response\ health aide -- blaming\ incident -- child\ illness -- flu\ treatment\ illness -- encephalitis\ brain -- inflammation\ patient -- loss of\ family -- support\ family -- reactions from\ Johnson, Barbara|
5) Relying on prayer to get her through the hard times, the difficulty of not being able to discuss cases because of confidentiality requirements, and community support that is now available with locally trained Emergency Medical Services (EMS) personnel.
pressures -- dealing with\ prayer\ faith -- importance of\ difficult times -- getting through\ confidentiality -- adherence to\ support -- availability\ support -- limited\ co-workers -- talking to\ debriefing -- introduction of\ debriefing -- talking\ debriefing -- benefit\ coping\ Johnson, Barbara\ support -- peer\ health aide -- turnover\ turnover rate -- high\ health aide -- solo\ village -- support\ Emergency Medical Services (EMS)\ Emergency Trauma Technician (ETT)\ EMS -- benefits of\ Emergency Medical Training Level 1 (EMT1) -- requirement|
6) Her training as a health aide, and the health aide manuals she used for medical reference.
health aide -- training\ training -- levels\ training -- location\ Mt. Edgecumbe\ Anchorage\ health aide -- manual\ manual -- versions\ manual -- using\ Community Health Aide Manual (CHAM) -- updated\ CHAM -- usefulness\ CHAM -- reference\ patient -- education\ CHAM -- description of\ treatment -- examples\ manual -- content\ content -- expansion of|
7) Medical equipment and medication that was available in her early years, and how the use of technology has changed during her career.
medical equipment -- types of\ medications -- type of\ medications -- changes in\ penicillin -- reactions to\ technology -- changes in\ technology -- necessary\ telemedicine -- difficulties with\ technology -- advantages of\ Angoon\ clinic -- changes\ x-ray -- availability of\ physician assistant -- collaboration with\ treatment -- early days\ doctor -- communication with\ bone fracture -- treatment\ splint -- plaster\ patient -- travel\ cast -- use of\ cast training -- lack of\ treatment -- temporary|
8) The increasing presence and availability of physician assistants, and doctors and health aide interacting with each other.
physician assistant\ Angoon\ physician assistant -- collaboration with\ physician assistant -- permanent positions\ Southeast Alaska Regional Health Consortium (SEARHC)\ doctors -- visits\ visits -- frequency of\ frequency -- changes in\ doctors -- relationship with\ doctors -- teaching\ doctors -- reliance on\ doctors -- support from\ patient -- care\ guidance\ decision-making\ patient -- travel\ health aide -- training\ training -- changes in\ IV -- use of|
9) Demands placed on health aide, and the changes in how health aides communicate with doctors and patients.
health aide -- expectations\ health aide -- apprehensive\ patient care -- story of\ patient -- male\ injury -- scrotum\ patient care -- hesitant\ patient -- travel\ patient -- reporting on\ doctors -- communicating with\ physician assistant -- help from\ communication -- schedule\ doctors -- teaching\ health aides -- abilities\ health aides -- expectations\ doctors -- knowledge\ knowledge -- sharing\ listening -- importance of\ doctors -- relationship with\ doctors -- advice from\ health aide -- training\ training -- communication\ communication -- style\ medical terminology -- use of\ patient -- information\ information -- standard|
10) Non-Native doctors and Native health aides working together, and changes in on-call care and services.
doctors -- non-Native\ knowledge -- cultural\ culture -- respecting\ doctors -- learning\ village -- visits\ doctors -- relationship with\ doctor -- first\ Franks, Dr. Hood\ patience -- importance of\ doctors -- differences\ doctors -- communicating with\ health aides -- turnover\ co-workers -- loss of\ job -- pressures of\ pressures -- effect of\ work -- schedule\ schedule -- on-call\ health aides -- loss of\ Johnson, Barbara\ schedule -- balance\ visits -- on-call\ on-call -- training\ schedule -- improvements\ family -- strain on\ job -- demanding\ health aide -- house calls\ husband -- strain on\ patient -- splinter\ patients -- needs of\ people -- expectations\ expectations -- meeting\ health aide -- calling\ communication -- radio\ Angoon -- radio number\ communications -- dispatch\ calling -- changes in\ emergency -- response to\ emergency -- definition of\ patient -- education\ situation -- prioritizing|
11) The benefits of educating and advising patients about personal responsibility, continuing to work after retirement, maintaining health aide certification, and the costs involved with hiring new health aides.
patient -- education\ patient education -- training in\ patient education -- benefits\ child -- injury\ wound -- treatment\ parent -- advising\ people -- expectations\ health aide -- role of\ patient -- adapting\ appointments -- making\ patients -- walk-in\ appointments -- importance of\ emergency -- response to\ health aides -- current\ Angoon\ health aides -- advice\ health aides -- peer support\ retirement -- partial\ work -- as needed\ help -- need for\ on-call -- not included\ medical assistant -- employment\ medical assistant -- description\ doctor -- helping\ patients -- not see\ certification -- lapsed\ certification -- community health practitioner (CHP)\ certification -- cost of\ certification -- process\ requirements -- continuing education\ requirements -- clinical hours\ license -- payment for\ Southeast Alaska Regional Health Consortium (SEARHC) -- assistance from\ health aides -- hiring\ health aide -- training\ training -- cost of\ health aide -- investment in\ health aide -- quitting\ agreement -- signing of|
12) The need for constant training of health aides, the introduction of patient charting methods, changes implemented to help retain health aides, and examples of why on-call care is stressful.
health aide -- training\ training -- funding\ training -- clinical update\ patient charting -- difficulty with\ patient charting -- changes in\ patient charting -- early process\ patient assessment -- procedure\ Subject, Objective, Assessment, Plan (SOAP) -- description of\ health aides -- retention\ salary -- improvements\ training -- completion\ salary -- step-increase\ on-call -- procedures\ work -- mentoring\ fear -- reduction\ health aides -- learning from others\ health aide -- resignation\ on-call care -- stress of\ on-call care -- personal story\ call-backs -- lack of\ work -- variability\ on-call care -- hardship|
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