LINDA:  And then from 1982 to '87, I was fortunate to be a member of the committee to work on the, what we call the White Community Health Aide Manual, which was published in 1987 and the primary author was Dr. Rob Burgess. 

And that book made a significant change in how the material was organized for health aides.  It allows you to go in with a symptom, and from that symptom, go in and collect a complete, focused, problem-specific history, exam, lab tests, and then it takes you to charts that allow you to analyze the information, sort of what we call compare and match, history and exam, for an assessment, and from that assessment, takes you directly to the page number for the plan.
 
And the clarity of that book significantly improved health aides' not only ability to work with a patient, but I think ease in -- and that's the goal. 

My purpose in all of this over the years has been, you know, several.  One is to improve quality health care through well-trained individuals who are supported and nurtured themselves, but also to provide materials that are easy to navigate, easy to use, that allow the health aide to do their job so that they really can focus on the patient and not on the -- the books or the materials. 

And so that they can just have a -- because the role of -- of being a medical provider is pretty complex, and it's not about the complexity of the information, I think, as much as the organization and the ability to use it, to find it and use it in whatever situation they find themselves in, whether it's a prenatal patient who is vomiting or if it's a child who has a sore throat or a gunshot wound or an emergency delivery, whatever it is, they will learn it in training, but they need then tools that assist them on a day-to-day, patient-by-patient visit that they have, the care they are giving. 

Yes.  And what was exciting about that was to watch the health aides' ease, the ease with their work by having those materials. 

KAREN:  So you could see that it really helped them?
 
LINDA:  Oh, yes.  I mean, if you can imagine that you were going to give health care and you had a blank piece of paper and a book that guided you but wasn't clear in its -- each patient -- I mean, I'll always remember that individual in Atmauthluak who was lost and it wasn't her ability. 

And, you know, I can think of times when -- there's lots of things that I don't know and I -- I mean, well, talk about computers.  I want them to work.  I don't understand them.  And if somebody were trying to teach me how to do that, I would feel pretty incompetent and, you know, not able to -- to make it work.  I want it to work but I couldn't make it work. 

So I think that my belief is that the individuals who choose to be a health aide are amazing individual who, if you ask them why are they doing the job, it's about heart.  And these are individuals who historically are the nurturers, the caretakers, healers in their community.
 
And I know that that has changed over time now as it becomes sort of one of the things that's happened is that it's a job in the community.  We're seeing a little different individual apply. 

I think they still come from the heart because you can't do this job without it.  If you don't have a passion and a caring for people, I don't think that you can stay doing this year in and year out.  It is just such a demanding job.