KAREN:  So now, what are you -- are you still a health aide or your position has changed within the system? 

RITA:  I'm still a certified health practitioner, and I work in the clinic two days out of the month. 

And my main job is the village supervisor instructor.  And I have five villages that I supervise.  I have a big village which is Shishmaref, they have five full-time health aides, two CTCs. 

KAREN:  What's CTC? 

RITA:  A clinic travel clerk.  They are the ones that answer the phone, make appointments.  We have an appointment book system.  And they are just a -- like a secretary. 

I have Shishmaref and I have Brevig Mission.  Brevig Mission has three part times and a CTC, and they have a PA.  Shishmaref has a PA.  The PA in Brevig Mission has Brevig, Wales, and Teller. 

Then I have Elim, which is another big village.  They have three part-time health aides and an opening for one.  And a CTC.  And they have a PA living there and she covers Elim, Golovin, White Mountain. 

And then I have Koyuk, they have three part-time health aides.  They just got a new clinic.  And they have a PA, the PA lives in Unalakleet.  He has Unalakleet, Shaktoolik and Koyuk. 

And then I also have Shaktoolik, it's a smaller village.  So the VSIs, there's four of us, we all -- all the villages are divided. 

KAREN:  And what do you do as a VSI? 

RITA:  We go to the village and observe the health aides as they work.  We evaluate their patient encounter forms.  Make sure they are following the CHAM.  Because the health aides do not have licenses, you know, we are working under a doctor's license.  Make sure they are following the CHAM, following medical standing orders. 

And we do some training like doing backboard, you know, if there's time, make sure they all know how to use the oxygen tanks.  All their equipment, like the Zoll, AED, and we check some other things like the medicine control drug logs, make sure they are -- there's no discrepancies.  And just the overall run of the clinic. 

There's Clena (phonetic) involved, you know, Clena is the lab, you know, like the doing HemoCues and finger sticks for hemoglobin, urine checks, glucose checks, all the equipment needs to be -- make sure that their maintenance is running, stuff like that. 

There is a lot that we have to do.  Observe the health aides, how they work with patients.  Patient encounter, evaluation. 

And we also, if there's a health aide there that is going through training, we maintain their -- I follow through with their skills. 

When they complete a training, we have to do post session learning needs.  The health aide trainers will send them home with a list of things that they observe them in training that they might needed help on doing more. 

So we finish up their post session learning needs and make sure that they pass that session.  Then they are ready for the next session.  It's a lot of paperwork. 

KAREN:  And how long have you been doing that job? 

RITA:  Must be going on five years.  It's challenging and interesting. 
I love going to all the other villages.  Every village is different and the communities are different.  Every community has good people.  And all the clinics, they do things all different, but all their things that they do work for them. 

And so sometimes if there's something that is working there, I might incorporate in another clinic.  Okay.  This is how someone doing it, you might want to see how it works for you, you know.  So it's very interesting and I like it.