"Bless y'all"

June 3, 2019

"Bless y'all"

Today began with a tour of Swain County Hospital. We were able to speak with a number of administrative personnel as well as several employees. The hospital was only a 48 bed hospital but typically only use 25. The emergency room had four rooms but had the ability to make six by placing some patients in the halls. They stated a number of patients come in for mental illnesses, therefore, they are seeking funding to construct a mental health ward.
We then toured the Museum of Cherokee Indians where we learned about the history of the Cherokee people as well as their saddening story of "the removal." Following the museum, we went to the reservation where several of the Cherokee people reside. They demonstrated hand-weaving, beading, pottery, and weapon making. We were also able to watch and even dance with members of the tribe as they performed historic routines.
After our learning of the Cherokee people, we spent the rest of the day tubing down the river. It was all fun and games until someone would get stuck on a rock in the middle of the river. Or the next person to go on the rope swing forgot to catch it after the person before them was done.
Finally, exhausted from the days activities, we came home and had dinner as a group and are all relaxing and winding down to prepare for tomorrows adventure.

Now that you're here, what is your first impression of Cherokee?
I think that my idea of what I thought Cherokee was going to be has been moderately met. I knew the community would be tucked away in the mountains. There are a lot of run down trailers and homes on the drive in. There are some nicer homes in the community. The town mets the needs of the tourists that visit, but clearly overlook the needs of the community. There are limited hospitals, grocery stores, and limited gas stations but there are an excessive amount of tourist excursions and shops.

What did you find most interesting about this culture's history?
I found it interesting that some of the population ran to the mountains during "the removal." I was under the impression that they were all completely forced out of their homes. I thought it was inspiring that there were a number that fought tirelessly for the land and ensured their heritage remained at its original grounds. I also find it interesting that the reservation still practices the ways of their ancestors to this day. While some of them have modern luxuries such as cell phones, they still practice traditions that older generations did back in the 1800's.

What are the services Swain County Hospital is able to offer the community?
They are able to offer the community emergent services. They also offer inpatient services for general conditions. During the tour, we asked numerous times about specific conditions they admit but we never received a straight forward answer. They offer referrals to larger hospitals such as Harris Hospital which is located about twenty miles away. They have a pain clinic at the facility as well. Currently they are working on adding a mental health ward to the facility. Swain County also offers lab services, outpatient clinics, and radiology services.

Are there workforce shortages in this community?
During the tour, we were told that the employees that work there are typically there until retirement. They stated that nursing staff can face shortages when there is a call in. Lucretia stated that they often pull staff from other areas of the hospital when they are facing a shortage or call in. Sometimes the CNO steps in and works the floor. They also spread their physicians very thin by having them cover essentially the whole hospital.

What types of healthcare services are frequently difficult to access in rural areas?
Specialty services such as cardiologist, renal, respiratory, neurology, GI/GU, etc. Rural hospitals often will refer patients to other facilities when they are unable to accomodate the needs of patients. Our guide stated that the facility actually only admits about 2-4% of the patients that come to the facility. I think this is due to the fact that they are unable to treat such specific conditions that they have to stabilize and refer them elsewhere.

The group at the Museum of Cherokee Indians.

Swain County Hospital visit

Before we were dancing at the reservation