Help Wanted -desperately needed

LAME DEER, Mont. – Everywhere in America, “Help Wanted” or “Hiring” signs are posted at businesses, those employers desperate for reliable good help. Even McDonalds is offering eighteen dollars an hour, scholarships, benefits and flexible work schedules for burger flippers or people who speak enough English to take an order over the speaker phone. Sometimes that gets done, sometimes not.

The problem is exacerbated in more rural areas such as the Northern Cheyenne reservation in southeastern Montana. Although this article features Northern Cheyenne it is only one example of what most Tribes in the Great Plains area experience regarding getting health providers.

Recently Native Sun News Today via this correspondent had the opportunity to visit with top officials at the Lame Deer Northern Cheyenne Indian Health Service (IHS) Clinic about the challenges they face in recruiting and retaining health care professionals. That included Sable Kerzmann, Northern Cheyenne tribal member, Chief Executive Officer (also a registered nurse with many years of service under her belt); and Mardel Nichols Acting Deputy CEO who has also served on many reservations including Pine Ridge.

According to Kerzmann, the Lame Deer IHS clinic at full staff capacity has 182 positions. However, due to problems with recruitment and retention, they normally run at about 130 filled positions, 56% staffed. “Our biggest challenge is getting doctors, physician’s assistants and nurses,” she reported.

At Northern Cheyenne, for example, there has been no optometrist for one and a half years. Want some glasses? Medicare does not pay for that. Figure it out. That might be why many Cheyenne’s are wearing duct taped glasses around, often missing a lens.

At the clinic there are about three hundred jobs, both I.H.S and others run by the Tribe, under P.L. 93-638, a significant economic force in the community, as well as being a lifeline. Those contracted and tribally supported programs include housekeeping, security, medical resources, benefits coordinator, resources coordinator, public health nursing, community health nurses, WIC, tobacco cessation, recovery, suicide prevention, and behavioral health.

“There is a critical shortage of health care professionals across the country,” Kerzmann explained. “That is why they can choose where they want to be. Quality of life is just as important as the wages.”

Think about quality of life in Lame Deer, Mont. The nearest Walmart is 110 miles away. The only opportunity for amusement would be the local casino, where the restaurant is open whenever the employees show up. Movie theater? Bowling alley? Yep, only twenty-one miles away in Colstrip. A prime rib dinner? Nope, unless you drive to Colstrip on Friday night (42-mile round trip); Hardin on occasion (110-mile round trip); Sheridan 125 mile round trip) or Billings (220) mile round trip.

Swimming pool? Not at Lame Deer. But there is one at Colstrip. A saloon for a cool after work drink? Yep. You could sneak down to Jim town and get harassed by the beggars.

Shopping Mall? Yes, if you want beadwork, a Cheyenne designed t-shirt or extremely expensive pants. A place to eat? Yes, if you go for deep fried fat stuff available most of the time at the Cheyenne Depot, (local convenience store) or the IGA deli, when and if those workers show up.

Want to get a pedicure, manicure or your hair done? Forget it in Lame Deer. Figure on an all-day trip for that luxury.

A McDonalds, Arby’s or Applebee’s for a quick lunch or dinner? Sure, but plan on a two-hour drive to get there and back. Yet there are two little nice places for lunch at the mini mall. Soups, salads, and hamburgers from ranch raised ‘pure” beef. A little pricey, but available during the daylight, but not at night, not after five p.m. when most people like to eat.

“Many times, we have recruited wonderful docs, dentists, nurses and so forth,” Sable explained. “But often their spouses do not like it here. They find employment opportunities difficult, often winding up with nothing to do.”

One doctor while submitting his resignation told her “I like it here. The working conditions are great. But my wife is very unhappy, and I cannot see myself commuting from Billings (220 round trip) every day.”

The educational system is also rather weak on the Northern Cheyenne Reservation, in large part to related recruitment and retention problems. The school is the lowest rated in the State, discouraging to high achievers such as the children of professional health care providers. And it must be acknowledged that “white” kids will face a degree of racism at a reservation school. Such was reported by Bill Parker, Northern Cheyenne tribal member, former Superintendent of that school and later Chairman of the school board.

Housing? Yes. IHS will provide that. It will not be a condominium with an ocean front view, but you will have a lovely view of the mountains and the facilities crew will even mow your lawn in the summer and shovel your driveway in the winter.

Help with student debt? IHS can do that to, under a Student Loan forgiveness program created by the late Montana Senator John Melcher. To qualify, a time commitment is necessary.

A signup bonus? Yep, they do that too.

Relocation expenses. Yes.

Retention bonus? Yep, after a year a certain raise from base pay is offered.

What about training local Cheyenne’s for the health care business?

The Northern Cheyenne Tribe does have a few tribal members who are health care professionals: three doctors, physician assistants, numerous nurses, a dentist, dental assistants and one pharmacist. Why not try to recruit them?

“We have tried,” Sable said. “But for a variety of personal reasons, they too, prefer to live in an area with more amenities. It is hard to capture the right candidate.”

“We do offer scholarships and student loan forgiveness, an extremely important resource for people who have invested thousands to gain an education.” Sable said.

There is also a program through Montana State University, Missoula called “Grow your own,” training Native Americans in the health care fields, the objective for them to return home and serve their own people.

“It takes a very special person to serve in a rurally isolated area like Northern Cheyenne,” Sable noted.

If there is such a medical professional out there who reads this article and might be tempted to serve, please feel free to contact any of the following people: Sable Kerzmann, CEO Lame Deer IHS service unit at (406) 477-4400; Mardel Nichols, Acting Deputy CEO (same number) or Susan Parker Swan, Montana Area Office recruiter at the Area Office (406) 247-7104.

Cheyenne country is beautiful, providing a wonderful environment for an outdoors lifestyle – hiking, fishing, horseback riding, new cultural experiences with real cowboys and Indians, a wealth of western history and so forth. The people are kindhearted and really need some more help from compassionate medical care providers.

The Northern Cheyenne I.HS. clinic as already received numerous national awards for excellence of service and currently has built an excellent team They just need more help to continue doing that. Thus, the goal is to recruit and retain more health care providers who will commit to a similar mission.

(Contact Clara Caufield at 2ndcheyennevoice@gmail.com)

 

 

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