Nursing with the Yupik Indians in Alaska


Nursing with the Yupik Indians in Alaska

One nurse's adventure in remote Alaska

By Kristin Cassell
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What if adventure was one of the perks of your nursing position? Would you take the chance of a lifetime? The remote regions of the world are desperate for nurses, and Tina Griffin, RN, found her niche in the great Alaskan wilderness. A nurse for 15 years, Griffin saw an article about Alaska in a nursing magazine and followed her instinct by calling a nurse travel agency. “The agency asked about my likes and dislikes, whether I like to be alone or with lots of people,” explains Griffin. Determining that she was a solitary creature who would fit in well with a remote area, and that she liked the outdoors, fishing, hunting and hiking — it was agreed: Alaska would be a good fit.

Nursing in Remote AlaskaWith assignment in hand, Griffin began her adventure in Dillingham, Alaska, population 2,500. Located on the Bristol Bay, Dillingham proudly announces it is the only town on the bay with two grocery stores and two banks. When Griffin walked off the plane, it was 30 degrees below zero. She stepped onto a runway with four inches of ice and 40 mph winds, then walked into a building that seemed like a small coffee shop. It turned out to be the airport. She soon learned why everyone else had packed their belongings in coolers rather than suitcases: Everything brought on board — including cosmetics and toiletries — froze solid within 10 minutes.

The Flu Wiped Out the Population

From Dillingham, Griffin moved on to Bethel, Alaska, a tiny town located on the Kuskokwim River, where the population is three-quarters native Alaskan. “The Yupik people have lost so much in last 30 years,” she says. "The flu wiped out 70 percent of their population.” Visitors have introduced disease, viruses and bacteria to the local population, which had no immunities to the diseases due to their isolation; epidemics taught in history books are not history here. The nursing team introduces the local population to the concept of vaccination so future epidemics will be prevented. “The people really do appreciate the healthcare we provide. They used to suffer a lot.”

Yet, progress is a mixed bag. Traditionally, most of daily living for a native Alaskan was fishing, hunting or trapping. In the past, there were no supermarkets — as food was extremely expensive to import — so the local population thrived on the resources at hand. “The introduction of our food has been disastrous,” Griffin observes. “Diabetes doubled because they are not used to milk, soda or sugar. Now a big part of teaching and education is trying to get them to stick to traditional foods.”

Alcohol is also an issue of concern. Alcohol aggravates the problem of long winters and depression. Griffin reports that the native councils are trying to bring back traditional culture to help with the problem. When alcohol is introduced, the despair becomes so pronounced that suicide is prevalent. Continued efforts, medically and culturally, are providing a positive impact.

While battling new and changing concerns, Griffin relishes in the joys of living and serving the native population. She loves their culture because they live so close to nature. Because everything is based upon seasons, the people don’t think about time or workweeks or what to do during retirement. They tend to have very large families to the point that it’s not uncommon to see a woman with 13 or 15 kids and no running water. Despite this, the children are very well cared for. “They thrive in weather that would kill us,” Griffin says with admiration.

Ever conscious of the difference in cultures, Griffin learned to appreciate a new approach to conversation. When talking with an elder, answers to questions often took three to five seconds. Griffin used to keep talking or repeating the question, feeling uncomfortable during the long pause. She learned that it is rude to interrupt. and that the speaker indicates he or she is finished by remaining silent. It takes a long time to take a patient history.

Extreme Resourcefulness

Nursing in Remote AlaskaBecause of the remote area, emergency surgery is not much of an option. As patients come in, they are required to sign a form stating that if emergency surgery is needed, they could die due to lack of resources. This includes performing a cesarean section for a birthing mother. A common practice in the lower states, C-sections are not an option provided to expectant mothers in remote Alaska. The only time they are done is in a rare emergency to save the life of the mother. The native women give birth as they have done for thousands of years, delivering their children without much more than a whimper. Griffin elaborates, “It’s almost like they don’t feel pain like we do. It’s so natural for them. The pain is not scary and the women don’t react the same way.” The native women stay on their feet during delivery, constantly up walking around, allowing gravity to help the process.

Showing how adaptable one has to be in a remote location, Griffin recommends packing an essential piece of equipment: duct tape. “If there is a hole in the IV bag, use duct tape. If you don’t have any poles to hang bags, use duct tape.” Equipment and supplies are scarce. Nurses need to be enterprising and make do. Medical treatment is not always limited to humans. People often bring their dogs in because dogs are critical to the lives of the native people. It’s important to adapt. With no vets, the nursing team will pull out a fishhook or supply IV fluid.

Closeness and Camaraderie

In remote Alaska, the medical team is just that — a team. The closeness and camaraderie between coworkers is unique to the setting. The doctors confer with the nurses and are sometimes outvoted when deciding a patient’s care. The hierarchy between doctors and nurses evaporates. “The doctors here are team-oriented and don’t look at you as a different profession. It’s a team decision,” Griffin says. “We are all RNs with the same basic training. If the ER is quiet, you go over to L&D and see if they need any help. You eventually move between departments like they don’t exist. You get to do so many different things.”

Between the nurses, the camarderie is very genuine. Griffin explains that’s it’s so isolated that they really depend on each other. One nurse might need to call around to borrow a frying pan, another nurse might come back from Anchorage with 20 rolls of toilet paper for the group. This bond is strengthened with the unique challenges presented to the medical team. Griffin described one situation where a storm was so bad the the kitchen staff couldn’t come into the clinic. The patients would not have been fed that day if the nurses and doctors hadn’t stepped in to clean and cook the fish.

More Than a Paycheck

Extreme nursing often offers a higher salary than traditional hospital nursing, and because of the secluded area there isn’t a temptation to spend as much, allowing a nurse to save more of his or her income. But for Griffin, it was not about the money. She explains that a nurse can go anywhere and make good money. “I didn’t become a nurse to make money; I am a nurse because I like to help people, to have an impact.” She explains that in the lower 48 states, patients are assigned by acuity, whereas in Alaska she would keep the same patient for days, developing a bond with patients, families and children. She goes on to say that the native Alaskan people are eccentric but genuine, and she loves being surrounded by the majestic mountains and glaciers.

When asked if it is difficult being away from friends and family, Griffin responds simply that it is. After a pause and consideration, she continues on, saying that it is not a career for those with small children who need their parents around.

Would Griffin recommend this adventure to other nurses? “When I first went, I had so many people try to talk me out of it. Nobody else will understand why you are doing it, but every nurse who has the desire should try it. When you get older and are ready to retire, all you have are your memories.”

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