{"version":"1.0.0","segments":[{"startTime":0.0,"endTime":29.96,"body":"[Music]"},{"startTime":36.76,"endTime":42.68,"body":"Hello welcome to this episode of NLN podcast "},{"startTime":36.76,"endTime":42.68,"body":"Nursing EDge Unscripted. I'm your host,  "},{"startTime":42.68,"endTime":49.04,"body":"Dr. Steven Palazzo, a member of the editorial "},{"startTime":42.68,"endTime":49.04,"body":"board for Nursing Education Perspectives. In  "},{"startTime":49.04,"endTime":54.96,"body":"this episode, we will discuss effective retention "},{"startTime":49.04,"endTime":54.96,"body":"strategies for Native American nursing students. My  "},{"startTime":54.96,"endTime":60.04,"body":"guest today is Dr. Cody Bruce. Dr. Bruce is an "},{"startTime":54.96,"endTime":60.04,"body":"associate professor at the University of North  "},{"startTime":60.04,"endTime":65.48,"body":"Texas Health and Sciences Center College of "},{"startTime":60.04,"endTime":65.48,"body":"Nursing in Fort Worth, Texas. We will discuss  "},{"startTime":65.48,"endTime":70.0,"body":"the article, \"Promoting Retention of Native "},{"startTime":65.48,"endTime":70.0,"body":"American Nursing Students - Insights From a  "},{"startTime":70.0,"endTime":75.6,"body":"Qualitative Study.\" This article can be found in "},{"startTime":70.0,"endTime":75.6,"body":"a November-December issue of Nursing Education  "},{"startTime":75.6,"endTime":82.36,"body":"Perspectives. Welcome Dr. Bruce. Hi, thank "},{"startTime":75.6,"endTime":82.36,"body":"you so much for having me on the program.  "},{"startTime":82.36,"endTime":86.32,"body":"Yeah, we're looking forward to your conversation. "},{"startTime":82.36,"endTime":86.32,"body":"You know, let's start off with just how about  "},{"startTime":86.32,"endTime":91.28,"body":"a description of how the self-determination "},{"startTime":86.32,"endTime":91.28,"body":"theory that you used in your study influenced  "},{"startTime":91.28,"endTime":100.0,"body":"the aims of your study. So really as I began "},{"startTime":91.28,"endTime":100.0,"body":"looking at Native American nursing students  "},{"startTime":100.0,"endTime":107.16,"body":"and what kept them in the nursing programs and "},{"startTime":100.0,"endTime":107.16,"body":"made them be successful and what led to them  "},{"startTime":107.16,"endTime":113.68,"body":"not being successful or leaving the program, I "},{"startTime":107.16,"endTime":113.68,"body":"really wanted to answer a question of what were  "},{"startTime":113.68,"endTime":119.96,"body":"those effective retention strategies? And so I "},{"startTime":113.68,"endTime":119.96,"body":"really want to know what drove those students  "},{"startTime":119.96,"endTime":129.44,"body":"to complete that degree. And part of that was "},{"startTime":119.96,"endTime":129.44,"body":"reviewing a number of theorists, educational  "},{"startTime":129.44,"endTime":136.24,"body":"theorists, that really looked at motivation. And "},{"startTime":129.44,"endTime":136.24,"body":"as you well know, and our listeners know,  "},{"startTime":136.24,"endTime":141.68,"body":"motivation in education is something we've "},{"startTime":136.24,"endTime":141.68,"body":"looked at for a long time. And mainly we look  "},{"startTime":141.68,"endTime":149.96,"body":"at grades and financial rewards and that did "},{"startTime":141.68,"endTime":149.96,"body":"not really seem to fit this population. Native  "},{"startTime":149.96,"endTime":157.32,"body":"Americans have a a deep spiritual connection to "},{"startTime":149.96,"endTime":157.32,"body":"the earth, to nature, to their being, and especially  "},{"startTime":157.32,"endTime":164.52,"body":"to their communities. And I knew that many of them "},{"startTime":157.32,"endTime":164.52,"body":"wanted to go back and serve their community after  "},{"startTime":164.52,"endTime":170.96,"body":"they graduated with this degree. This was something "},{"startTime":164.52,"endTime":170.96,"body":"that they saw that really wasn't just for them but  "},{"startTime":170.96,"endTime":180.84,"body":"was a way to give back. And so it really led me "},{"startTime":170.96,"endTime":180.84,"body":"to the self-determination theory because of these  "},{"startTime":180.84,"endTime":189.12,"body":"kind of intrinsic factors that were leading those "},{"startTime":180.84,"endTime":189.12,"body":"students to completion, which was a bit different  "},{"startTime":189.12,"endTime":195.4,"body":"than the grades and financial rewards that you "},{"startTime":189.12,"endTime":195.4,"body":"know had been seen in some other publications"},{"startTime":195.4,"endTime":203.16,"body":"before. Well for our listeners, can you describe "},{"startTime":195.4,"endTime":203.16,"body":"briefly the self-determination theory and how  "},{"startTime":203.16,"endTime":209.8,"body":"you found that very useful to look at "},{"startTime":203.16,"endTime":209.8,"body":"the aims of your study? So the self-determination  "},{"startTime":209.8,"endTime":217.88,"body":"theory really helped describe what the Native "},{"startTime":209.8,"endTime":217.88,"body":"American student was experiencing as far as  "},{"startTime":217.88,"endTime":225.24,"body":"internal motivation factors. Whenever I had "},{"startTime":217.88,"endTime":225.24,"body":"conversations with the participants they  "},{"startTime":225.24,"endTime":236.8,"body":"were identifying things outside of financial "},{"startTime":225.24,"endTime":236.8,"body":"support and outside of grants and just travel and  "},{"startTime":236.8,"endTime":244.92,"body":"access to be able to persist. And what they were "},{"startTime":236.8,"endTime":244.92,"body":"really centering in on was a sense of belonging,  "},{"startTime":244.92,"endTime":253.28,"body":"kind of peer networks or social networks that were "},{"startTime":244.92,"endTime":253.28,"body":"very unique. Some of the nursing programs actually  "},{"startTime":253.28,"endTime":262.56,"body":"even had a special Native American nursing entry "},{"startTime":253.28,"endTime":262.56,"body":"program and part of that program was that all of  "},{"startTime":262.56,"endTime":270.96,"body":"the faculty were trained with cultural safety "},{"startTime":262.56,"endTime":270.96,"body":"courses, which helped them develope cultural  "},{"startTime":270.96,"endTime":278.16,"body":"competency and cultural humility toward Native "},{"startTime":270.96,"endTime":278.16,"body":"Americans and it also connected them with the  "},{"startTime":278.16,"endTime":285.88,"body":"community that they were serving. So those nursing "},{"startTime":278.16,"endTime":285.88,"body":"professors were out in the community and they met  "},{"startTime":285.88,"endTime":294.6,"body":"the elders of the tribe, or tribes in the area, "},{"startTime":285.88,"endTime":294.6,"body":"and they knew that they were kind of also really  "},{"startTime":294.6,"endTime":299.88,"body":"cheering on those students to be able to go "},{"startTime":294.6,"endTime":299.88,"body":"back and serve in those communities. Some of the  "},{"startTime":299.88,"endTime":306.64,"body":"other things that really kind of aligned well "},{"startTime":299.88,"endTime":306.64,"body":"with the self-determination theory was this idea  "},{"startTime":306.64,"endTime":316.84,"body":"of giving back, where a student would return back to the "},{"startTime":306.64,"endTime":316.84,"body":"reservation and one student even pointed out that  "},{"startTime":316.84,"endTime":324.08,"body":"they wanted to break this cycle that was happening "},{"startTime":316.84,"endTime":324.08,"body":"in their reservation, which was when people would  "},{"startTime":324.08,"endTime":329.88,"body":"leave and would be possibly successful "},{"startTime":324.08,"endTime":329.88,"body":"at getting an education they would never  "},{"startTime":329.88,"endTime":336.08,"body":"return. Their very best of their tribe would"},{"startTime":329.88,"endTime":336.08,"body":"become educated and because of lack of  "},{"startTime":336.08,"endTime":343.6,"body":"resources and job opportunities there they would "},{"startTime":336.08,"endTime":343.6,"body":"not come back except for social or family events  "},{"startTime":343.6,"endTime":349.6,"body":"so they weren't in the community and in supporting "},{"startTime":343.6,"endTime":349.6,"body":"the community any longer. So several of the nursing  "},{"startTime":349.6,"endTime":356.24,"body":"students really talked about they wanted to work "},{"startTime":349.6,"endTime":356.24,"body":"within their reservation system at the Indian  "},{"startTime":356.24,"endTime":363.32,"body":"Health Service clinics or hospitals that were "},{"startTime":356.24,"endTime":363.32,"body":"run there to treat their own families and their  "},{"startTime":363.32,"endTime":370.88,"body":"own community and that they realized that that "},{"startTime":363.32,"endTime":370.88,"body":"was a significant decision because it determined,  "},{"startTime":370.88,"endTime":377.64,"body":"you know, financial implications, because a lot of "},{"startTime":370.88,"endTime":377.64,"body":"those small clinics did not pay as well in those  "},{"startTime":377.64,"endTime":384.6,"body":"areas as it would in a larger city. However, the "},{"startTime":377.64,"endTime":384.6,"body":"students wanted to be close to their families and  "},{"startTime":384.6,"endTime":390.36,"body":"they knew that that was of great importance to not "},{"startTime":384.6,"endTime":390.36,"body":"only themselves but also if they had children. So  "},{"startTime":390.36,"endTime":397.76,"body":"that was a a really huge motivating factor because "},{"startTime":390.36,"endTime":397.76,"body":"the students that had children that I interviewed,  "},{"startTime":397.76,"endTime":402.88,"body":"their extended family were caring for them while "},{"startTime":397.76,"endTime":402.88,"body":"they were in nursing caring for their children  "},{"startTime":402.88,"endTime":409.16,"body":"while they were in nursing school. So they knew "},{"startTime":402.88,"endTime":409.16,"body":"that that family model was just very important and  "},{"startTime":409.16,"endTime":416.08,"body":"central. Great. So from the work of your study, what "},{"startTime":409.16,"endTime":416.08,"body":"would you recommend if you just had one strategy  "},{"startTime":416.08,"endTime":420.76,"body":"to recommend and I know it's multifactorial and "},{"startTime":416.08,"endTime":420.76,"body":"there's more than one strategy and it's much more  "},{"startTime":420.76,"endTime":425.84,"body":"complicated than that, but for our listeners, if you "},{"startTime":420.76,"endTime":425.84,"body":"had one strategy to promote retention for Native  "},{"startTime":425.84,"endTime":434.08,"body":"American nursing students what would that be? Well, "},{"startTime":425.84,"endTime":434.08,"body":"I think it's really important to get to know the  "},{"startTime":434.08,"endTime":442.12,"body":"students. You have to know the community you serve "},{"startTime":434.08,"endTime":442.12,"body":"and as nurses, I think we all know that to some  "},{"startTime":442.12,"endTime":448.16,"body":"degree that your population at one hospital will "},{"startTime":442.12,"endTime":448.16,"body":"be very different than if you're a community nurse  "},{"startTime":448.16,"endTime":456.4,"body":"in another setting. And I would say if you were "},{"startTime":448.16,"endTime":456.4,"body":"a nursing Ppofessor or or a nurse that's working  "},{"startTime":456.4,"endTime":462.96,"body":"in a hospital that's precepting students, I would "},{"startTime":456.4,"endTime":462.96,"body":"say get to know the community that you're serving,  "},{"startTime":463.56,"endTime":470.76,"body":"whether they're Hispanic or if they are Native "},{"startTime":463.56,"endTime":470.76,"body":"American, and so I would say that first strategy  "},{"startTime":470.76,"endTime":476.28,"body":"would be get to know the community. As you know "},{"startTime":470.76,"endTime":476.28,"body":"the community, you're also going to unknowingly  "},{"startTime":476.28,"endTime":484.44,"body":"be invested in that community and if you have, you "},{"startTime":476.28,"endTime":484.44,"body":"know, one big strategy that you could take forward  "},{"startTime":484.44,"endTime":494.92,"body":"with students is allowing them to see someone that "},{"startTime":484.44,"endTime":494.92,"body":"is like them in the role. Yeah. That was the number  "},{"startTime":494.92,"endTime":504.28,"body":"one takeaway from my study was that the students "},{"startTime":494.92,"endTime":504.28,"body":"really valued seeing another Native American in  "},{"startTime":504.28,"endTime":511.2,"body":"the role of professor, in the role of a preceptor, "},{"startTime":504.28,"endTime":511.2,"body":"or just a registered nurse that the faculty  "},{"startTime":511.2,"endTime":518.32,"body":"brought in from the community to help talk about "},{"startTime":511.2,"endTime":518.32,"body":"heart failure in this clinic that they worked  "},{"startTime":518.32,"endTime":524.32,"body":"in or that they were a diabetic nurse or just "},{"startTime":518.32,"endTime":524.32,"body":"different issues that they were seeing within that  "},{"startTime":524.32,"endTime":533.72,"body":"population. One really great program that one of my "},{"startTime":524.32,"endTime":533.72,"body":"students described was, I think this was in South  "},{"startTime":533.72,"endTime":542.8,"body":"Dakota State University, the student said that they "},{"startTime":533.72,"endTime":542.8,"body":"have a program where the nursing students that  "},{"startTime":542.8,"endTime":548.04,"body":"were Native American they let's say they probably "},{"startTime":542.8,"endTime":548.04,"body":"had about 10 nursing students that were Native  "},{"startTime":548.04,"endTime":555.72,"body":"American, they partnered with the community health "},{"startTime":548.04,"endTime":555.72,"body":"nursing faculty and they actually went to the  "},{"startTime":555.72,"endTime":562.92,"body":"tribe. The whole class went to the tribe and would "},{"startTime":555.72,"endTime":562.92,"body":"do assessments with the elders and that community  "},{"startTime":562.92,"endTime":569.36,"body":"so in order to prepare the non-Native American "},{"startTime":562.92,"endTime":569.36,"body":"students to be able to know those cultural norms  "},{"startTime":569.92,"endTime":574.8,"body":"out in the Native American community those 10 "},{"startTime":569.92,"endTime":574.8,"body":"Native American students became the leaders  "},{"startTime":574.8,"endTime":582.84,"body":"of that course. They actually taught the other "},{"startTime":574.8,"endTime":582.84,"body":"students, you know, what to expect, how to show  "},{"startTime":582.84,"endTime":589.84,"body":"respect to the elders, what to do if you're "},{"startTime":582.84,"endTime":589.84,"body":"offered something, things like maintaining eye  "},{"startTime":589.84,"endTime":597.4,"body":"contact, all those very important things are so "},{"startTime":589.84,"endTime":597.4,"body":"nuanced in various communities. And so that was  "},{"startTime":597.4,"endTime":604.32,"body":"their really contribution to that community "},{"startTime":597.4,"endTime":604.32,"body":"assessment project and they were seen as leaders  "},{"startTime":604.32,"endTime":610.84,"body":"not only in that one course but to their "},{"startTime":604.32,"endTime":610.84,"body":"entire cohort because they were addressing and  "},{"startTime":610.84,"endTime":616.44,"body":"and even giving back to their own community. "},{"startTime":610.84,"endTime":616.44,"body":"That's great and I and you know you bring up  "},{"startTime":616.44,"endTime":621.8,"body":"a great point about students wanting to see "},{"startTime":616.44,"endTime":621.8,"body":"others like them in faculty roles. And as we  "},{"startTime":621.8,"endTime":629.76,"body":"know nursing in general and more specifically "},{"startTime":621.8,"endTime":629.76,"body":"nursing education is very heterogeneous as far as  "},{"startTime":629.76,"endTime":637.08,"body":"faculty are concerned. And it's important also "},{"startTime":629.76,"endTime":637.08,"body":"that I think we have conversations with students  "},{"startTime":637.08,"endTime":642.48,"body":"about coming back to nursing education to be one "},{"startTime":637.08,"endTime":642.48,"body":"of those people that represent an other  "},{"startTime":642.48,"endTime":649.24,"body":"somebody who looks different or is, you know, "},{"startTime":642.48,"endTime":649.24,"body":"is ... I don't want to say is different, but you know,  "},{"startTime":649.24,"endTime":659.8,"body":"is representing a broader perspective than "},{"startTime":649.24,"endTime":659.8,"body":"our traditional nursing faculty. And it really  "},{"startTime":659.8,"endTime":666.36,"body":"does make a difference I know in universities "},{"startTime":659.8,"endTime":666.36,"body":"I've been at when we have faculty of color,  "},{"startTime":666.36,"endTime":674.88,"body":"we have faculty of that are men, LGBTQI faculty, "},{"startTime":666.36,"endTime":674.88,"body":"it makes a difference to students to see those  "},{"startTime":674.88,"endTime":681.96,"body":"role models and the work you're doing is very "},{"startTime":674.88,"endTime":681.96,"body":"important in better understanding how students can  "},{"startTime":681.96,"endTime":689.24,"body":"rise up and be leaders and also represent their "},{"startTime":681.96,"endTime":689.24,"body":"their culture, their ethnicity, their perspective.  "},{"startTime":690.64,"endTime":698.8,"body":"One thing I may also mention to our listeners "},{"startTime":690.64,"endTime":698.8,"body":"is not all Native Americans are the same and  "},{"startTime":698.8,"endTime":708.76,"body":"each tribe is so individualized and the historic "},{"startTime":698.8,"endTime":708.76,"body":"trauma that each each tribe has experienced is  "},{"startTime":708.76,"endTime":715.2,"body":"similar. It's a thread that is shared across all "},{"startTime":708.76,"endTime":715.2,"body":"of Native America, but I think it's important to  "},{"startTime":715.2,"endTime":723.56,"body":"know that just because you're looking at someone "},{"startTime":715.2,"endTime":723.56,"body":"that may have pale or white, lighter colored skin  "},{"startTime":723.56,"endTime":729.6,"body":"isn't to assume that they are not Native American. "},{"startTime":723.56,"endTime":729.6,"body":"Right. Also, if you have someone with really, really  "},{"startTime":729.6,"endTime":737.04,"body":"darker skin it you know not assuming that they're "},{"startTime":729.6,"endTime":737.04,"body":"African American because they could very well be  "},{"startTime":737.04,"endTime":745.28,"body":"Native American and be part of a a tribe. And so "},{"startTime":737.04,"endTime":745.28,"body":"I think it's important to ask our our clients,  "},{"startTime":745.28,"endTime":754.32,"body":"our patients, our students, you know what do you "},{"startTime":745.28,"endTime":754.32,"body":"identify as, because I myself am Native American  "},{"startTime":754.32,"endTime":762.0,"body":"from the Choctaw-Apache tribe in Louisiana "},{"startTime":754.32,"endTime":762.0,"body":"and I'm very fair skinned. And so it is often  "},{"startTime":762.0,"endTime":769.44,"body":"you know assumed that I'm I'm not Native American "},{"startTime":762.0,"endTime":769.44,"body":"but I have been a member of the tribe, you know,  "},{"startTime":769.44,"endTime":778.48,"body":"since birth. And so one of the things, this is "},{"startTime":769.44,"endTime":778.48,"body":"one this is one of the messages that I think  "},{"startTime":778.48,"endTime":786.08,"body":"people are trying to get out there as well, "},{"startTime":778.48,"endTime":786.08,"body":"is to ask people how they identify as well  "},{"startTime":786.08,"endTime":797.96,"body":"as their respected...if they're LGBTQ. And "},{"startTime":786.08,"endTime":797.96,"body":"certainly one other aspect that is unique to being  "},{"startTime":797.96,"endTime":809.36,"body":"a Native American is a new newer term to many "},{"startTime":797.96,"endTime":809.36,"body":"listeners maybe indigiqueer or two spirit. And that  "},{"startTime":809.36,"endTime":816.88,"body":"is those two terms identify Native Americans that "},{"startTime":809.36,"endTime":816.88,"body":"are from the LGBTQIA community and so those may be  "},{"startTime":816.88,"endTime":824.52,"body":"a couple of terms that you hear in some of your "},{"startTime":816.88,"endTime":824.52,"body":"interactions with students so I just wanted to  "},{"startTime":824.52,"endTime":829.52,"body":"share that. I think that's great and I think "},{"startTime":824.52,"endTime":829.52,"body":"you bring up a wonderful point, right, a great life  "},{"startTime":829.52,"endTime":835.4,"body":"lesson is never make assumptions. And you know, "},{"startTime":829.52,"endTime":835.4,"body":"every day we make assumptions about  "},{"startTime":835.4,"endTime":841.2,"body":"lots of things but it's important not to make "},{"startTime":835.4,"endTime":841.2,"body":"those assumptions and clarify those assumptions.  "},{"startTime":841.2,"endTime":845.92,"body":"Dr. Bruce, I want thank you for joining us "},{"startTime":841.2,"endTime":845.92,"body":"for this important conversation. Your expertise  "},{"startTime":845.92,"endTime":850.64,"body":"has helped broaden our understanding of some of "},{"startTime":845.92,"endTime":850.64,"body":"this work and gives us some insight in how we can  "},{"startTime":850.64,"endTime":856.16,"body":"introduce this at our own institutions. And to our "},{"startTime":850.64,"endTime":856.16,"body":"listeners, if you've not had the opportunity please  "},{"startTime":856.16,"endTime":861.52,"body":"look for Dr. Bruce's work, \"Promoting Retention of "},{"startTime":856.16,"endTime":861.52,"body":"Native American Nursing Students - Insights From a  "},{"startTime":861.52,"endTime":867.4,"body":"Qualitative Study,\" in the November-December issue "},{"startTime":861.52,"endTime":867.4,"body":"of Nursing Education Perspectives. And I want to  "},{"startTime":867.4,"endTime":891.92,"body":"thank you again Dr. Bruce for joining us sharing "},{"startTime":867.4,"endTime":891.92,"body":"your information with us. Thank you very much."},{"startTime":891.92,"endTime":892.456,"body":"[Music]"}]}