BY ANNA MARIE MURPHY
After graduating from Boston College's School of Nursing, Kelvie Pleas
'01, of Seattle, headed north for the summer to remote Bethel, Alaska
(population: 5,471, mostly Yup'ik Eskimo). There she worked in a small
hospital run by a tribal consortium. The hospital services an area
of approximately 50,000 square miles, flying in patients from 56 villages
on the Yukon-Kuskokwim River Delta. "When you discharge patients,"
says Pleas, "you need to make travel arrangements."
To get to Bethel, you have to go by boat or airplane. There's no other
way. The Kuskokwim region is called the "Bush of Alaska," but it's
really just swampland. There are no trees, only swampy grass and dirt
roads. The houses--mostly shacks--are on stilts because of the way the
ground freezes and thaws. The horizon stretches out forever and ever.
Bethel Hospital, where I worked, looks like six yellow submarines
connected and on stilts. It's a 50-bed facility. I worked half as
a clinical nursing assistant and half as a temporary registered nurse--giving
meds, IVs, doing wound care, respiratory care. There's only one floor,
and it's for infants to elderly, so I got the whole human cycle up
In the summer, most of the people are at fish camp, catching their
fish for the winter. The villagers live off seal and fish. One day
we were serving lunch in the hospital and some patients asked, "What
is that stuff?" It was chicken. They had never seen chicken before.
The natives talk in Yup'ik, and many don't speak English. Yup'ik is
a very hard language to learn, because much of it is not written.
I did feel like an outsider. Most of the people who work in the hospital
are white, and I kind of felt like we were invading, even though the
board of directors and the people that run the hospital are native.
The hospital is completely different from any in the lower states.
For one thing, visitors are allowed to wander around. Since everyone
seems to be related to everyone else in some form, people just come
in and look at the board where we write the names of patients, to
see if a relative is in. And at least one relative always is. They
go into the room and say, "Hi, I'm your cousin (or whatever), and
I just came to make sure you're okay."
The hospital is a hangout. People sell crafts and fish and ivory in
the waiting room. I've heard that in the winter the hospital's more
packed, partly because of the colder temperatures, but also because
the villagers can use the river as a freeway for their snowmobiles.
Everyone socializes more in the winter.
Bethel is a pretty good hospital, but it's not equipped with everything
you need in the case of an acute emergency. So a decision often has
to be made about whether a patient can stay or has to be flown out
to Anchorage. You don't want to send many patients, because, although
Bethel's not very big, it's big to a lot of people coming from the
tiny little villages. To them it's overwhelming. To send them from
their families, their tribes, is a big decision for a new nursing
school graduate to make, and it is a responsibility that the hospital
places on you. I was asked to stay on this year, but I think it would
be better to get a year of experience in an acute care hospital before
going back. I want to be more confident in my decision-making skills.
My goal is to become a nurse practitioner, so I can work by myself
and prescribe meds. What I want to do is traveling nursing, meaning
that from BetheI I would go for two weeks or so from village to village.
You have to have a little experience before the hospital will send
you out in charge, but that's my next goal. That's what I want to
Alaska. Photo by William Sanford