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    Nome, Alaska

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    Sarah (left) and Corissa, a friend and fellow traveler, pose for a photo atop Anvil Mountain with Nome and the Bering Sea serving as their backdrop.
    When Sarah Swartz, LPN, arrived in the "Land of the Midnight Sun" for her first assignment, she planned on staying for 13 weeks. That was in November.

    Now, she is on her second contract extension at Norton Sound Regional Hospital (NSRH), a non-profit institution that serves the roughly 4,000 residents of Nome as well as those who live in 15 "neighboring" villages, which are spread out over an area the size of Pennsylvania. "While each village has its own clinic," says Sarah, "when patients need further treatment, they're sent here."


    Sarah in nearby solomon, a vacant, old mining town that's home to the "Last Train to Nowhere" and an old gold dredge.
    NSRH has a Level IV trauma center, an outpatient clinic, 18 inpatient beds, and a 15-bed, long-term care center. No surgery, CT scans, or MRIs are provided at the facility, so people in need of such services are sent to Anchorage, which is about 600 miles away. The hospital has roughly 300 employees, according to Sarah, who works with six other nurse travelers. "I'm really enjoying my assignment at NSRH. It was the first contract Preferred Healthcare Staffing—a travel company based in Fort Lauderdale, Florida—offered to me, and I am so glad I accepted it!"

    She works 12-hour night shifts, from 7:45 p.m. to 8:15 a.m. on the inpatient unit. Her average patient load is three to four, and she and her colleagues take on additional responsibilities since some departments close at 5:00 p.m. "There aren't any nurses' aides or secretaries on duty at night," states Sarah. "The hospital lab closes at midnight, but my coworkers and I usually draw blood, collect specimens, and do urine dipstick tests as a courtesy. We give respiratory therapy treatments to patients who need them during the night, as well." The unit employs a total of 16 nurses—four per shift—and some are always on call. When patients need one-on-one nursing care, the workload is adjusted.

    In fact, she has pitched in and helped care for pediatrics, OB/GYN, and psy-chiatric patients. She has even assisted with the delivery of five babies. Sarah—who practiced at hospitals in St. Louis, Missouri, and Memphis, Tennessee, before becoming a traveler—says her experiences in Nome have been markedly different. When she first came to NSRH, she was given a formal orientation. Then, not only did she learn about a number of specialty areas, but she also learned about the locals and their customs.

    The Native culture

    "Alaska Natives tend to be a quiet people who often communicate through facial expressions," explains Sarah. "A raised eyebrow, for example, means 'yes,' and a frown means 'no.' In addition, many of the Natives will not look healthcare professionals directly in the eye when communicating with them because it's a gesture they consider to be rude."

    Thankfully, language barriers have not been a problem for Sarah. While a lot of the residents speak Inupiaq and/or Siberian Yupik, most, with the exception of some elders, speak English, too.

    There is a prematernal home located near the hospital, where women from outlying areas come to live during the last 4 weeks of their pregnancies—especially during the harsh winter weather—to ensure optimal prenatal care and delivery. Sarah relates that the nurses at NSRH are sometimes called in to help with their care.

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    Laura Gater
    Laura Gater is a freelance writer based in Columbia City, Indiana.