One nurse, two worlds
For RAIN’s Indigenous speaker series, Whitney Fear Johnson − tribal member, documentary subject and nurse practitioner – spoke with nursing students
Whitney Fear Johnson, a psychiatric mental health nurse practitioner and member of the Oglala Lakota Tribe, walked onto the Memorial Union ballroom stage carrying a small box. The box contained earrings, letters, a coat, all given to her by former patients.
“Today I wanted to talk about what it’s like being able to walk in two worlds at the same time,” she said as she pulled items from the box.
Fear Johnson was on campus to speak following a screening of the documentary, “Who Cares: A Nurse’s Fight for Equity. Both her talk and the documentary were presented as part of the College of Nursing & Professional Discipline’s Recruitment and Retention of American Indians into Nursing (RAIN) Indigenous Spotlight Speaker series.
The short documentary, produced by the nursing community platform SHIFT and the Robert Wood Johnson Foundation, follows Fear Johnson as she interacts with patients and colleagues while working with the Fargo-based primary care clinic Family HealthCare.
The “two worlds” that Fear Johnson described reflect her dual identities as an Indigenous woman and a psychiatric mental health nurse practitioner. For her, the personal and professional experiences overlap, allowing her to advocate for her patients and herself authentically and effectively.
With images of her family and childhood in Pine Ridge Indian Reservation, S.D. projected behind her, Johnson removed items from the box and recounted the experiences and patients she associated with them.
Earrings made by the last patient she put in hospice care. Letters from patients who were in jail. The favorite coat of a patient in whom she found a kindred spirit.
The objects became part of a larger tapestry of relationships and connections she had made through a shared understanding of what it means to navigate the world and healthcare system as an Indigenous person. Ultimately, she said, these connections can make a big difference for patients.
“I want for indigenous students here to know that there are people that really need us,” she said. “They’re really looking for that connection, and it’s huge for them to not have to explain where they’re coming from and what their experiences are.”
Fear Johnson said that she approaches therapeutic relationships differently than standard Western practices, encouraging a more significant level of personal detachment. She said that her personal life and professional practice tend to bleed together, allowing her to be a more empathetic and effective nurse.
“The way that we interact with one another can be really healing,” she said. “I still have some boundaries with my patients, but we exist in the same spaces. We’ve been in ceremony together, many of them have met my kids and I know, for me, that is the right thing to do.”
However, she did not smooth over the difficulties, mainly regarding her advocacy work. She detailed some of her harrowing encounters with victims of human trafficking (also a significant theme of the documentary), as well as watching patients struggle with injustice.
“It is tricky. It takes some navigating,” she said. “There are going to be some parallels of things that are happening or have happened in your personal life, and that can be difficult.”
However, she believes that shared experience can make nurses better advocates for their patients. The intersection of the personal and professional worlds can be an asset in healthcare, and she encouraged RAIN students to trust themselves when the opportunity comes to make a change.
“There is no degree equivalent to being an indigenous person,” she said. “We’ve got a lifetime of experience being native people, and that’s all that’s required for expertise.
“Insist on representing yourself and our people because we’re the experts on that matter. It can be really intimidating, and it is hard, but if we insist on things being different, then they do have to change.”
Following Fear Johnson’s presentation, RAIN staff opened the floor to questions from the audience. Many of the questions centered on diversity in healthcare and best practices for serving diverse communities.
Fear Johnson said increasing diversity in nursing requires an intentional effort from higher education institutions. Drawing from experiences that she and people close to her have faced, she said that new prospective student evaluation methods have shown promise in states such as Colorado.
“Some students don’t have access to things that schools want to get into their programs,” she said. “When we look at things like holistic admissions, it gives those students a chance, and I think it makes a big difference. Schools that do this see the diversity of their programs go way up, and their rate of degree completion doesn’t go down.”
Another question came from a student who asked how non-Native nurses could better care for Native patients.
In response, Fear Johnson reflected on an unjust situation she had seen, which left an elderly woman homeless with end-stage liver failure. Though the situation she described was severe, she made it apparent no injustice is too small to be addressed.
“To be a good ally and advocate for patients, I think it’s important to make sure that things are equitable and call attention to things that seem unfair or biased,” Fear Johnson answered. “Things that seem miniscule can really adversely affect somebody’s care. It can have a domino effect that affects their whole life.”
Conversely, the domino metaphor Fear Johnson uses can also apply to the positive changes that nurses make when they bridge the gap between their personal values and professional ethics — serving patients by walking in two worlds at once.