Describe Family and community are especially important to the Amish people.

1:This week, the assignment involves the Amish and Jewish cultures, so for the discussion, I chose to write about Indians, Eskimos, and Aleuts. To do so, let us travel back to a time of Cowboys and Indians. In the years before 1871, it was the beginning of reservation subjugation. During this process, the Indians land shrunk from 2 billion acres to 200 million acres. Treaties were signed, and for this colossal chunk of land, the government guaranteed compensation through provided provisions, health care, education, protection against trespass, supplies, and annuities (Jorgensen, 1996). However, in 1871 Congress had a change of heart and decided there would be no more treaties signed with Indian Tribes. Indians faced a hard road filled with many holes and obstacles over the years. Some reservations were faced with infectious disease to the point children were sent to boarding school, or they would lose their provisions. The problem was that the schools were riddled with illness and death as well. The Eisenhower Administration oversaw the Indian health service under the Bureau of Indian Affairs (BIA) transferred to the new Indian Health Service (HIS) in the umbrella of the Public Health Service (Jorgensen, 1996). During the Johnson Administration, funds were freely given to Indian programs but did not produce fruitful returns. More than a decade later, the Indian Self Determination and Education Assistance Act intended to help increase tribal sovereignty and promote economic development. This allowed Indian tribes to have access to the HIS, BIA, Housing and Urban Development, Department of Transportation, and other federal dollars that had never been available to Indian tribes before. Bipartisan support for the tribes all but evaporated in 1993, which is of concern since the health care of Native Americans, is considered a federal obligation.The IHS only survived for about 40 years, but during its tenure, it provided full and regular innovative health care services to Indians, Eskimos, and Aleuts. Indians became identified by whether or not they were enrolled. The IHS physicians would see everyone and answer every call for assistance. However, the BIA physician would not see unenrolled Indians. Even if both parents were enrolled, and unenrolled child would not be seen. Indian health, unfortunately, has always been driven by economic concerns that are fueled by political interests. The ironic part, the IHS provided high-quality, affordable health care to the Indians. Even today, as we drive across the reservations in Arizona on vacation, the basic needs are hard to come by. I have often wondered where the grocery store is on the reservation because we haven’t found it yet. Discussion post 2: A literature search was conducted using EBSCOhost for health and Amish to locate an article related to the health of the Amish people. An article titled, Amish Health Care Beliefs and Practices in an Obstetrical Setting (2006) was chosen for review. This article is a case study that describes an Amish heritage, Amish mutual network, family role, genetics, conception, prenatal care and birth. It describes a case study of an Amish family with a newborn baby that was admitted to a neonatal intensive care unit (ICU), as well as defining an Amish birthing center that accepts prescreened patients on physician recommendation. The article is about making accommodations for the Amish people when delivering quality health care both inside a traditional hospital type setting or Amish birthing center when delivering care to mothers and babies. The case study of the Amish infant admitted to the ICU discussed that the family did not have medical insurance and were fearful of the cost. Also, the mother visited daily with her other children in attendance in the waiting area, with their grandmother and neighbor, all dressed in their traditional attire. The infant’s father would visit on weekends. Extended family and friends would also visit, and all bring their own food. The Amish Birthing Center was constructed using donations and private subscriptions. It allows patients to receive skilled maternity care outside of the hospital setting. “New Eden Care Center is a place where the physician or midwife can bring their patient for delivery in a more relaxed, home-like environment” (Lemon, 2006, p. 57). There is a flat fee for services and the facility charges a fee to cover expenses and maintain the facility, not to make a profit. The center is designed to cater to the Amish culture with no televisions in the rooms, and having the patient stay in one room for her stay accompanied by her infant. There is also a kitchen area for family to dine together and parking for horse and carriage. Family and community are especially important to the Amish people. They have distinct family roles, and a large community support system. Having this knowledge impacts my nursing practice by being more sensitive to their culture, needs, and desires. Understanding that the Amish patient may utilize folk wisdom practices or herbal formulas can assist with providing them culturally competent care. Being in a hospital environment surrounded by technology maybe very overwhelming for Amish families that are used to a more simple life without technology or electronics.