5 Reasons Nurses Should Watch the “Who Cares” Documentary

South Dakota is one of the poorest communities in the United States. More than half of the estimated population of 40,000 of the Oglala Sioux Tribe, living on The Pine Ridge Reservation of South Dakota, lives below the federal poverty line. The life expectancy is averaged at 48 for men and 52 for women.

The documentary “Who Cares: A Nurse’s Fight for Equity,” set in Fargo, North Dakota, features Whitney Fear, a psychiatric nurse practitioner who grew up on Pine Ridge and is a member of the Oglala Lakota Nation, one of the seven members (or council fires) of the Lakota Nation.

“Who Cares” explores how Fear’s experiences with alcohol use at a young age, almost failing out of high school, family struggles, and watching young people die on the reservation helped shape her clinical practice today.

Despite these experiences, “people not giving up on me” is why Fear is a nurse today. Fear knows far too well the healthcare barriers Native Americans face. She doesn’t want to give up on them and believes every nurse can play a pivotal role in health equity.

Fear worked as a nurse for six years treating patients experiencing homelessness at Family HealthCare in Fargo. The clinic is a federally qualified health center and the only homeless health clinic in North Dakota. Fear eventually received her master’s as a psychiatric nurse practitioner and opened her own psychiatric practice at Family HealthCare.

Her unique practice focuses on caring for and treating mental health conditions and substance use disorders. She uses holistic and trauma-informed care, a different approach than many other healthcare providers, Fear points out.

The Trauma-Informed Care (TIC) Implementation Resource Center defines TIC as healthcare organizations and care teams acknowledging a patient’s past and present to provide “effective healthcare services with a healing orientation.”

According to their website, trauma-informed care strives to:

The benefits of opening your own practice as a nurse or nurse practitioner are endless. Knowing why you want to open a practice and how you want to run it gives you the type of freedom and opportunities you may not have working at a hospital or facility.

Fear chooses to use TIC in her practice because evidence shows this is an effective way to care for and treat patients with mental health conditions and substance use disorders.

Fear mentions the book “Notes on Nursing” by Florence Nightingale and how surprised she is at the number of nurses that haven’t read the book. (I haven’t read it either but plan to after watching the film.) She talks about how even Nightingale understood the importance of returning to the basics.

Nightingale writes about the importance of preserving people’s dignity. She also writes how nurses should know the population they are working with and their specific needs.

Going back to the basics also includes meeting patients where they are. Fear believes a nurse must treat everyone fairly and with respect.

“Don’t expect people to be nice to you when they are sick,” Fear says.

Fear discusses her own Lakota culture in the film. Lakota culture believes in respecting all living things. She says this is how healthcare providers should approach patients.

“It is about respect rather than compliance,” Fear says.

It is also important to know your own needs as a healthcare provider. Far too often, healthcare workers suffer from burnout. Many also develop substance misuse or depression as a way of coping with the job.

Melissa Kaiser is a social worker and independent consultant in the antihuman trafficking field featured in the documentary. She suggests healthcare providers should have an honest conversation with themselves.

Fear believes health maintenance for healthcare providers should include therapy.

Human trafficking is another obstacle Fear is trying to overcome at her facility. In the documentary, Kaiser defines human trafficking as “the exploitation of someone for the purposes of compelled labor or a commercial sex act using force, fraud, or coercion.” The film reports millions are exploited across the world, including in the U.S.

Kaiser points out that every survivor has their own story. She states:

Fear and Kaiser believe nurses need to know how to recognize human trafficking in their patients. If spotted, it is important not to judge them and provide resources to help.

One of the reasons Fear became a nurse is because she noticed the lack of representation in healthcare from the Indigenous American community. Studies show representation in nursing improves healthcare outcomes.

As a nurse, you have to be culturally sensitive and provide culturally competent care in nursing to all patients. It begins with being aware of your biases and becoming skillful at repeating culturally competent behaviors.

It is also important to center patients’ care around their needs, not yours. Being aware of what they need culturally is being culturally sensitive.

Fear attributes her not failing out of high school to a guidance counselor. Her counselor gave her the support and confidence she needed to finish. Fear talks about the power of support and how she wouldn’t be where she is today without her support network.

A support system or network has been shown to greatly benefit a patient’s health. A support system:

Patients need to feel supported. They need to feel safe. Ask patients about their care and what they think is possible, Fear says.

All in all, the documentary provides valuable information all healthcare providers can use in their communities. The documentary also successfully shows how nurses can play an integral role in providing patient-centered care.