Katherine Baltazar, APNA Psychiatric-Mental Health Nurse of the YearKatherine Baltazar, PMHNP
2014 APNA Psychiatric-Mental Health Nurse of the Year

Katherine Baltazar, the APNA Psychiatric-Mental Health Nurse of the Year, has spent the past two years working with members of the Lakota tribe on the Eagle Butte Cheyenne River Indian Reservation. Since September of 2012, she has worked for the tribe as a Psychiatric Nurse Practitioner, a Supervisor for the Social Work Department, and a member of a community suicide prevention team. This work has given her insight into the unique challenges that this Native American community faces.

“What I have seen over the 2 years of working on this particular reservation, is that though their culture is still alive, it is sorely wounded by the history of government policies towards them since the time of Thomas Jefferson,” she says.  “The intentional destruction of their culture is today reflected in the extreme rates of poverty and health disparities that would be unacceptable for mainstream America.” She sees, though, the thread of joy in the Lakota culture has never unraveled. “Through this all, the Lakota maintain a delightful sense of humor,” she marvels. “You hear laughter every day. There is something they teach me with this,” she continues, “that in the hardship, life is still affirming and a mystery.”

Baltazar herself has devoted much energy to learning about the Lakota. As colleague Wailua Brandman says, “Early on in her work at the reservation, she realized that the behaviors she was intent on modifying were symptoms of decades of betrayal...and that her work would be to nurture healing in the community through storytelling and understanding of the difference in Lakota logic and customs.” She took Lakota language and history classes at Oglala Lakota College. “Katherine challenges the traditional roles and perspectives of PMH nursing as a nurse ethnographer, living in a specific culture and reporting her activities,” says Susan Jacobson, who nominated Baltazar for the award. “Katherine’s work is an exemplar of community mental health nursing. She leaves no stone unturned to address the health concerns of her patients and community at Eagle Butte.”

From a systemic perspective, “Governmental programs coming from the top down are not solving the problems,” she says. “This has to come from the grassroots.”  Funding alone is not a solution, she believes. “Money thrown at a problem is not the answer. To me, money is the last thing I look for. I first look for the energy - for I believe that when there is energy - the money will come,” she explains. “I find hope every time I meet someone that has passion... when I find a spark of it; it always nourishes my faith for their future.”

One issue which Baltazar has tackled on a grassroots level is Fetal Alcohol Syndrome Disorder (FASD) – of which Native American children have a 40% incidence. Together with her coalition, she spearheaded a FASD Awareness walk, which had 150 children participate. In keeping with her cultural sensitivity, she integrated Lakota traditions such as drumming and chanting into the walk and commissioned a mural on FASD by a Lakota artist. She arranged for two experts from Stanford to give a training on FASD for clinicians at the Indian Health Services hospital and is currently looking for grant monies to hire a FASD Coalition Leader, to help root the messages of prevention in the communities.  In addition to this grassroots approach, she also participates at a policy level in interagency meetings that include the tribal judges who can help make changes to how law enforcement and the judicial system partner to support bringing and keeping people in treatment. Baltazar also integrates an educational approach into her work, teaching classes on pregnancy and growth development. “My hope is for my project–bringing awareness around the Fetal Alcohol Spectrum Disorder (FASD) - to organize itself into a functioning coalition,” she says. “It will take a community effort to prevent FASD. The future of the tribe hinges on the success of having healthy births.”

Baltazar’s community efforts (which are many, in addition to her FASD activities) all have the same aim: to create a healthier, happier environment for the entire Lakota community. “I chose psychiatric-mental health nursing because I wanted to help alleviate some of the suffering of people," she says. The combined skills she has acquired as a Clinical Nurse Specialist and Nurse Practitioner are “powerful healing tools,” she says. “It’s like if you were both a mechanic and a driver,” she explains, “because you have an understanding of how the car runs, and also have the skills to diagnose and repair the problems.” In addition, as a Medical Mission Sister of the Roman Catholic Church, she feels “comfortable to address spiritual needs when appropriate.”

She hopes that one day a Lakota Psychiatric-Mental Health Nurse Practitioner will follow in her footsteps. “I am aware of only one in all of South Dakota,” she says. “Psychiatric Nurse Practitioner is a rare specialty, and so they can command higher salaries than what tribal governments can offer here.” Ultimately, she hopes for future continued culturally sensitive mental health care for the community.  She wishes “for anyone who follows me to respect the spiritual beliefs of the Lakota, realizing how important honoring their tradition is, for healing.”

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