This is the continuation of an interview with Jessie Jim on May 31, 2006 by Karen Brewster in Juneau, Alaska. The interview took place in Juneau instead of at Jessie's home in Angoon, Alaska, because she was in Juneau to participate in the Southeast Alaska Native dance gathering called “Celebration.” In this second part of a two part interview, Jessie talks about the emotional impact of traumatic accidents and dealing with death when working as a health aide, the use of traditional medicine, the importance of transportation for emergency patient evacuation, and shares memories of delivering babies. She also talks about what it has meant to her to be a health aide, the importance of community and family support, collaborating with other health aides, healthcare management in Alaska, and changes in the Community Health Aide Program.
Digital Asset Information
Project: Community Health Aide Program
Date of Interview: May 31, 2006
Narrator(s): Jessie Jim
Interviewer(s): Karen Brewster
Transcriber: Carol McCue
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Dealing with traumatic accidents and witnessing the death of a patient
The emotional impact of traumatic accidents and death, and positive outcomes with patients.
Community support of health aides, and changes taking place in the health aide profession.
What being a health aide has meant to her, and memories of delivering babies.
The availability of air transportation for emergency patient evacuation, and her family's involvement in the health aide profession.
How her family supported her work as a health aide, and the importance of meeting with other health aides to share their experiences.
Working for the Indian Health Services (IHS) and the Southeast Alaska Regional Health Consortium (SEARHC), the role of health councils, and the effects on Angoon.
How traditional medicine and mid-wife practices were not used when she was a health aide, and training she has an emergency medical technician (EMT).
Helping and encouraging young people to become health aides, the role of Dr. Lee Schmidt in improving the health aide pay scale, the importance of teamwork within the health aide field, and changing technology that health aides have to work with.
The impact of physician assistants working in village clinics, the rewarding part of being a health aide, encouragement to others to become health aides, and the many responsibilities health aides have.
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After clicking play, click a section of the transcript to navigate the audio or video clip.
JESSIE: We had at one time -- I got called into the clinic. I wasn't on call, but sometimes we'll call each other to help. This other health aide called me in because she said they're having a hard time trying to settle down -- This one guy he had gotten stabbed on his leg. He was bleeding a lot. She called me and then I came in there. He was irrational, he was fighting off everything they were trying to do for him. And I looked, and there was blood soaking on his pressure bandage that they had on him. They couldn't get a pulse. They couldn't get a blood pressure because they couldn't settle him down enough. And they couldn't get an IV going. And we called in some people from the EMS (Emergency Medical Service) system and asked them to hold him down for us. And I told them we need to get an IV going. So we got that going. And got it in him. And he was like -- the blood volume thing, I mean. He settled down. We were able to get a pulse on him. And were able to get a blood pressure. Just to get the IV going. He had lost so much blood that he was just pale, too. After we got the IV going on him he was getting some color back, too. But, he was still bleeding. I told her, “We have a bleeder on us. To me it seems like we need to get him out.” But the doctor kept having us just call back. Well, I wasn't the one on call. The one that was on call had to keep calling back. And they finally got him out of there. He sent in -- he had gotten stabbed, I believe, on the leg, in the artery. I believe that is what he did. He made it though. But, the one like -- You know, they had a murder -- homicide in Angoon. And I happened to be there. I wasn't on call, but I happened to be there, because it happened next door to my daughter. And that was a tough one. I believed he had already been gone when the EMS arrived and tried to revive him. The feeling of helplessness, I mean, there's -- what could we do. His blood was coming out of his mouth and his nose. He had been -- I believe they had got his main blood vessels, that he was stabbed in the back. The wound wasn't even that big. It's like you can hear a person's last breath. I could still hear it. It was like all the breath, you know, went out of him, one last -- then I could hear my daughter screaming because she was trying to help him. That's when my knee first started bothering me where I could hardly even walk on it. And I made it to hobble over to where they were though. She was screaming at me, “Mom, he stopped breathing. What do I do?” I didn't know what to tell her to do. I was kind of like helpless. I didn't think we could do CPR with all that blood coming out of the mouth and the nose. Unless you could get a suction machine there.
KAREN: Those kinds of traumas have to be hard for everybody who does that kind of work anywhere. I can't imagine it in some place where you know everybody or you're related to everybody. JESSIE: Yeah. KAREN: And how you handle that. JESSIE: In a small village, everyone knows each other. Things like that are kind of hard to take. My daughter had a hard time. That was her first experience with seeing someone die, someone die in front of her. KAREN: Do you remember your first experience seeing someone die? JESSIE: We were called many times to different places where they had already been gone. They were dead. But we've had different experiences like -- that was one for me. There was one where this guy had pancreatic cancer. And I got called. She said he had collapsed in the bathroom and they wanted him to be checked. And when I got there, I couldn't hardly get a blood pressure, or a pulse. So, thank goodness the doctor was in town on a visit then. So I called him, and we took him (the patient) to the clinic. And we were trying to get an IV going. Well, the doctor was there telling us what to do. And it was like, he was talking to us but he was in a lot of pain. And then it was like he let out a loud yell like -- oh, that was painful. But after that, he slid into a coma. And he passed away not even too long after that. He was pretty fairly young man, too. KAREN: Let's turn it around to the more positive. What about success stories you had, where you thought somebody wasn't going to make it and something you did saved their life? JESSIE: I don't know. KAREN: Because it wasn't -- in thirty-five years it wasn't all the horrors and deaths and all that. There must've been some good. JESSIE: Yeah. There's some like -- This one I was telling you, the bleeder. To get the IV going. I was glad that we were taught how to do IVs and -- KAREN: And that man got shipped out and he survived? JESSIE: Hm, mm. He's still around, I believe. There are quite a few of them, I just can't think of them. But, yes -- Even my little great granddaughter was medivaced out. Not too long ago, she had had pneumonia, was having a lot of trouble breathing. KAREN: It must feel good to be the one somebody calls, and you do something and you help somebody or save them. JESSIE: Yeah. That's like, they taught us how to do EKG's (Electrocardiogram), too. There was this guy having trouble with chest pain. And he always says that -- Well, he says he's grateful for health aides because they're the ones that realized he had something wrong with him and shipped him in. And they took care of the problem. He had trouble with his heart. So, we had done an EKG and sent it in and then they sent for him. He's always telling us. It makes you feel good, you know, when they say -- He's always telling us that he is glad he came to see a health aide and he was glad for the health aides because they're the ones, he said, he thinks saved his life. KAREN: So, it's not always like that case you talked about where the little girl died and the people were blaming the health aides? JESSIE: No.
KAREN: I wonder is -- how the communities support or don't support the health aides, and if that makes a difference? JESSIE: Uhm. I think -- It's just, you know, with people being -- so, you want to do something but you can't and then you expect someone else to then. And usually it's the health aide they expect to take care of some. Then, if it doesn't turn out then -- KAREN: In other places in the world where they don't have health aides and you just go to a doctor and something doesn't work out, people blame the doctors, too. JESSIE: Hm, mm. KAREN: I'd say, as humans, we need that. JESSIE: I try to even myself not say anything about the health profession, 'cause it's a tough thing. I mean, do the best we can with what -- I used to tell them we do the best we can with what we have. We don't have all that much equipment. I think that with the Health Aide Program there now, it has saved quite a few lives. They're taught so many things now. Things I wish we were taught. I learned a lot from the new health aides that come on. I tried to help them through, but they taught me a lot, too, from the things they learned. From going training. Training is a lot better now, I think, then when we started.
KAREN: So, how do you feel about having been a health aide? How do you feel about -- What has being a health aide meant to you in your life? JESSIE: I guess it's taught me a lot. Geez, I wouldn't know. KAREN: Like what has it given you, personally? JESSIE: I just said earlier that some people, I don't know if they're like me where you like to feel needed. And you're there to help people who need you, in whatever way that I could have helped them. It just makes me feel better. KAREN: Do you feel like it was a good choice for a career? JESSIE: Yes, I believe so now, I mean, it could have -- KAREN: Yeah, you became a nurse, sort of not necessarily -- but I don't know -- JESSIE: Not thinking I want to be a nurse. But got in there. You know, sometime I wonder why I stayed in there so long. KAREN: That's why I say, there must have been good things. It couldn't have all been trauma. JESSIE: There's a lot of good things. Like if you see the baby born, you know, see a baby born, and everything turns out good. You take care of someone, they get better. That's why it's hard for health aides to deal with death, I think, because they're trying to help them get better. And then when it doesn't happen, it's kind of a hard thing to deal with. KAREN: In the training, either the training you had or the new training they do, do they provide training on how to deal with death and those issues? JESSIE: I don't know if they do now. But, I don't think they ever did with us. But I took a class where one of my supervisors encouraged me to take, in dealing with death and dying. I thought, who would want to take a class on -- but it was a good class. It helped me deal with my own issues, too. KAREN: Yeah, I think it would be something in that job you'd deal with it all the time. I'd think you'd need to know about. JESSIE: Yeah. Well, I had my own personal issues. My second husband committed suicide, and that was, I think, the worst time I went through. It took a long time to come -- get back into living again. KAREN: Did you continue working through that difficult time? JESSIE: I had two weeks off. I talked to my family. I called them aside and told them, "You folks have to help me through this time." I told them, "The people will expect be to bounce right back on the job. It's going to be very hard for me." I remember going back after that, the first time. That was the worst time I ever went through, I think. KAREN: That's been a while ago now? JESSIE: Hm, mm. It's going to be twenty years this December. KAREN: Do you remember the first baby you had to deliver? JESSIE: Yeah, I remember. It was in Barbara's (Johnson) house. We set it up, and we were there with her all the way through. It was something, I mean. But neither one of us had ever had the experience. We just got set up with what we could in her house to have that baby delivered there. I see that woman now -- she's a woman. I remember our first delivery, and our second one, and then I lost count. KAREN: So, had you had any training in how to -- ? JESSIE: I don’t think so. You have to go by doctor’s guidance. KAREN: I was going to say, how do you know what to do? JESSIE: Yeah. She had a phone in her house. And we’d tell the doctor. KAREN: Was it scary? JESSIE: Hm, mm. I remember we tried to put a gown -- make her put a gown on when she was in labor. You know, woman in labor, they’re in a lot of pain. We gave her the gown to put on and she got mad. And she tore it out, and threw it at us. The baby was born not too long after that. It was in her last stages of labor, I think. And the next day, all my muscles were aching. I think we were pushing with her, too. The second one was born right in their house. But thank goodness those deliveries were ok. I remember one delivery I was there by myself. And I was, “Oh my god, what am I going to do.” Here I see this big ol’ bag of water coming out before the baby. It hadn’t broken yet. KAREN: The water didn’t break? JESSIE: Hm, mm. And I called the doctor. They didn’t have a phone so I have to run somewhere nearby to call on the phone. I called the doctor and told him what was going on, what it looked like to me. And he said well, get a sharp-edged, sterile scissor and poke it. “I don’t want to.” What if the baby comes out. Poke the head, you know. But I said, “Oh I’ve got to.” So I went ahead and get there and pfft the water came and not too long after the baby. KAREN: So, what would happen if you hadn’t poked it? JESSIE: I don’t know. I should’ve asked the doctor what could have happened. Maybe it would’ve eventually broke. But that was weird.
JESSIE: Before we ever learned how to do IVs, we had one woman who delivered back home. The placenta wouldn't come out. She delivered the baby. And the placenta wouldn't come out. She was bleeding, bleeding and -- Thank goodness she made it to the hospital in time, barely. She had bled quite a bit. If we had had IVs, that would've helped. That was before they ever taught us how to do them. KAREN: So did you always have access to an airplane for medivacs? JESSIE: Planes fly in and out of Angoon. Yeah. Depends on the weather KAREN: Yeah. Were there times when you needed a plane and you couldn't get one? JESSIE: Hm, mm. KAREN: Then what do you do? JESSIE: Do the best you can. All you have to do, mostly take care of the patient right there in the clinic. Stay with the patient until the medivac comes. KAREN: Did you ever lose a patient 'cause the plane didn't make it in time? JESSIE: I don't think so. Somehow the Coast Guard will make it through. KAREN: They come from Sitka? JESSIE: Yes. But thank goodness in my experience, even working thirty-five years, I don't think we ever had to take care of a patient and lose them waiting for a plane or a helicopter to come. KAREN: While you were doing all this health aide work, your on-calls, twenty-four/sevens, you had your own family you were raising. How many children did you have? JESSIE: Three. One boy and two girls. KAREN: How did you balance being on-call, full time -- ? JESSIE: I can't talk any of my children into the health profession, now. They're always asking my daughter. She helped me a lot. One of my daughters, she works in a clinic now. KAREN: That's Debbie? JESSIE: Uh, huh. As a receptionist. She helped me a lot in some of the calls I'd have to go on. KAREN: She'd go with you? JESSIE: Hm, mm. And she'd help me a lot. She would make a good one. She's got a -- kind of a -- kind of a personality that stays calm when you have to. KAREN: Yeah, I was wondering what kind of person do you have to be to be a good health aide? JESSIE: A tough one. I don't know. Keep your head, and level-headed. But she got kind of a complement, too, where you hardly get complements from doctor -- our doctor now. He said that she would make a good health aide because she stays calm in exciting episodes, I mean, you know. KAREN: But she hasn't wanted to do it? JESSIE: No, she won't do it. They keep asking her. I think she'd make a good one, too, but she won't do it.
KAREN: So, if you got called in the middle of the night and you had to see somebody, what did you do with your kids? JESSIE: Well, when my husband was alive, he was there. By the time he had committed suicide, they were already big enough to take care of themselves. KAREN: And what about when you had to go to Anchorage for two weeks of training? Did you take them with you? JESSIE: No. My husband then was alive and would stay with them. Or family members would help. KAREN: It sounds like for a lot of health aides, it was a family job. JESSIE: Hm, mm. KAREN: It wasn't just you. It took the whole family to make it happen. JESSIE: Yeah. You had to have a real supportive -- a real supportive family. Sometimes I feel like I missed a lot of my children's upbringing because of my job. I go back to work now, and I say I hate to get up. I'm used to sleeping in now. KAREN: When you first got the job and kept doing it, what did your husband think you having the job? JESSIE: Sometimes he would give me a bad time, too, you know, they want you by them. Your family wants you by them, too. But I remember one time -- I can't even remember why this family was so mad at me. They were saying so much about me. About how I didn't do my job and everything. I said this is too much, I just can't take it. And I was thinking of quitting it. Surprisingly, it was my husband that kept talking to me about staying on. I said, “Geez, you always want me home. I'll be home if I quit.” KAREN: Were you able to meet with the other health aides from the other villages? JESSIE: Hm, mm. KAREN: And did that help, getting to talk to each other? JESSIE: Hm, mm. We'd get to compare notes and we could talk to each other because of the confidentiality -- we could -- with co-workers we can. When we'd meet, like health forum. I don't know if you've ever gone to that? Up in Anchorage. We have one every year. Different health aides from around the state go up there. They used to -- it doesn't seem like they do anymore, but they used to have about twice a year -- they'd have a -- I don't know if you call it a retreat, no. It's kind of like a workshop for the health aides to go to in the spring and in the fall. KAREN: But, that was different than the Forum? JESSIE: Hm, mm. Just for the Southeast. In Sitka, at Mt. Edgecumbe. So, we'd be able to get together then.
KAREN: So you worked for both Indian Health Service and SEARHC (Southeast Alaska Regional Health Consortium)? JESSIE: Hm, mm. KAREN: Do you have any thoughts on pros and cons of one versus the other? The differences? JESSIE: It didn't seem like we had anyone to talk to in what you call upper management in the Indian Health Service. Where as now in SEARHC, you have different ones you know you can talk to. You know that SEARHC started with the Health Aide Program. It was only the health aides. Now it's such a big thing. They employ hundreds of people now. KAREN: They run the hospital at Sitka, right? What else do they do? JESSIE: And here (Juneau) too they have a clinic. KAREN: What other kinds of things do they do? JESSIE: SEARHC? Geez, the hospital is the main one, I think, in Sitka. I think they even take care Prince of Wales (Island). KAREN: Oh, they go way down there, huh? JESSIE: Uh, huh. I'm always hearing them talk about P.O.W. (Prince of Wales). Which is where the PA (Physician Assistant) from our town is moving to now. KAREN: Well, yeah, I mean, the regional -- the Native Regional Health Corporations took over the service areas that Indian Health Service had. And, I would think that (Mt) Edgecumbe was Southeast's service area. So it would be all of it, Yakutat on down. JESSIE: But some pulled away. I think Yakutat and Hoonah. Where they decided they'd try to do it on their own. KAREN: Oh, through their Tribal Councils or something? JESSIE: Uh, huh. Yes. But it's mostly southeast for SEARHC. KAREN: Were you involved in any of the setting up of SEARHC and the Health Aide Program, or associations or health councils? JESSIE: No, I don't think so. KAREN: You were never on any of those boards or anything? JESSIE: We were automatically on the health council as health aides. Back home, they don't even have a health council anymore. KAREN: When did they have one? JESSIE: Before the PA's came along. KAREN: When you first started as a health aide, there was a health council? JESSIE: Yes, they always got appointed by the City Council. KAREN: What did the health council do? JESSIE: Just try to take care of the health problems back home. But now we have a SEARHC rep. They call them SEARHC representatives. That belongs to the SEARHC board. But we don't have a health council that I know of anymore. KAREN: Do you know how big Angoon is? How many people live there? JESSIE: I'd say about 600 population. KAREN: That's pretty big then. JESSIE: 500 to 600. KAREN: Has it changed since you grew up? JESSIE: Hm, mm. Yes. KAREN: How has it changed? JESSIE: More housing. They brought in theTHA (Tlingit-Haida Assocation) housing about like -- And now they have new Post Office, new clinic. And paved roads. KAREN: Oh, paved roads? Wow. JESSIE: Well, kind of like, yeah. KAREN: And running water? JESSIE: Hm, mm. KAREN: It probably wasn't there when you were born? JESSIE: No. I remember our tank for our water supply where we'd go up to it some times when -- We used to have to do a lot of packing water. We had faucets outside, I remember. KAREN: So when you first became a health aide was there running water? JESSIE: Hm, mm. KAREN: You already had the running water? JESSIE: Yes. KAREN: 'Cause I would say how would you do all the health aide work without running water? JESSIE: Yes, it would be kind of hard to. But we had running water. KAREN: Was it a smaller village back then? JESSIE: Hm, mm. Much smaller. Now it's grown to where they have the housing in this -- Anyway, they call it Circle City now. I don't know why. It goes in a circle. Where they put those THA housing, and then it went up to this second -- Then they had some more houses built here. Now it's up further. KAREN: The town has grown.
KAREN: When you first started as a health aide, was their traditional healing and mid-wives practicing in Angoon? JESSIE: By that time they weren't really. But they did have mid-wives. KAREN: Did they help you with delivering babies? JESSIE: At one time I thought they were going to, instead they seemed like they depended on me to do it. “Oh good, I have these two. They delivered babies before.” As I was there by myself at that time. KAREN: Did you ever learn any traditional medicine from anybody when you were growing up? JESSIE: No. My mother was one of the mid-wives. They'd call her when the baby being delivered. KAREN: Did you ever go with her? JESSIE: No. I don't think she -- I don't think -- at that time I don't think they thought that children should be around. KAREN: I didn't know if she'd inspired you to become a health care worker. JESSIE: I don't know. KAREN: So, was the community pretty accepting of western medicine and health aides? JESSIE: I think so. KAREN: So you becoming a health aide, you were -- Barbara asked you to apply or the council came to you or -- ? JESSIE: Barbara came to me firs, and then asked me. They thought I should and could do it because I was at the time an LPN (Licensed Practical Nurse). KAREN: Did you feel like you could do it and should do it? JESSIE: I guess. I remember where trying to give a shot the first time after -- I can't do those things anymor. But you learn to. KAREN: Can you think of anybody -- particular people who were especially important to you as mentors or teachers? JESSIE: There were so many. There was -- when we first started going training as a health aide, I remember -- she was kind of an elderly lady, one of the ones that was our instructors. And one of the questions I remember her asking us one time was, “If they try to take the job away from you, would you let them?” Well, our answer was no. So I never let them, I guess. There're just so many that help us through, even towards the end of my career. Like the EMT (Emergency Medical Technician) level part of it, that was hard for me to do. I felt like that was the hardest thing I had to go through in my health aide training. Because, especially EMT-2, you had to have had chemistry, it seems like, in that field. In EMT-2. I never ever had chemistry. Biology is about all I had in high school. KAREN: What did you need chemistry for in EMT training? JESSIE: To figure the -- for the IVs. The different kinds of IVs and why they're being used. The acid-base balance. All those things. I remember when I first went to EMT-2, I was sitting there thinking why am I doing this to myself. I was going crazy, because I'd -- They'd give us a little exam every day to see how we're doing. I'd barely pass those exams. It's not even a requirement of my job. I was thinking, I said, “Wow. I think I'm just going to drop this class. I can't do it.” It seemed too hard for me. Instead, the next day I went back to class and I took the daily exams we had, and I almost got them all right on that. "Well, Lord, I guess you want me to keep taking it, okay." I made it to pass. But that's to teach you how to do IVs and intubation, it's called. Where you intubate patients to help them breathe. It is more invasive then EMT-1.
KAREN: Anybody in your life that was a role model, that inspired you to keep doing what you were doing? JESSIE: I don't know. I can't think really. KAREN: Do you think maybe you're a role model for the next generation? JESSIE: I don't know. I hope so. I tried to help as much as I could with the new ones that were coming in. Guide them along so they could hang in there. So far Daphne's hanging in there, I don't know how much longer. She's had to go through so much. KAREN: Yeah, it's interesting. I mean your generation, in thirty-five years you went through so much. Somehow you stuck with it. What's the difference between then and the group now? JESSIE: I don't know. Maybe things have gotten easier for people, and it's harder for them to handle tough things. But I started -- honestly, just to make some money at the time. But you said you're going to talk to Dr. Schmidt. He was the one that started the pay scale for us. Though it seemed like -- for health aides to start getting step increases. 'Cause I remember before that. I remember making $9.42 an hour for a long time. I think I finally went up to $26 dollars and something an hour. I said after thirty years, I think I deserve it. KAREN: So Doctor Schmidt ran the Health Aide Program? He was the Director? JESSIE: Yes, he was. KAREN: For SEARHC? JESSIE: Hm, mm. KAREN: For a long time? JESSIE: I don't know for a long time, he was for a while. Now I think it's Mark Gorman. Steve Gage was kind of like the ones we'd answer to. I think it's Kari Lundren now. KAREN: So, are there any particular incidents or stories that come to mind that are funny, that you tell when you tell health aide stories? Funny instances, things that, you know, you made mistakes that were funny or when you look back on it now? JESSIE: I can't think of them now, but there have been some. Where we'd laugh about it. KAREN: Or learning to give shots on oranges? JESSIE: Oh, yeah. KAREN: Is that what you had to do? Or lemons? JESSIE: When we were learning, yes. On oranges. KAREN: What about the first time you gave a shot to a person, you remember that? JESSIE: Uh, huh. I remember it, because it was -- I hope she doesn't mind me saying, but it was Barbara. She had had a bad throat and she wanted me to give her a shot of penicillin (Alibisol). And I said,” I haven't done it in a while.” And she said, “It'll come back to you. Go ahead. Come on. You just…” “Okay, I'll try.” She was brave, I think. But she was the first one when I started, that I gave a shot to. KAREN: And did you get it right? JESSIE: Hm, mm. Made it. “See, you can do it,” she'd tell me. I really missed her after she left. She's kind of like -- do crazy things to -- But, I don't know. Some silly things. I guess I was always the serious one. KAREN: It sounds like you and Barbara were a good team. JESSIE: Uh, huh. Yeah. We were it for a while. KAREN: You'd have to be able to work well together in a situation like that, I would think. JESSIE: Hm, mm. You have to. That's why Daphne was having a hard time making me retire, I think. Her and I went through a lot together, too. KAREN: That's pretty much all of my official questions. Anything else you could think about through your thirty five years that I -- we haven't touched on? Okay. Other things in your thirty-five year career that I haven't asked you about that you want to talk about? JESSIE: I don't think so. So much has happened. So much happens. So many changes. I guess that's one thing, all the changes. Modern technology. It's hard for us old ones to -- maybe the others were okay, but for me it was hard. Turn into computers. My grandchildren love computers. But, I don't care for computers. I sit there and wonder what in the world do I do. KAREN: Are there some changes that haven't been good? JESSIE: I don't think so. For a while, to me, it seemed like they were kind of almost trying to do away with the health aides back home and putting in the PA's (Physicians Assistant) and Nurse Practitioners and stuff like that. But now they have, I'd say, I think two and half. Where there was three of us at one time. KAREN: So there's two and half health aides and one PA? JESSIE: Yeah, and two. KAREN: Two PA's.
KAREN: So there was some resistance at the beginning to have those PA's? JESSIE: I don't know. You know what, it was hard for me. Because we were on our own so much that it was hard for me to accept supervision. Having someone there telling me what I should and shouldn't do. Because Daphne and I were on our own for so long trying to hold up, hold the fort. KAREN: That makes sense. JESSIE: But, I don't think there was that much resistance to PA's. KAREN: But, now you're saying that they were trying to take health aides away so -- JESSIE: Yeah, it just seemed like that to me because they were bringing in -- I said, “It seems like they're doing away with the health aides and bringing in the PA's.” But PA's don't like to go on call either. KAREN: Did you ever think about going and getting a degree and being a PA? JESSIE: I thought about it once. But I didn't know if I want to -- seems like a whole lot of training. I remember when I was in PN (Practical Nurse) training, they were trying to get me to go into RN (Registered Nurse) training. Because they said that to them it seemed like the PN training was a little bit too easy for me. Should have tried going further on to -- And no, one year was good enough for me. I was young then. KAREN: What made you decide not to go to PA school? JESSIE: Probably leaving my family again. KAREN: Well, we're are just about out of tape here, so anything else you want to add? JESSIE: Just to other health aides? Hang in there. People need you. A lot of them do a good job. KAREN: It's a hard job. JESSIE: Hm, mm. I think one of the toughest. Sometimes though it feels like a thankless job. There are rewards. Especially if you see someone you know, like you took care of them, pulled them through something. Health aides have many -- what do they call -- their many coats they have -- they're healers, they're psychiatrists, they're dentists, they're just about everything. KAREN: Well, thank you very much. I really appreciate it.