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When I had my phone interview for my assignment in Guymon, OK, I was told the patient population there was very diverse. Now, I had never been to Oklahoma before, the panhandle was especially foreign to me, but I must admit that statement caught me by surprise. When I arrived, I was surprised again. Guymon is home to a very large, very diverse immigrant population. Seaboard, a pork packing and process plant, has attracted an influx of foreign-born workers into rural America.
One of the teachers I met at the YMCA (I try to join a local gym when I can) invited me over for dinner one evening. Not only did she teach fitness classes, she also taught at the one of the elementary schools. She discussed with me how much the demographics of the town had changed over the past twenty years and how those changes impacted the local educational system. For me in the clinic, we treated women from Guatemala, Laos, Eritrea, Ethiopia, Somalia and Sudan. Most of us who have practiced in any of the major cities have encountered a growing Spanish Speaking Obstetric population especially, however in Guymon, some of the Guatemalan women didn’t speak Spanish, they spoke Keche, a native Guatemalan language.
In addition to negotiating the language barriers, which at times required two interpreters, each culture approached interactions with medical providers in a different way. Some women embraced the historical patriarchal framework of medicine, they did not participate in decision making, said yes to all recommendations, never missed an appointment and seemed genuinely grateful for the care they received. Others felt our way of practice was rigid, rejected most recommendations and appeared more bothered with our care than appreciative. For example, on the first day of my second stint in Guymon I was briefed about the patients due in the next month. One patient, by our dating was at least 2 weeks past her due date and refused any intervention. She arrived to her appointment with me, I again reviewed our recommendations and detailed the possible consequences to expectant management (i.e. wait and see…). Her husband responded, “it will be fine, don’t worry.” So I wrote my note, prayed on it and tried not to worry. And guess what? It was fine. She delivered a healthy baby a week later with no complications. Will this always be the outcome? Of course not. However, it reinforced my role in the situation. My role was to explain the options and then respect her autonomy.
Today we talk to Megan Furnish, one of the staples of the medical community, a labor and delivery nurse turned midwife in Guymon, OK.
- Tell us about yourself.
Originally from Walsenburg, CO I came to Oklahoma Panhandle State University (a small college in tiny Goodwell, OK just 10 miles outside of Guymon) and started the nursing program. I graduated with my ADN in 2002. During my time at OPSU, I met my husband Jake of 12 years, whom was born and raised in Guymon. We were married in 2005, at which time I also graduated with my BSN. In 2007, we had our daughter Claire followed by our 2 sons Cooper in 2010 and Colten in 2014.
- How did you decide to go into Nursing? Midwifery?
Starting college @ 17years old I wasn’t really sure what I wanted to do in life, but becoming a doctor had always sounded like a good plan. So my first year of classes were focused on fulfilling the Pre-Med pre-requisites. During this time, I realized the extensive requirements to becoming a doctor. I could not at the time see how these would fit in very well with my goal to get married and have children some day so I decided on Nursing instead. The 2 year program was appealing & it was along the same line as my original plan. I had no idea what it really took to be a nurse or the in’s & outs of this position.
With this being said, I absolutely hated every part of nursing school except for L&D. I probably would have quit but I’ve never been a quitter so this wasn’t an option. I toughed it out and made it my goal to work anywhere I could in L&D. This proved quite challenging because most hospitals want L&D nurses with prior experience and are very reluctant to take on new nurses in this area including the hospital in Guymon. So I drove 1.5 hours to Dumas TX to get my year of experience then returned to Guymon as an “experienced” L&D RN. I went on to complete my BSN in 2005 while also working full time.
As an L&D nurse I got to see the good, bad and the ugly. I was amazed at the variation of care provided by different doctors but one thing always seemed to be lacking, patient autonomy. Very rarely was the patient asked what they wanted their experience to entail, mostly they were told this is what we are going to do. It bothered me…. a lot. “We are going to break your water now” or “You need an epidural”. So as a nurse I strived to make the patient experience as autonomous as possible yet I could only go so far. You see there is great power in a provider saying this “is what you need”, so I decided to go back to school. With two small children (Claire 3 & Cooper 1) going to Medical school was not an option so an online Masters in Midwifery it was. Another driver to my going back to school was the constant challenge of maintaining OB/GYN providers in our community. Over my years here we have seen 9 delivering providers come & go.
- How has Guymon changed since you’ve lived there?
Over the 17 years of living in Guymon, I have watched it continue to grow with unique populations of people from all over the world. More and more restaurants and stores are offering diverse foods, products and supplies. Although I did not live here prior to the packing plant, community members frequently converse about the changes Seaboard has brought. Some embrace the thriving growth while others reminisce of the old days.
- What are the unique challenges and rewards from working with such a diverse population?
The unique population and differing patient cultures are just two of my favorite things about my job. It is so intriguing to me to learn how women & families experience childbirth differently. They bring extreme variations of beliefs around why things happen and who, or what is ultimately in control. The views of religion, hot/cold, witchcraft and superstitions, just to name a few, are huge factors brought to the table when caring for Non-American patients. Sometimes, these beliefs, conflict with, and even contradict modern medicine proving to be quite challenging and eye opening for our practice.
- Is there anything you wish you would have known or would have done during your training now that you’re in practice?
Having worked with the diverse population here in Guymon for many years as an RN prepared me well for the challenges I would face as a CNM. I have learned to become somewhat fluent in Spanish which has proven very helpful. If there is one thing that I wish I could have learned, it would be to speak the 25 other languages used in our communities 🙂
Sunsets in Guymon:
