Oral History Interview with Martha
Gisselquist, 2018
Tue, 3/9 5:06PM
18:26
SUMMARY KEYWORDS
augsburg, nurse, nursing, guests, lutheran, twin cities, commons, health, bev, volunteers, people,
oxford, years, relationships, strengths, church, nursing program, resources, grew, community
SPE... Show more
Oral History Interview with Martha
Gisselquist, 2018
Tue, 3/9 5:06PM
18:26
SUMMARY KEYWORDS
augsburg, nurse, nursing, guests, lutheran, twin cities, commons, health, bev, volunteers, people,
oxford, years, relationships, strengths, church, nursing program, resources, grew, community
SPEAKERS
Martha Gisselquist, Kathleen Clark
Kathleen Clark 00:00
Thank you for joining us today. My name is Katie Clark. I am an assistant professor of
Nursing at Augsburg University. Could you please introduce yourself for the recording?
M
Martha Gisselquist 00:10
Good morning, I'm Martha Gisselquist.
Kathleen Clark 00:12
How many years have you been here at the Health Commons?
M
Martha Gisselquist 00:16
I started volunteering on a regular basis in the summer of 2000. So it's been over 17 years
of being involved with this fantastic program.
Kathleen Clark 00:28
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Thank you for joining us. Before we begin, I just want to make sure that you confirm that
you can send to be interviewed and have the interview recording stored at Augsburg
University, which will be made available to the public.
M
Martha Gisselquist 00:39
Yes.
Kathleen Clark 00:40
Great. Okay, can you just start off by telling me a little bit about where you grew up and
who you called family.
M
Martha Gisselquist 00:51
I grew up in Sioux City, Iowa. Born in Minnesota, father's family, mostly from the Twin
Cities. And my mother's family from northern Minnesota and North Dakota both my
grandfather's and father were Lutheran pastors. So a lot of involvement in the church
growing up.
Kathleen Clark 01:15
So how did you end up in the Twin Cities?
M
Martha Gisselquist 01:20
came up here for school.
Kathleen Clark 01:24
Okay, so I know that you're a nurse. So what led you to want to be a nurse and come here
for school?
M
Martha Gisselquist 01:33
I don't remember wanting to do anything else. Three of my aunts were nurses. Of course,
options seemed rather limited for women when I was growing up. You know, you could be
a teacher or a nurse or secretary or a stay at home mom. I always wanted to be a nurse.
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Some people accuse me of being a little too much of a caregiver. But always wanted to be
a nurse.
Kathleen Clark 02:03
Great no can What about your educational background? What what path Did you take to
become a nurse?
M
Martha Gisselquist 02:10
I came directly to Minneapolis from high school to attend Lutheran deaconess hospital
School of Nursing, which was a three year diploma program. And that was also the alma
mater of my odds. I really did not get anyplace else. Of course, I would go to Lutheran
deaconess. And then then I worked for a number of years and attended the University of
Minnesota in the early 80s to receive an aging studies certificate. In the mid 80s, I enrolled
in the first weekend nursing program at Augsburg to get my BSN.
Kathleen Clark 02:53
And what year was that?
M
Martha Gisselquist 02:55
83-86.
Kathleen Clark 02:57
And was that the first group that
M
Martha Gisselquist 02:59
was the first weekend college group, not the first RNs to complete the BSN programs.
Kathleen Clark 03:09
And what made you choose Augsburg?
Martha Gisselquist 03:12
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M
Martha Gisselquist 03:12
My family has a long history with Augsburg, my grandfather, Uncle, father, five of my
siblings are all graduates of Augsburg. My uncle taught history at Augsburg for many
years. I was not going to be the only one of the six kids not to say that I graduated from
Augsburg and the program fit my timing and my interests.
Kathleen Clark 03:40
Now what, as far as the Augsburg central health comments, which was used to be called
the Augsburg nursing center, What do you remember about the beginning of it all?
M
Martha Gisselquist 03:52
I recall during my student days doing a variety of public health practicums throughout the
Twin Cities, I think the professor's and especially the dean Bev Nilsson, were looking for a
community experience that would be more unique for the Augsburg nursing programs.
Kathleen Clark 04:15
So you first learned about it through your schooling.
M
Martha Gisselquist 04:18
Correct.
Kathleen Clark 04:20
And do you remember any ideas are foundational theories of Bev Neilson beginning at
all? Do you remember any of her? Did she say much? Oh, yes.
M
Martha Gisselquist 04:32
During my student days, I was there during what perhaps would be considered the
discussion phases. I recall Bev Nilsson having many meetings with administration, both at
Augsburg and at Central Lutheran where she was a member. There were just many
logistics to figure out the responsibilities of each entity where the funding was going to
come from the space, the timing, the incorporation of you know how the students would
be involved in the professor's. So I was there during its development phase.
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Kathleen Clark 05:14
Would you say her ideas that then are what it Ruth represents now? Or does it look a lot
different than what she thought it would look like?
M
Martha Gisselquist 05:26
I think it is pretty much what she envisioned perhaps more refined. At this point. It seemed
like a, like a nursing center where nurses did hands on. And I think it's broadened
extensively from that. Yeah, and I recall when it was started, I think some of her ideas were
that Bev felt very strongly that the two organizations, central Lutheran, and Augsburg
could work very well together to offer needed health care services to the inner city
homeless population, the partnership would also provide an excellent experience for
nursing students. It's not easy, I don't think to find the practicums around the Twin Cities,
and for the process to follow them and etc.
Kathleen Clark 06:30
So do you think it'd be it'd be more open, not just for nurses makes it stronger, or
something that we could improve? We don't have it doesn't make it stronger. Or it makes
a difference, right?
M
Martha Gisselquist 06:49
It definitely makes it different, when in the early phases, you were able to give over the
counter beds and spend a lot more time on what were health issues, it did not give a
whole lot of time to just sit down and build relationships, which I think is one of our big
strengths now. Getting to know the folks getting to understand a bit what the issues are. I
think that's, that's some of the improvement. I see now.
Kathleen Clark 07:30
Um, so as far as you What keeps you coming back,
M
Martha Gisselquist 07:35
I really enjoy the guests who come here, as well as I enjoy the volunteers, the Augsburg
staff and students that come and the central Lutheran community, it's a great group of
folks. And I am learning a lot about the issues that face those who are more marginalized
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in our society. I love having the time to visit and get to know the guests. I feel it's a really
wonderful gift to be able to use my nursing skills that I've gained over the past almost 50
years. In this way. It's it's a fun nursing,
Kathleen Clark 08:17
and you're in natural here. Do you feel that the over that overall, the health Commons is a
very welcoming space? And how do you kind of create that sense of hospitality when
you're caring for people?
M
Martha Gisselquist 08:32
Yes, I think for the most part, it is a welcoming place. But currently, our space doesn't help
too much.
Kathleen Clark 08:41
We're in a trailer. Currently, yeah, for this year during the remodel,
M
Martha Gisselquist 08:45
I want to welcome guests as if they were coming to my home. I want to be able to greet
them. When they come by, I want to be able to sit and talk to them maybe offer coffee,
and just let them know that they matter.
Kathleen Clark 09:02
So how would you say that when somebody comes in, you're able to acknowledge their
need.
M
Martha Gisselquist 09:10
I think by listening and observing, what what are they looking for? What are they saying?
But also what are they saying? It really helps to have those hygiene products and socks
available to give freely. It allows our guests to come in and check us out in a very non
threatening way. And then conversations and relationships often begin just with that
benign entrance into need some supplies.
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Kathleen Clark 09:45
What is something that we can improve at the health Commons?
M
Martha Gisselquist 09:48
I think space makes a huge difference. Do guests feel safe to check us out? Is there a
comfortable place to visit? Is there some place for privacy when it's needed, is there
something that tells the first time visitor, who we are and what we do? Are all of the nurses
and volunteers attentive to all of the guests? I think those are things we need to always be
aware of and watching and improving on.
Kathleen Clark 10:25
So can you tell us more about what your favorite part of being part of the community at
the health Commons is? For example, could you share a story with us?
M
Martha Gisselquist 10:34
Well, I know the needs of the homeless in our community are huge. However, I feel I'm
doing just this small part to help. I think I've been able to share some of the concerns and
needs that I've seen with others in my network, which pains me has led to others
volunteering, making donations, merely just becoming aware of some of the issues in what
you as an individual can do. You asked about a story. Let me use the name Karen, to
describe a young woman who was in and out of addiction, sometimes abused, with
numerous health issues that she coped with, but really didn't have the strength to fix. I
really appreciated the health commons being there for her. She would come in when she
was really down in just difficult situations. And know she could come to us for support for
supplies for direction. But she would also come to us when she was feeling good. And
when she had some successes in when she started to do some art projects. And I, you
know, we were there for her in the low times and in the high times. And I think the health
Commons, staff, volunteers were there for her at her death. The whole church, put on a
conducted a wonderful funeral, and even identified and gave her a burial spot in the
columbarium in the church. And that all started because of the health comments and that
relationship that we were able to develop with this one young woman
Kathleen Clark 12:45
that is a beautiful story. What are some of the typical health concerns that you see with
Oral History Interview with Martha Gisselquist,
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participants who come in?
M
Martha Gisselquist 12:55
mental health issues are huge
M
Martha Gisselquist 12:58
addictions.
M
Martha Gisselquist 13:01
And just some with basic blood pressure issues that they monitor here. Skin Problems, a
lot of aches and pains, fungal infection also have the feet poor foot care, nail care. Those
are some of the typical ones, you see.
Kathleen Clark 13:20
So you mentioned Karen having strengths but what what are some kind of overall
strengths you see in the people who come into the health commons,
M
Martha Gisselquist 13:29
toughness to make it on their own outside creativity in finding supplies, finding resources
that they need to live just day to day and in a tough environment.
Kathleen Clark 13:43
What are some of the challenges that you've heard people discuss and their ability to
access health care?
M
Martha Gisselquist 13:50
finances is huge, especially for medication co pays, transportation, also knowing where to
go and when to get the health care. That's huge.
Kathleen Clark 14:04
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Very much. So what should nurses know when they're taking care of people who may be
experiencing homelessness or who are marginally housed?
M
Martha Gisselquist 14:15
I think they need to orient themselves to what resources are out there. I really appreciated
when Augsburg provided a walking tour of a number of the services in the area so you
could see that firsthand. I think familiarizing oneself with the information in the booklet
Handbook of the street is helpful in identifying resources and showing folks
M
Martha Gisselquist 14:43
what's available. That's just some of the how tos. What else should nurses know? Boy,
you've got to be willing to Be around folks who have who don't smell so good maybe or
have some other diseases that you think do I really want to give this guy a hug? But of
course you do.
M
Martha Gisselquist 15:19
How do you look at that person no matter what situation they're in and just say, this is a
guest in my home, and I am going to welcome them the best I can.
Kathleen Clark 15:31
Well, that sounds like you're almost answering the next question. But I'd like to answer.
Ask it again anyhow. How do you accompany people on their journey of health?
M
Martha Gisselquist 15:40
I think just being present, remembering who they are and what they've been going
through, and connecting them with those appropriate resources.
Kathleen Clark 15:49
And you talked a lot about relationships. So how do you really begin to develop
relationships with people come into the space?
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M
Martha Gisselquist 15:56
Well, it happens only over time, welcoming them, introducing yourself to them, trying to
find out something unique about each person that you can hopefully remember and, and
be a part of that discussion each time they come in, and definitely not being judgmental,
trying to keep an open mind of why they've come in in the first place? And what kind of
what kind of what can what can we offer each other?
Kathleen Clark 16:32
So if there is one thing that you could change about healthcare, what would it be?
M
Martha Gisselquist 16:38
I think training and retraining and retraining all health care workers to look at the whole
person and providing easier access to health care for everyone without the financial
burdens.
Kathleen Clark 16:55
So what do you think the health common should be like 20 years from now?
M
Martha Gisselquist 17:02
I could see it be replicated in other churches that are located near populations that are
marginalized. I see Augsburg partnering with other nursing programs in the Twin Cities to
meet the staffing and financial needs to provide these types of centers
M
Martha Gisselquist 17:19
for one thing.
Kathleen Clark 17:21
Well, that's all I have for questions for you. Is there any thing you'd like to add or want, or
want want to share regarding either the history or your experiences?
M
Martha Gisselquist 17:35
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I'm very appreciative of Augsburg commitment to sticking with this program since the mid
80s. Really, I know it didn't start functioning until 92. And there were other organizations
involved to help it financially. But that's that's that's a real commitment for Augsburg to
continue this and I hope that that, that they will see that this type of outreach to the
community for their nursing program is really fits the mission that Augsburg has.
Kathleen Clark 18:15
Well, thank you so much for taking the time.
M
Martha Gisselquist 18:17
You're welcome.
M
Martha Gisselquist 18:18
Thank you, Katie, for your leadership and for your energy and for putting this history
together.
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Show less
Oral history with Ruth Enestvedt
Wed, 3/10 2:32PM
1:23:16
SUMMARY KEYWORDS
people, nursing, commons, students, nurses, health, augsburg, money, university, model, college,
cheryl, experience, community, talk, faculty, work, taught, education, thought
SPEAKERS
Ruth Enestvedt, Kathleen C... Show more
Oral history with Ruth Enestvedt
Wed, 3/10 2:32PM
1:23:16
SUMMARY KEYWORDS
people, nursing, commons, students, nurses, health, augsburg, money, university, model, college,
cheryl, experience, community, talk, faculty, work, taught, education, thought
SPEAKERS
Ruth Enestvedt, Kathleen Clark, Kaija Freborg
Kathleen Clark 00:00
Well thank you for joining us today on this oral history project are on the health commons
and the Department of Nursing at Augsburg University. My name is Katie Clark. I am an
assistant professor of nursing. Also with us I have another faculty member.
K
Kaija Freborg 00:17
My name is Kaija Freborg. I am also an assistant professor in the nursing department and
current director of the BSN program.
Kathleen Clark 00:25
Great. And then for our interviewee, can you please introduce yourself for the recording?
R
Ruth Enestvedt 00:32
Ruth Enestvedt.
Kathleen Clark 00:34
Great. And can you tell us your title when you were here at Augsburg?
Oral history with Ruth Enestvedt
Page 1 of 29
Transcribed by https://otter.ai
R
Ruth Enestvedt 00:40
an assistant professor of nursing.
Kathleen Clark 00:43
Right. Good. And we're gonna come back as requested by Dr. Enestvedt said to go over
the consent at the end. change things up a bit. Good. Good.
R
Ruth Enestvedt 00:55
Thank you.
Kathleen Clark 00:56
Alright, well, to get us started. Can you just tell us a little bit about you, for example, where
were you born? And who did you call family.
R
Ruth Enestvedt 01:06
I was born in northwestern Minnesota and a rural community and then a farm in my
childhood and was post war. So it was a dramatic change from rural culture to focus on
moving into the urban environment in order to assimilate this immigrant family. So I went
to college, but was just the second person family for college. My older brother did, but he
got recruited for football. So it was no big deal for him to apply and think about who
before me went to college. I thought I wouldn't get into college because I couldn't put on
the forum that I had any family members who'd gone to college. So we made up
something about uncle gummy teaching at Gus Davis - it really wasn't made up. But
anyway, I got into college and my mother, who was a nurse. And I've one of the things you
wanted to know was something about her saying, and my mother was a nurse that I was
always interested in how she was respected when anybody was sick. And she could talk to
the the medical people and I couldn't understand what they were talking about. But I had
aunts that were nurses, and at that time you were a nurse, you were a teacher. And thing,
thanks to my mother, she said if you're going to be a nurse, you're not going to a training
program, you're going to go to a college. So but I you know, months before final
applications, where do I started to apply and ended up going to St Olaf my first
educational experience. So I thought from there that I really wanted to work in a hospital
and then we're going to high powered hospital. So I went up to Mass General in Boston
thinking this is a high powered hospital. And I was in an orientation program with nurses
from the University of Michigan. They were high powered nurses. This was a whole
Oral history with Ruth Enestvedt
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different, whole different background of education when I say no, but they went into the
middle upper middle class part of massgeneral, which it was at that time probably still is
the most expensive private hospital in the country. And that's called the General Hospital.
Well, I went to the so called welfare part of the hospital, which was a part of how I was on
the National Historic Register. And I found that although it wasn't the high powered
medical place, it was really interesting for the diversity of the patients who came there. We
got people from South Boston. So we have a lot of Irish from South Boston, Italians, we
have a lot of people from different backgrounds. And they were primarily low income, of
course, because this was the welfare part of the past. And I found myself being intrigued
by this diversity. But what I couldn't stand about the hospital setting was the gender
politics and the idea that I was supposed to do what the doctors ordered. I recall for
example, being told that I was to at that time, all the guys in the ward, it was an open
word for smoking, if they want to smoke, they can smoke. guy with liver problems a doctor
wrote on the chart, no smoking. And I looked at the chart, the head nurse said you need to
tell him he can smoke. I said if the doctor doesn't want him to smoke, he can tell them. So
needless to say I was not the person they're in but I lasted I lasted because I was too
scared to work in Roxbury. I really would have liked community health but you know, white
girl from the rural community, I just didn't have the street, whatever to do that. I'm sorry
now because it would have been fascinating. So anyway, I came back to Minnesota
worked in community health, saw that a lot of the things that we considered crises at
nurses were kind of daily life for the people we were working with, that there's something
wrong here we are really, you know, we really don't know how to intervene in this
situations. So I thought, I'm more education. That'll do it for me. So I got a master's degree
at the University of Minnesota and in public health thinking, now I'll really learn how to
intervene and really help people. The one thing I knew when I went to that master's
program was I did not want to teach. I knew that for sure. So after I get done with the
program, one of my friends who was teaching at the university asked me if I would come
and teach. So that's where I started teaching in community health, and found that it was a
lot of fun, especially because I was teaching in clinical settings. And, you know, that's what
I really liked. Well, long came children and I dropped out in nursing for a while and had a
friend working for Humphrey Institute, a research project. And she asked me if I wouldn't
come and take do the nursing part of this research project. It was a federal federally
funded grant, looking at homecare, nursing home care for the elderly. And I learned some
interesting things there. Number one, we were on that grant for at least two years without
any identified objectives. And they kept getting funded and funded, funded. I thought,
This is strange. How does this work? I didn't know you could get funds and keep getting
friends? Well, it turns out that people who are running the program had a lot of
connections in Washington, that's how it's done. I've learned one little thing about how
that federal funding actually works. Anyway. So I worked there for a while and decided
that was coming to an end. So I went back to the school, nursing University, Minnesota.
Oral history with Ruth Enestvedt
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And there was a lot of pressure then to get a PhD, if you're going to teach at the university.
So a couple of friends and I decided we better go ahead and do that. And I had no
absolutely no interest in doing data focused research, I had no interest in hypothesis
generation. Even though as an undergraduate, I had studied nursing research with a
friend in January, when an inner moving to Washington DC just wrote letters to people
who are leading the research, work in nursing. And some of you might have come and talk
to you. They set up appointments, we went up to Washington, we, with the people out
there, and we're really leaders in nursing research at the time. And it was interesting to
me, but here was one of the ironies of my nursing career. I thought I wanted to be an
expert in something, because I wanted to be sought out as an expert. And as you guys
know, one of the things that I have come to at the end of my career was expert is the
wrong perspective to take, you can be an expert, if you're going to sit in a room among
experts and compete about who's got the most, you know, to say about the poor, the
disadvantaged, the people who are homeless, then you can be an expert, but only with
those kind of experts. So let's see, where was I going to get sidetracked something you can
edit out of? No, I okay. So I got my master's degree, I was teaching and pressure to get a
PhD. And I didn't want to do hypothesis does, I just didn't want that kind of research at all.
But I was really interested in doing quantitative research. I have always been curious
about how other people live their lives, how they solve their problems, what kind of things
they encounter and where they came from, what they think about. So it just seemed like a
natural that I would choose anthropology, they had a whole different kind of process of
scholarship of learning. So that's what I did. And it took me a while to kind of get sorted in
that department with who is going to be the right people to work with. And I always felt
kind of marginalized because I didn't come through there. I didn't get a master's degree in
anthropology. It was coming from a side, you know, department but I kept at it or dead. It
took me a long time. But I didn't feel bad for a long it took me because it only took me a
couple of years longer than the average length of time it takes to get a PhD in
anthropology. And meantime, I had a full time job at the university. I had a part time job
with Hennepin County. I was raising two kids, you know, the you know the story. It's kind of
the typical woman's story right? So it took me a little bit longer to get the PhD. And finally,
it was kind of like do or die. And I decided, well, I want to do the PhD. But I could give a
crap about the University of Minnesota. So I said, I'm leaving here, goodbye. And thank
you for the education because they paid my way in the PhD program. But I gave them a
lot too. But at that time, what I really enjoyed with my friends, I had two good friends in
the community health department, and we worked with the Center for Urban and
Regional affairs at the Humphrey Institute and develop what we call the high rise project.
And at the time, we were doing the high rise project, we heard about Ben Nillson, starting
a nursing Center at Central Lutheran, we were straightforward about we're really not so
much helping people as we're exchanging some experience in community work
community help with people who went in for that the students are getting this experience.
Oral history with Ruth Enestvedt
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And however we can help in this community, we will help. And the funny thing was, people
weren't so interested in having health intervention, they were more interested in making
Halloween things or having some kind of coffee, things like that, that seemed to the
students, of course, like totally not nursing. But it struck me that, of course, this is nursing,
because what we are really doing here is helping to create a community with in a place
where there's a lot of mistrust, a lot of fear. It was at a time when thanks to Reagan, the
money was going out of public housing, and going into senior housing, private fully
developed senior housing, so forth. And so what happened was the housing got emptied.
And in moved, the guys from the rust belt, who were out of jobs, and many Minnesota was
Minneapolis was a great new area fertile field for the drug trade. So people started
moving in to public housing. And at that time, they only that's if you weren't over 65, you
had to be disabled, or disabled meant you were addicted. So or you were mentally ill one
or the other. So it became kind of a frightening environment for people who were living
there. But it also became a lot more fascinating in a way. So I ended up doing my
research there my dissertation research, and found it to be I probably heard many stories
about this before, but I found that to be really interesting, really, I have always found that
diversity, you know, interesting, but also to see just the kind of cultural dynamics among
the poor. I remember, for example, you guys saying to me, great diversity, you can sit
somewhere and talk about how we need to have diversity here. Have you ever really lived
in diversity? And you know, when people are scrambling for scarce resources, diversity, it
looks a lot different, I think, you know. So anyway, they taught me a whole lot about how
you how you get along, when things are very scarce. And you have used up all your money
and pull tabs after the first week. You know, what do you do? How do you get along? So
there I am.
Kathleen Clark 13:34
So can you tell us a little bit more about what your dissertation was?
R
Ruth Enestvedt 13:38
Yeah, my dissertation was about critical medical anthropology focus, looking at
controlling resistance to or non resistance or professional control among low income
elderly women.
Kathleen Clark 13:54
And what did you do for that project?
Oral history with Ruth Enestvedt
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R
Ruth Enestvedt 13:57
I talked with the elderly women in public housing, spent a lot of time in the public housing,
just hanging out there and seeing that, that social dynamics were spent a lot of time
talking to a lot of different people in the building, had some experiences where I really
blew it. I remember a woman who I had a really good relationship with she was really a
sharp little lady. And she had called the security guard one night, she was telling me this
story that she called the security guard, who to tell her that you know, somebody tried to
break into her apartment, and the security guard didn't do anything didn't even come up.
So Miss intervention Miss solved the problem. I was going to go and talk to the security
guard and make sure that this didn't happen again. So I went and talked to the security
guard, who was like the elderly woman, African American. The next time I came into the
public housing setting that other laywoman was downstairs waiting for me and she just
ripped into me. I had crossed a line. As a white woman, I do not interfere with her. Her
situation, when it's another black woman, keep my nose out of her business. It was like,
Whoa, Okay, I get it. You know. And I had another man, I naively said, I will help you get to
the doctor, I'd be glad to give you a ride thinking, you know, this would be real helpful, too.
And he looked at me, was an elderly African American gentleman, he looks to me said,
You have no idea how much trouble I could get into. If I was seen with you. Whoa, okay.
There is a whole lot behind this. And I don't have a clue about. But you know, I developed
a lot of trust with people. And I could, you know, one time dollars, really, this ex gang
member who was just really a big guy can be really intimidating. And he said, The came
into where I was one day, and he said, so he said, You know, I was walking home last night,
and a couple young guys pulled a gun on me. He says, what do you do? So I looked at him,
I said, you could shoot me. But you'd end up in in the pan. I'm telling you, that would be
really bad life for you. I said, so what am he says? So they walked away said, well, you
probably looked like somebody who knew what they were talking about from experience.
He said, Yeah, I did. I said, So what was it like being in a gang? He said, terrifying. I was
scared all the time? Well, you know, this is I was always in a base that people would tell me
things like this. And of course, who knows how they said, you know, here's this little white
girl who, you know, what does she know? fill her full. But nevertheless, there were you
know, you can tell when people I can tell I think a little bit when people are being honest.
So anyway, it was quite a great experience. And the dissertation research ended up to be
quite fascinating. In fact, two of my readers said they actually read it.
Kathleen Clark 17:13
You're not supposed to make us laugh. Um, so if anybody were to want to read your
dissertation, is it anywhere publicly available?
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R
Ruth Enestvedt 17:23
Well, the dissertation abstracts the University of Michigan, it's there.
Kathleen Clark 17:29
And then one question, just going back to your teaching at the U, What did it look like
when you taught community health in that time?
R
Ruth Enestvedt 17:39
Well, the classic, the classic way to teach community health was to have lectures, and
then you would have clinicals and the clinicals. Or to go and sit in an agency, while you
the nurses took care of the students, you know, they took them out on their visits. And
they took them to really, you know, two people who would agree to have students alone.
That was how it was taught. And at the same time, this was supposed to be community
centered nursing was supposed to be community health, and what they were getting was
seeing individuals in their home, which isn't to me much community you get, you certainly
get a flavor of things that are different from the hospital. But we felt my friends and I, this
is not community, we really need to go into a community and try to see what some of the
dynamics are, that are work that are affecting people and influencing them. We had a
fight on our hands with the faculty, who were not us the rest of the faculty who just wanted
to do the traditional public health, they will never be able to pass their public health. This
isn't really public health hand wringing and handling. So we would get people on our
sides, like, you know, the Humphrey Institute or the president of the university, or we went
to we were so naive, we went down to the there was the assistant in the ER, she was just a
dynamic woman from Don Fraser was the mayor at that time. And this woman was just
dynamite. And we would go to her and she'd say, Well come and talk to this. We have this
committee on poverty or something like that. Can't remember exactly what's coming, talk
to them, tell them what you're doing. So we went to them. And we said, you know, this is
what we're doing. They said, How much money do you want? Oh, okay. Well, you know, we
could probably, I don't know, a couple $1,000. So they gave us a couple $1,000 a week
came back to them then with the report about what we had done, what would have
happened with the medicine. Whoa, we don't often get feedback like this. How much
more money do you need? We were just we had no clue how we could have really had a
lot more influence than we did. So we you know, we carried on like that and it was really a
I think it was a very good project. But when we left, nobody in the faculty wanted to go out
into the community actually practice. They wanted to sit in the agency and let the nurses
take the students out. So it just ended. So then thank goodness for the outcome. Nursing
center.
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Kathleen Clark 20:21
We are so you mentioned the high rise project. And that's when you learned about Be
Nillson's work. So how did you end up at Augsburg?
R
Ruth Enestvedt 20:32
Well, I got a PhD in anthropology, partly to get out of nursing. Because I really couldn't, I'd
have no good experiences really, in nursing. Community Health was the closest thing to
making use of what I have my education, but I didn't feel like it was really relevant for the
people I was dealing with, even though I felt more comfortable in it. So that okay, maybe
I'll just get out of nursing. Maybe I'll just do the anthropology PhD and see where that
takes me. Well, it was a good time to get employed in universities, which was above the
only place you could go, you know, with that kind of a degree. So hearing about the
transcultural nursing program, beginning at Augsburg and how all that makes a lot of
sense. Why don't I try that? and Cheryl Leuning, and I had tied together at the University.
She came into the high res project as a new person on the faculty and got it right now she
got it and she took her group of students into a public housing and did a fantastic job. So
we have worked together there. And I knew she was at Augsburg too. So that kind of
there. I remember my interview with Bev. And she said to me, so what's your theory of
nursing?
Kathleen Clark 21:53
No.
R
Ruth Enestvedt 21:57
So I said, I think my theory of nursing is supporting autonomy through relationships. Well,
Beth got on to that very well, she could figure out I didn't have to put a theorists name to
it. You know, she agreed with it. So I came to Augsburg and what year was that? 1999.
Kathleen Clark 22:21
And was it just the BSN completion program then are we had the master's program
started?
R
Ruth Enestvedt 22:27
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Cheryl and Bev had started one course I think it was maybe the I don't know, whatever
500 is now. And they were teaching it as an immersion. immersion Friday night Saturday
in Sioux Falls. And people like Deb Schumacher, and there were a couple of people who
drove to Sioux Falls for the weekend to take this course and transcultural nursing, and so
on. Since that was underway. And I started teaching. The first course I taught was a BSN
research course in Rochester was adjusted at the time that the Rochester program was
starting. And there was a lot of dis cord at the college about being forced to teach a ride
down in Rochester. And one of the tenured faculty members here at Augsburg had been
teaching research and she refused to go down to Rochester to teach. So I said, Okay, I'll
go down a register to teach their course. She didn't want to have anything to do with me
teaching. Of course, she taught her course, I taught my course. And it was a disaster.
Probably some of the worst teaching evaluations I've ever got in my life. I didn't look. So I
got out of that, thankfully, and into developing courses in the master's program.
Kathleen Clark 24:01
So how do you know much about how the program began at all?
R
Ruth Enestvedt 24:06
Not really - well, there was the early early days, you know, that this? I believe Augsburg
was focused on an education, of quality education for working people, you know, people
couldn't afford other private colleges. And I think they started out with the ministry. That's
where they started as a seminary. And then I think one of the next focuses was on
education and business was in there the summer and then the next one was nursing. And
they had a relationship with with deaconess, Lutheran deaconess hospital, and maybe
Martha, you know, talked about this and there was clearly an early early arrangement
with Lutheran deaconess to have the science courses taught here. For the their nursing
students, which is, you know, nursing program if you ask me it's connected to the college,
the BSN program I recall, there was what year might it have been? I was just probably
back teaching at the university. So maybe it was in the 70s. Probably Bev Nillson was
starting this completion program was just the beginning of completion programs in the
state of Minnesota. It was at somebody from my graduate program started one up in
Morehead. Anyway, so there was this completion program and starting here.
Kathleen Clark 25:50
And then as far as the transcultural nursing emphasis, I know you just mentioned that Bev,
Cheryl, were, you know, kind of starting the MAN program at a time but do you know how
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it was kind of decided upon that that would be the focus of the MAN and transcultural
nursing.
R
Ruth Enestvedt 26:11
I think that's what Bev and Cheryl wanted to do.
Kathleen Clark 26:15
I just didn't know if like, I'm trying to think even through leininger. And when she came out
with you should know, Kaija. Oh, when our theory came about in the 60s
R
Ruth Enestvedt 26:28
Cheryl had Cheryl had been had she had a degree in transcultural nursing. So she had
already been connected to leininger. But we started, we started the program before it was
accredited. Well, we still had about, I don't know, three or four courses to develop. And
before those courses were even developed, we were being accredited. It was just a kind of
a bizarre situation. And I know because I was the interim chair at the time, it was
Kathleen Clark 27:10
how to did a small group of women not only run the department, but create many
different programs and tracks. How did you manage all this?
R
Ruth Enestvedt 27:19
You know, I think there was Cheryl was the chair. Well before that Bev, of course. And there
was somebody who was very creative, very open to ideas. She was very frugal money wise,
and was not so interested in reaching out into national spheres. But when Cheryl came on,
Cheryl was really interested in connecting nationally. And she was not as frugal as Bev.
And Cheryl was just if you have an idea, try it out. I mean, it was really it has always been, I
think a department like that, at least in my experience. Okay, try it, see what happens. Go
ahead. And that made it a it was always supported that kind of creative work. We are now
I think many of the nursing faculty at that time. And even until just a few years ago, we're
in a non tenure track. And now there's kind of this shift to move towards a tenure track as
a department. What do you think that shift came about, do you have any idea? Well, I
think it changed as the college changed, you know, the college became more formalized
in who can who needs to be reviewed? What does review have to look like if you're a non
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tenure track, and you have to go through the same thing, practically the tenure track
people do. You know, Cheryl came here. I mean, there was some petty stuff that
happened. Cheryl came here as a tenured professor from Augustana. And they would not
give her a tenured professor position. She they would give her professor but she had to go
on expedited track to tenure, which was just Bs, and it was really cheap, cheap stuff. And I
think one of the things that the nursing department fought against, was this belittling this
dismissive attitude that nurses I think, have always faced, you know, not being taken
seriously. Not really listened to being kind of marginalized as a, you know, you girls go and
do what you want to do, you know, this touchy feely stuff, go ahead, you know. And so,
when we got this graduate program going, it was it took a long time. Time. And I don't
know if it's even still completely divorced from the idea that this graduate program was a
Rochester program. And I have no idea why they wanted it to be just a Rochester
program. But there was a took a long time to kind of get the end. I don't know if Joyce is
still fighting it or not Cheryl fight it the whole time. This is one program. And you know,
that's that's a financial thing. And I am, but they they there's this mystifying
Kathleen Clark 30:38
How many years did you work at Augsburg total?
R
Ruth Enestvedt 30:42
99. To When did I finally retire? It must have been about 15-16 years, probably 15 years full
time.
Kathleen Clark 30:50
And what really kept you here? All those years...
R
Ruth Enestvedt 30:53
oh, the relationships of the faculty, the students the opportunity for the intellectual
stimulation, creating stuff all the time. It was so much fun. I mean, I created a lot of
courses, I created a lot of immersions. And it was just a lot of fun.
Kathleen Clark 31:11
How did you I believe that you were the first one to set up the Guatemala version?
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R
Ruth Enestvedt 31:16
I was.
Kathleen Clark 31:16
How did that come about?
R
Ruth Enestvedt 31:18
Oh, that Cheryl was at I think the Peace Prize forum sitting next to a big donor. And one of
just blanked on his name. He was had a maybe it will come to me anyway, she was sitting
next to this big donor. And they were talking about Guatemala and San Lucas. And this
donor said, You know, I really think it would be good if there could be some nursing
involvement in San Lucas at the mission. And so you know, we'll we'll find some nurses to
go down there. Okay, so there were some, the first the first trip down there. I think Sue and
I went down there, like just for a couple of days, just to kind of scope it out, meet Fidel,
kind of see what we were going to do. And then we brought a group of nurses and the
nurses got it paid for by this donor, it was a pledge, the donor never came through. Her
husband got really sick. And she started begging for money. So it was kind of an
unfortunate thing that happened, because that could have been a really helpful thing for
more students to go. But once it gets in, and at first, the we we took graduate students,
and then the next year undergraduate students went, and then the next year, it was, there
were just many students interested in it. And it just kind of felt like this should be an every
other year thing to me. And, and not an undergraduate thing. You know, it just, it's my
bias that I think these immersion experiences are for the cost. And for the time to set it up.
I think graduate students do a better job of taking advantage of it and getting into it.
K
Kaija Freborg 33:24
Can I ask a question?
R
Ruth Enestvedt 33:24
Of course. So it seems like I'm feeling that there's this, like, overwhelming theme of like,
innovation on your part with little resources, little money, little support? What kind of
advice would you give either faculty or nurses in order to get things done without always
necessarily having the help to do so? Well, I think, I think that the small size of the faculty
and the close relationships, there's a lot of support, at least there was, you know, where
people really backed each other up and did their job, we had a couple of people who were
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here who didn't do their job didn't do their part, and they're no longer here, which was just
fine. And we had some bad experiences with some tenure track people who didn't do the
work, you know, didn't show up. So I think that was another element relative to the tenure
track for not doing you know, I, I, I kind of worry about going to university status in a way
because just as my friend at the university said, when we they went to a doctoral
program, every lower probably because the real status thing and then the lower programs
get less respect less resources, you know, it just doesn't seem to get spread around as
equally so. I don't know, when it was small, but you know, I served on the Senate, and I was
not I was neither in a tenure track. Or Associate Professor even. And I can remember being
asked to be in some regions committee and I said, I can't be an associate professor and
people in the senate were, like, you're not an associate professor No. You know, so you
could participate without having to be in a kind of box of a certain kind. And that helps in
a way because you get access to people and, you know, to things other things at the
college. I don't know. I, it's a, it's a very interesting question, because I think a lot was done.
And, you know, there was a point at which the joke was do we do we need to pay
Augsburg now? You know, because we weren't, we didn't feel like we were getting paid for
all the time we were putting in. But there were other things about it that kept this going.
Kathleen Clark 36:02
Well, onto a different topic. But so when did your work at the health commons, which was
then called the nursing center? When did that? When did that start?
R
Ruth Enestvedt 36:13
The same year that I became interim chair, started the immersion in Mexico, we had the
accreditation for the master's program. It was a busy year.
Kathleen Clark 36:29
And what did it look like when you first started?
R
Ruth Enestvedt 36:35
There was one long room that looked a little bit clicky and had dividing had had an exam
table and had medicine things it had curtains to draw. And it had a desk where people
had came to ask for help from the nurse they had ever probably need help with. But it was
clear that most people were coming for socks. So we would run from the desk back to the
whole behind the curtain and get socks back to the curtain and get sucked back to the
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curtain and get sink. And this is a little silly. We just have socks today and out. So we
moved the socks up to the front. We also had pharmacy vouchers we had there was a
deal with Walgreens pharmacy and we would people would come and this was brilliant.
We wouldn't we couldn't diagnose right. So on this voucher, we would just write what
people told us. This is what they say is their problem, or this is what they say they need.
And they would take this voucher to Walgreens look for something themselves or ask the
pharmacist. Well, that was running into a lot of money. People were using them to shop
you know. And so we decided that this isn't working so well plus Walgreens closed and we
couldn't find another resource to connect to it. So you know, there was still in our mind
that there were going to hire a permanent person here to do health promotion, health
promotion, health education was the beginning I think of the nursing center. Well, I'm not
a big believer in health education. And health promotion is kind of still an expert model.
So it just didn't seem to be something that was working here. And I think, well, we got the
we got the mail room for a little quiet place. So we put some recliner and some other
comfortable chairs and you know, subdued lighting in there and would offer that as a
place for people to sleep. If they've been walking the streets all night. They seem really
anxious or they needed just a place to be quiet by themselves. We tried some other little
things that didn't really work too well. So I think it it just sort of gradually moved away
from you got to come with a problem. But what you really want are these other things
that you really need to but let's just start there, instead of starting with, you have to come
in here and make up something or ask for something, you know, what do
Kathleen Clark 39:15
you know about the beginnings of nursing?
R
Ruth Enestvedt 39:20
Well, like I said, I think it was focused on I think it was focused on Maternal and Child
Health health promotion, things in the idea that there was a part time director or clinician
who was there I think there used to be white coats hanging in the closet. So I think they
were wearing white coats and you know, it really was more of a medical clinical mock
clinic model. And yet I know that at one point, there was so much money sitting in that
account just sitting in the account. And we had shifted to bring the getting stuff for people
because That's what they were looking for they were needing, and here was all this money.
So this became a, a big discussion point at meetings of their Advisory Committee. What
are you doing spending the money? Are we doing keeping the money? But are we saving
afford? Why you spending it? Right? Well, what's it for it is important, even here's need
right in front of our eyes. So. So that's kind of started to shift. But I think the rainy day
security part was for the idea that they were going to give a full time practice person
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there, our halftime practice person, they needed to have some money to pay that person.
But that didn't really seem to make sense, because this was becoming more and more
integrated as an educational experience as well. So
Kathleen Clark 41:03
So, since the beginning, or since you started the health Commons, what's changed the
most since the last time you were there?
R
Ruth Enestvedt 41:09
since the last time I was there? Yeah, I don't know. Since the last time I was there.
Kathleen Clark 41:14
What's changed the most from the time you started until the time you retired?
R
Ruth Enestvedt 41:21
I, I think, the space and the name opened up a whole new kind of view of what it is, could
be done, what was happening there. I think you're Katie's efforts to open and get that
room and open it up and make it you know, much more inviting, to make it to make it
work for what we're actually doing now, which was inviting people in to get these supplies,
and to have another space that was welcoming and relaxing for people to talk with
nurses. And I think more and more student experience has become a part of the part of
the health commons. I think going from the term nursing center to health commons was a
real shift that opened things up, because then people didn't have to feel like, well, you're
What are you doing here? Are you doing medicine here? Are you diagnosing people? are
you treating people? Is this legal or illegal? We had we'd have a doctor from the
congregation come down on Sunday mornings when we're in the nursing center and say,
What are you doing here? In so with that kind of dissipated, just like in the neighborhood
here in Cedar Riverside, when we came up with the commons name, suddenly, all of the
territorial, you know, stuff just evaporated. We aren't competing with you. We are not a
health provider. How can you provide health anywhere? I'd like to know, you know, so
what we're doing is creating a different opportunity for people.
Kathleen Clark 43:16
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And what do you remember on the events for changing it?
R
Ruth Enestvedt 43:20
Well I Rrmember, we're working with sahra you know, and working at the, the Cedar River
site, we're working on, trying to get some sense of what the neighborhood would accept
and sorrow was going to people and getting the feedback. We don't want nurses here. You
know, we don't need nurses here. If you come in as a nurse, you're going to either be
suspected, or you're going to be dismissed because you're not a doctor. So that's not
gonna work. So I think when we came up with the idea was to help, let's just call it a health
commeon That was just gone.
Kathleen Clark 44:01
So as far as nurses, and being skilled at certain things, how do you think nurses can really
think about creating a welcoming space when they're at the health commons?
R
Ruth Enestvedt 44:12
Well, I think it's a great shift. And this again, of shift that can only happen if you there are
a few times, I think, the first time you're there, I think there's sort of a culture shock that
happens, where people just could think, Oh, my gosh, what am I supposed to do? What's
going on here? This isn't like anything, I have no role, what, you know, this isn't this is just
so loose, and so ambiguous, and there's just really nothing happening here. And, I mean,
just the constant pressure to show evidence of, you know, impact effect, you know, is part
of this whole view, that somehow this is a health care process. You know, And when I
heard when I heard before,before the the Obama Health Care Initiative, when I heard, I'm
just no good with names with the person who's now working with the state health
department say, No, we just don't need to talk about health care systems anymore.
putting money into that system is just a black hole. And I think we've seen that it is just a
black hole. If we want to talk about health, we've got to talk about something different
from health care, you know, so I think what the what the health commons does here is
open up an opportunity to see, well, what is it what makes for this kind of experience that
can be health producing or an opportunity for health? And I think just the fact that
students will come? And when they're leaving to kind of say, Well, that was really fun.
Yeah, well, what does that mean? Is it healthy to have fun? Does that give you a different
experience, a different kind of fulfillment, a different opportunity to really find humanity.
And then when we had somebody come, who was from us from Iraq, and he was part of
the health ministry from Iraq, and he came as part of the University of Minnesota, he
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wanted to find out what was this place? You know what? And so we explained that we
gave him curriculum, we showed him everything written and talked to him, and finally got
day said, Ah, he said, this is our humanitarian project. Yes, that's what it is. It's
humanitarian. And what better thing should it be, but more complete more holistic? Could
it be the humanitarian So? So I think, students when, you know, we get to the getting to
the student learning, all those years you spent at the health commons? How did you feel
their their education was transformational, or help them shift from being at the health
commons? What's kind of your experience on how we got to our student outcomes that
we wanted because of being at the health commons? Well, I think students who want to
come back, I think, was a clear indication that this was something that was was providing
something missing, that they wanted to experience. But I remember to especially what
comes to mind, as you asked that question is a guy who worked at Hennepin County, I
think, in a year, it was either an ER or an mental health unit, psychiatric unit. And when he
came in, it was sort of like, Oh, I know, this manipulation. I this is not, there's nothing new
here to me. And so you know, you say, Well, good, you can really help us out then and, you
know, give us some ideas about how this works. And, you know, in other words, respecting
what they already come with, I think, and, and that nothing as I'm thinking but not saying
wrong attitude, you don't come here thinking you know it all you get that's not, instead of
that just to say, Well, I'm good, you can help us that, you know, well, then he was not
feeling defensive. He didn't feel like he had to be showing his knowledge so much. And by
the end of it, he was really impressed with what was happening to people that he hadn't
known about. Because when you're obviously in a hospital setting, you're not talking to
people about what's really happening to you in the street. And it's, it's a dangerous place
for you to sink to lunch in a way. Well, I mean, it's a great generalization of hospital, but so
he he even though he thought he knew and had had experience with the population, he
could, at the end of the just one experience, say this was this was very enlightening. I
learned a lot here and could be specific about it.
K
Kaija Freborg 49:10
I think there's been discussion at the college level or university now around is being in a
faculty role at the health Commons considered service, or is it considered scholarship?
R
Ruth Enestvedt 49:21
Or is it considered teaching?
Kathleen Clark 49:23
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So what's your viewpoint on that?
R
Ruth Enestvedt 49:26
Well, I think the way you handle it, Katie makes it service because it was always a surprise
to me when I was at the University of Minnesota. When I learned that service was not
service in the community. I thought we were doing this high rise project was great service
that holy smokes, look at this. We've got the city council behind this and the president of
the university comes out and uses us as an example of the community, the university and
this is service, wrong service in it in a tenure position is service to the college. committees
are you on? What have you done to help me know with with serve on different task forces,
it isn't service in the community. Now you have been able to bridge that gap, I think, by
your work, to bring faculty to the health commons, to bring students who aren't nursing
students to the health commons, to bring the president students to the health commons,
that begins to look like a college that wants to be serving the community needs to think
about service differently. But I would guess that when you're in your tenure, work with and
it's work with committees, you're going to have to fight for the idea that this is, in fact
legitimate service, because they're going to think, what committees have you been on?
You know, but if you done here for the college, so I think it's a great view, I think you have,
you have are on the way to doing something very important about that. And, of course,
your work with very Boy, you know, whatever it is.
Kathleen Clark 51:15
So, back to more about health commons. So how do you acknowledge the need when
you're at the health commons? What should nurses be doing to acknowledge that need?
How do you see that first stage?
R
Ruth Enestvedt 51:32
Well, I think the first stage is, you know, just being open with what do you what stuff do
you need? You know, and I think one of the things you had asked about was a model. And
I'll just say it right here that the model really got the first the first efforts of this model for
the health commons was, it was stimulated by this constant or ongoing discussion
between Linda and I, who were co co coordinators of the nursing center that time, Linda,
that we shouldn't be spending so much money on stuff, we should that it was really, really
dehumanizing for people to stand in line for this stuff. And that we shouldn't really have
this stuff. Because it was, as a result, it was creating this kind of just, demoralizing,
humiliating experience for people. She has a point. I think there's, there's, there's truth in
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that, you know, but the fact is still there that people are lining up for this stuff. So what do
we say? Because we are too sensitive to do this, we wouldn't have it for them. So we go
around and around about this we got money. Yes. I know what we need to say no, but you
just go around and say that, okay, I've got to kind of formulate what is going on here. That
was humanizing. The humanized people who they had been taught in many, many places,
not the least of which were their family members saying, You can't go there. It's too
dangerous. These people, and they're kind of people, they're grateful people. They don't
even look crazy, you know, so that I think, was a great thing in itself. So from there, you
know, I think just to have things that if you, you have to use your imagination a bit, right?
So if you're a woman on the streets, what would you need? If you're a woman with a
baby? What would you need? Well, you certainly need pads, that's for sure. Where are you
going to get that? You mean, that's expensive stuff? You need diapers, that's expensive
stuff. So just a little imagination. If people are on their feet all the time, what do they
need? I mean, just think about what could just be there and offered.
Kathleen Clark 54:02
I think students especially their first time often struggle with how do you engage around
where you tend to have a struggle?
R
Ruth Enestvedt 54:13
How do you attend to the struggle?
Kathleen Clark 54:15
Yeah. And in a way that gets out of the expert model. They really struggle with that. So
what advice would you give students or nurses practicing health commons around that?
R
Ruth Enestvedt 54:24
Well, like I have hammered many times, don't ask questions. You're not doing an
assessment here. You are not diagnosing what the struggle is. You are, you're responding,
giving feedback in a way that elicits more, more about the struggle. So you are getting a
physical complaint. And that's real, you have to pay attention to it. But it is not the whole
problem. It is just the surface. It is the mediator sort of have the problem, they can bring
this symptom to you, and they can engage with you. And believe me, when they're
engaging with you, they are checking you out, you know? So don't think that you're not on
some kind of assessment in some kind of assessment, but you are. So they are they're
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looking for I do really care. Do you want to know? Is there anything more? Or do you just
really want to check out what this blood pressure is? And all you have to do is say
something positive to them a comment that is positive, through a good thing to check
your blood pressure, something simple. But you have to practice some ways of saying
things that are done a question for not what do you do for your blood pressure? While
your blood pressure seems to be pretty good, you're doing something? That's not a
question. But it certainly opens perhaps some discussion about what else you're doing.
And you will be amazed to find out how careful people are about things like their diet and
their exercise and how much they want to be well, you know?
Kathleen Clark 56:11
Could you give me some examples of what accompany in the journey?
R
Ruth Enestvedt 56:17
Oh, this is a tricky one. It really is a tricky one. Because you may think, and I've been
taught this by people who came to the, to the commons. One fellow came, and he was, he
was really in a bind in where he was living in his living arrangement. And he really wanted
he was wondering if maybe I could write a letter that, you know, told about his work with
the students and how he was a positive help to us at the health commons. And so I said,
sure, I can do that. I can write you a letter. So I wrote the letter. And I went to his living
place, walk in the door and asked for him hand in the letter and say, you know, if you
want, I can come to the meeting, because he was facing eviction or something like that.
And he was very kind, he was just very polite and civilized. No, that's okay. That's okay, I
can manage it. And, you know, went to the door with me, the next time they came to the
commons, he said, you know, you really don't need to do that for me, I come here,
because I want you to listen to me, that's where I get the help. Just listen to me, I'm not
asking you to do anything for me. Okay, so accompaniment is offering the support
listening, believing, trusting, you know, and then if they want something. So I wrote the
letter, but I made that when I made the mistake was delivering the letter, showing up, you
know, because I don't know what the social dynamics were in that setting. But me being
there didn't help his situation. And you know, what, it's like, you go to the you go to a
halfway house, drop in center, usually, or often, the staff there are on the defensive, like,
Who are you? What are you doing here, because clearly, you're not here looking for a
place to stay. So right away, I use some authority from some other place who are going to
check me out. So it's a tricky thing.
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Kathleen Clark 58:31
I think you've taken so many things that are so that are happening in that space that are
so complex and ambiguous, and somehow made it into this rational model that makes
sense, and gives us purpose and words to use to describe what's happening there. How do
you do that? How did you come up with what you came up with? I mean, you?
R
Ruth Enestvedt 58:56
Well, it was not hypothesis testing, there was no data collection. And I was just working it
over in my brain, you know, drawing it out graphically looking at that thinking, what does
that mean? You know, and then I really have in mind this idea of the, the rite of passage, I
think the rite of passage is a helpful way to think about what happens in the in the setting,
coming from formalized system into this ambiguity, and then having your back to the
formal system. So I think it's a good new can ever change. What happened in that little
setting you've been you have been changed somewhat. So I think that's a helpful and that
came to me. I think, then then, you know, I listened Honestly, I respected the students I was
working with who said, Oh, this has to live here. You know, that doesn't work. We need to
have something that shows this as you know, you kind of come in to a different places,
that isn't just a stepwise thing. So came up with I think, a model that represents kind of a
better a better conceptualization of this as not a stepwise thing. The, the part of it that I
feel very strongly about that I think is hard, especially for professionals to grasp is
recognizing how much they are getting from the people who come. So what was left out in
this circle was the activity of the people who come. So if you take what I think is the most
complex thing, the accompaniment, you only get to do accompaniment, if you are invited.
And you are only invited, if you have gone through the other things, and you have
developed trust, when you are attending to need, you have the answer, recognize how
much you're getting from people, you can fulfill a need Holy smokes, you know, that feels
good, no matter what I mean, that's why we're in the helping professions, right? So to see
the mutuality, and to see what people are actually giving to us, I am sure you've had the
experience where at the kind of at the end of the day going over debriefing with students,
and they're just dismissive of what they have heard from people, they don't realize what it
has taken to say, to tell people what they have told them about their lives. You know, I
think I just that was one of the things that was most frustrating to me was students that
they just didn't recognize, this was a great opportunity you had that is a rare opportunity,
a rare opportunity, you know, to have somebody speak honestly, with you about this, I
suppose it would make me most mad when I would have people come for the immersion.
And students would sort of not see what they were hearing from this person. So that part
of it, I think, needs to be emphasized as much as possible.
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Kathleen Clark 1:02:11
I agree. So as far as when you were at the health commons, what what was your favorite
part of ob in there?
R
Ruth Enestvedt 1:02:21
Well, you know, I was hanging out, just hanging out and talking to people, and you're
talking to people without any pressure of doing something to fix them, you know, I just am
and I am a kind of a radical non interventionist. So and that's, it's not a good thing. I
mean, we need people there who can kind of take charge and intervene when it's needed.
And I've done that too. But I think I've also learned that you can kind of wait a little bit,
things kind of unfold, and what they look like a giant emergency, like when the couple
came in, and they wanted us to, you know, file a police report, police brutality, and he was
all black and blue. And you know, we want they wanted our help. And we said, well, you
know, we'll tell us more about it. Let's talk more about it. Well, the more we talked about it,
the more it became clear that there was as much of domestic thing going on here. And an
opportunity that was being looked for it started to feel like so just take some time here
what looks like a big crisis. There's always more to it, it's more complex than it looks on the
surface. So I'm a non interventionist. So the fun was to be there, and just hang out and talk
to people. In the nursing in the health commons, it was easier than up in the community
room. Up in the community room, one of the things that I learned during fellowship and in
the fellowship hall, one of the things I learned from people who would talk to me outside
of the setting, people living in the street. The dynamics among the people who come are
really unrecognizable to us, but they are very active. So being up in the fellowship hall, I
would guess, who you sit with, where you sit, how you talk, who you talk to, is being
watched, and it's being calculated in some way about what your role is here and who
you're singling out. And, you know, why are you so interested in that person? I just think it's
because it's a bigger space. It's more there. They're more social stuff going on. I think it's
easier in the health comments where it's a smaller space, fewer people, and there's sort of
an expectation built up now. That Yeah, you know, they're going to listen.
Kathleen Clark 1:04:56
So for nurses who are caring for people Who might be experiencing homelessness or who
are marginally housed? What advice would you have for them?
R
Ruth Enestvedt 1:05:08
I heard I think it's I'm trying to put together words I think in there from Wendell Berry,
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they're not my words, but it's, it's affected curiosity. In other words, you respect them,
you're really interested in you're interested for your own reasons to, but you're also
interested in because you care about them. And you care about what their what their
experiences.
Kathleen Clark 1:05:47
So if, well, I guess there's so many things that I want to ask you. If there was one thing that
you could change about healthcare, after all, that you learned through this, through your
work at the health commons, and in other settings, what would it be? What would you
want to change?
R
Ruth Enestvedt 1:06:08
I'd rather talk about health and health care. You know, of course, the system could do
better for a single payer and universal, but we're still have, you know, money for this
system. That is, it's just a capitalist system that just sucks up money. It's just a black hole. I
you know, I don't think it works. My son and daughter in law just had a baby couldn't have
been easier unless they did it at home in a bathtub. It cost them $16,500. Which is just
absurd. Now, that's a big problem. And where is that money going? You know. So I think if
we quit talking about health care, and started talking about health, and got
pharmaceutical ads banned from television, banned, if you want to deal with the opioid
addiction, get rid of pharmaceutical ads. I mean, I think that just gives people the idea, a
pill will make me happy, contentious takes a pill, never mind a pill, it's all could be fatal.
You will be happy. You'll have a happy life. We'll have a dog and kids and picnics. And so
anyway, they're the I don't know how you get the corporation's out of the system or the
capitalist out system? I think you I think Minnesota had the right idea. Absolutely. With
Minnesota Care, tax, the places that are making the most money out of this tax, the
professionals tax, the health care delivery systems. You know what, of course, they didn't
like it, but they're making the most money off of it.
Kathleen Clark 1:08:06
So as far as the health commons, what what do you think it should be like 20 years from
now?
R
Ruth Enestvedt 1:08:12
Or 20 years from now, health aren't as many homeless people, but there's no doubt there
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will be in fact, the way this country is going. I just gave a guy a couple of dollars at the exit
because he had a nasty sign about the president. Okay, what do I think in 20 years? That's
hard to think about?
Kathleen Clark 1:08:40
Or is there something right now that you think that we should always remember moving
forward, that maybe we should work on changing a little bit as it was, than it currently is?
R
Ruth Enestvedt 1:08:52
Okay, here's something that I have noticed about nurses and nursing students. They really
don't believe in their own authority. They don't believe in what they have to offer. It's
always just a frame, what are referring you need that you need to go to somebody who
can really help you to step up and say, we are helping we can do this, we are doing this?
And I think, you know, this project to say, I don't have to do the model that is both the
undergraduate fallback default, nor is it the the natural sciences, the fault, the natural
sciences are limited. There's neat, there's more to scholarship. So I think, for scholars and
you guys can do this to really shift scholarship into something that is connected to making
a difference for people in their living situation. What we're, what they're people, people
who are struggling, and that's a lot of people.
Kathleen Clark 1:09:57
Well, you're such a radical thinker, and excellent teacher as you were my teacher, as well
as Dr. Freborg. So what advice do you have for current faculty, or future faculty in the
department teaching transcultural nursing to teach it in a meaningful way?
R
Ruth Enestvedt 1:10:16
well hang on to the transcultural part of it, you know, I, I think we're lucky that we have
students and faculty who going into nurse practitioner track are still open to the
transcultural concepts, because I always felt that's a real danger, because of the power of
the medical model to kind of broaden that. And I know, I don't I don't know how to get
past that, except to just believe in the value of understanding people's circumstances and
the context and how that both relates to what what opportunities they have. And just
keep pushing, pushing that scholarship, a definition, you know, so that, that you will be
pushed and pushed into that research model, that is not useful for everything. It's not the
only way to do things, you know, I, I refuse to do a survey, I refuse, because I think the
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data you get out of a survey is just dangerous, because it is used as if this hack is
generalizable. This has given you some data that you can quantify. No, it hasn't. It's just
limited the areas that you're asking questions about, you're not getting the information,
getting a very limited portion of it. So anyway, I keep pushing that scholarship idea.
Kathleen Clark 1:11:54
Is there one story that you want to share of your like most memorable teaching
experience or a moment at the health commons, that was just something that you reflect
on?
R
Ruth Enestvedt 1:12:05
Well, I've learned a great deal about the circumstances that people who come to the
common face by accompanying them into the hospital and seeing the the immediate, the
immediate dynamics of suspicion and defensiveness, that just gets exaggerated and
builds up and builds up to something that's ridiculous. But there's so much of controlling
that system. And it's, and this was something that I learned in my my doctoral work, it is
structured for that control. It is structured like that. So that was the question....
Kathleen Clark 1:13:00
story of a teaching experience that you Well, I can't go into the experience without
divulging you know, people. So just skip over that one. I mean, I've had experiences where
I've just had a keep going over and over just a terrible experience in a student, you know, a
student, we had a, we had a person from the community come, and the student just
contradicted the person's experience. And I didn't know what to do with it. I didn't, I just
kind of freaked out. I didn't say anything, which was absolutely the wrong thing. But I
couldn't figure out what to say when I was so flabbergasted that somebody would be so
disrespectful, you know, but they were from the same country, they had their own
experience, which was totally class different. So I've made some bad mistakes, do you
know what you would have done? Have a thought whenever I've done
R
Ruth Enestvedt 1:14:01
I think I would have asked the the guest to speak more about what she saw. Because the
student clearly was not open to see it. And I that's okay. But I want the other students to
know what that what that person experience. And she, you know, it was she was giving
sort of summary of things in her life. So she didn't go into and I'm sorry, didn't ask her to
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elaborate.
Kathleen Clark 1:14:33
So another key theoretical concept you established with the rules of thumb, thumb for
nursing practice, while engaging in marginalized settings. What can you tell me about the
rules of thumb and how did you come up with?
R
Ruth Enestvedt 1:14:46
Well, I would kind of hang this on to my idea about what nurses need to do and be more
confident about what they know. This just came out of reflecting on my experience, my
experience I have my education and my experience with people. You know, that's where it
came from. And of course you revise it and revise it, look at them and think what else
could you add? Or what is too much? What is the wrong way to say this? What? You know?
So you it's just a draft and a draft and a draft and a redraft. But it's coming out of
reflection, on my own experience, and just trusting that there is some value in that. So
when the first time I presented that model, and Sue Nash said to me, Oh, my gosh, are you
going to publish that? Well, I just expected because it wasn't based on research, that it
somehow wasn't legitimate. But you know, we've had enough experience, we reflect on it,
and reflect on it sincerely not through the reference of some other scholars or something,
but just how do we put words at what we know. That's what I did. Thanks to James Scott,
who already had, you know, come up with the idea to have rules of thumb, but
Kathleen Clark 1:16:19
where did the accompagnement come from? etc.
R
Ruth Enestvedt 1:16:27
that that certainly wasn't mine that's used in I think, a number, places now. I can't really
remember now. But I like the idea that that's, that's really that's really a lot of skills and be
able to be at that position.
Kathleen Clark 1:16:45
But, just because you always talk about the cultural guides, and like, the Oaxaca
immersion, and really breaking bread together. So that always kind of reminded me of
that. So I didn't know if it was a Gustavo thing, or
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R
Ruth Enestvedt 1:16:59
Yeah, it could have been, you know, this kind of all this stuff, kind of just get like, Is there
anything that isn't plagiarized?
K
Kaija Freborg 1:17:11
Can I ask another question? Since we're on that topic? Do you see the model morphing at
all? or changing or being applied in new ways? Or are there any hopes? regarding its use?
Or publications?
R
Ruth Enestvedt 1:17:26
Yeah, I can see, absolutely, I would love to see it, you know, added to develop more, I think
one of the things that really struck me in the evaluation book that I have had been so
dedicated believe so firmly in local context, but the idea that you can be innovative in a
local context, but if it's going to really have impact, you've got to be able to bridge it to
something that is going to get farther out there, you know. So I think it's, I worked at the
University with a woman who would go on television and talk about it. Whoa, okay,
there's a way to do it. You don't have to necessarily change what you're doing. But you
have to be open to giving what you do a little publicity, you know, so if you can't do that
hook up with somebody who can or, you know, because it has to reach a wider audience,
or it doesn't have to, it doesn't have to reach a right. But that's an A place where I think it
could go, not that it's going to be replicable. That's not the point. But it could help give
people ideas about how to do things. Give other nurses a little confidence to get out of
the medical model a little bit. Give people I guess, you know, I just that I think, one of the
things I used to like to tell students and see I could go on and on, I used to like telling
them, you know, you're not doing therapy here. That's a psychiatric model. And that's not
our model. We are not psychiatrists, so get off that therapy idea. You don't have to do
therapeutic communication, not to say the right thing, you know. So to you just do not, it's
not your role.
Kathleen Clark 1:19:24
One thing I think that I always struggle with, as a teacher that I think you excel that so
much is, you often came in very unstructured and come in with a PowerPoint with a
hidden agenda of what the outcomes are going to be. You didn't over prepare, you came
in students read what you wanted them to read or watch what you assigned, and you
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shaped conversations in a very meaningful way. And allowed students to always feel not
only heard but what they had said had To the conversation, even if other students were
struggling to make that connection. So did you? I mean, did you have something in your
mind that you always went back to? Or was that just your natural skill?
R
Ruth Enestvedt 1:20:14
was very kind of you to say, I should come a little more prepared. But it never worked for
me, because I couldn't. I couldn't manipulate people into what if I wasn't that clever, or
strategic, but what I did, I mean, I picked readings. And I really wanted to go into those
readings. And I would read fresh myself about those readings, so that when discussion
happened, I could connect it to the reading, because it was all fresh in my mind. So I
would do that. And I, but I was, I mean, I can think of times when, you know, somebody just
really criticized the book, the whole book, you know, just dismissed it completely. And I
wasn't ready for because of course, I believe. What's the matter with you can see this, you
know, so instead of saying something mean, and nasty to the student? I wouldn't say
anything, I wouldn't have anything to say. But, you know, I don't know. I don't know where
that came from, I guess, I guess, good students. That's where it came from, actually,
students who prepared and students who came and took it seriously, and wanted, wanted
some discussion. And I know, there were times when I couldn't stop people who
monopolized conversation, I should have done a better job of that. Because I think that
can be hard, or draw people who, you know, were quiet in class, and they knew there was
so much going on in their mind.
Kathleen Clark 1:22:00
Well, I think that's all the questions that I had for you, Dr. Freborg. Do not. Is there any?
Anything you want to tell us that we didn't ask about?
R
Ruth Enestvedt 1:22:10
I talked way too much
Kathleen Clark 1:22:17
Thank you so much for this go through the consent. Yep. That's very rich, and will be very
meaningful for future generations to come. And it makes me want to even go back and do
a whole nother interview with you. To hear more especially about some of the stuff that
along the lines of the trans cultural, advanced practice, transcultural nursing skills and
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things like that, but maybe that'll be a future segment. But as far as now that we're at the
end, would you be comfortable doing the oral consent now? Sure. Okay. So I was I need for
the record is to make sure that you confirm that you consent to being interviewed and
having the interview recorded and stored at Augsburg University, which we made
available to the public. That's Yes,
R
Ruth Enestvedt 1:23:09
I consent. Okay, do great.
Kathleen Clark 1:23:12
Well, thank you so much for your time.
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