Nursing students at MGH Institute of Health Professions don’t just learn about providing health care. Through their clinical placements and scholarly projects, they also learn about how providing health care can change the world. 

For Grace Riley, MSN ’20, this lesson started with her father. He always told Riley and her brother about Native American communities. 

“Your history books don’t teach you what actually happened,” Riley remembers her father saying. 

As an IHP nurse practitioner student, Riley was wary of programs that might be “medical tourism.” What drew her to IHP’s clinical rotation on the Rosebud Reservation in South Dakota was that she learned the tribe was welcoming of students and interested a long-term, sustained relationship. 

Federal reports point to the historical trauma and the social and economic challenges that exist on the Rosebud Reservation, where more than 10,000 people live in 20 communities spread across 1,970 square miles. But what Riley felt most strongly when she got there was energy. Tribal members welcomed her input and taught her about their culture, land, and lives. She visited a child care center and provided health care and health education in the tribal jail, where the men shared their own stories. 

“It was easy to feel that I didn’t know enough medicine,” says Riley. “But I learned about the benefits of being who you are. If you bring yourself with you, you can break down barriers and establish trust.” 

So when she suspected that a young woman didn’t understand what a doctor meant by behavioral health, Riley interrupted and asked the patient, who in fact, did not understand. “That’s also part of the training: learn to read your patient,” she says. 

These lessons led to a career for two students. One is Anne Cowles, MSN ’19, a New Hampshire native and alumna of IHP’s Nurse Practitioner program, who found her rotation on Rosebud to be so powerful that after graduation she moved to South Dakota and took a full-time job on the reservation. 

“This is one of our proudest accomplishments,” IHP Nursing department professor Jason Lucey says of paving a path that led Cowles and another IHP student, Kara Sprangers, MSN ’19, to go to Rosebud to work. “We want to improve the lives of the people our students serve. Having students return full-time is exactly what we were hoping for.” 

Returning was particularly powerful for Cowles. 

“When I left here as a student, I knew I was coming back. I could feel it deep down,” Cowles says. She wanted the challenge of working in a health system that was different than the one she had trained in. And she wanted to provide patients with stability. 

“One of my favorite things to say to patients is, ‘Hi, my name is Anne. I’m a new nurse practitioner on Rosebud, and I’m permanent and full-time.’ It’s really powerful to say, I am here, and if you want to follow up with me, let’s do that.” 

Cowles also works closely with fellow IHP alumna and Rosebud colleague Kara Sprangers. 

“We compare notes and work through cases together,” Cowles says. “It’s nice to have someone who understands what I’m going through. We’re both away from our families. Our friends don’t really understand the challenges like we do, so it’s really special to have that kind of professional relationship with someone.” 

For Dr. Matthew Tobey, a supervising physician on the Rosebud Reservation who is based at Massachusetts General Hospital, having Cowles and Sprangers is an important first step in becoming a model of how to welcome a new health professions graduate and have a positive impact in a rural community. 

“Part of the education we provide is showing that there are a lot of opportunities for health care providers to make a difference for patients.”