Whitney Fear, a psychiatric nurse practitioner from North Dakota, extends the compassion, empathy, and respect at the foundation of her Lakota culture to the many marginalized populations she meets at Family HealthCare, a federally qualified health center in Fargo, North Dakota.

Having grown up on the Pine Ridge Reservation in South Dakota, Whitney has firsthand knowledge of the many barriers Indigenous people face to good health, which helps her provide care that factors in the cultural, historical and social determinants of their past — and present. This trauma-informed approach provides a step toward a more equitable and healthy future. Because that’s the future of nursing: Daily acts of justice that answer this question from our society’s most vulnerable: Does anybody care? Nurses like Whitney are the answer.

Beyond the clinic, Whitney advocates for equity for Indigenous people and other underserved populations as a founding board member of the Indigenous Association, a board member of the City of Fargo Native American Commission, part of the steering committee of the Culture of Health North Dakota and a leadership team member for the North Dakota Center for Nursing.

Her story is one of adversity, compassion, and the difference one person who cares can make. Especially when that person is a nurse.

It’s been a year since SHIFT Films captured and virtually premiered Whitney’s story in the documentary, “Who Cares: A Nurse’s Fight for Equity.” Since then, the film had its real-life, in-person theatrical premiere. We hosted a “Nurses Night at the Movies” where nursing students and local nurses and their allies gathered for a screening and panel discussion at the Fargo Theatre, the same theatre featured in the opening shots of the film. That week and the months since, Whitney’s story has been featured in broadcast, radio, podcasts and news outlets across the country. Nursing schools are using the documentary to help teach courses about health equity. And future nurses, especially Indigenous students, have found encouragement and inspiration in Whitney’s story.

In honor of the anniversary on 4/22, we caught up with Whitney to hear about everything that has gone on in her life over the past year. You can watch a condensed version of interview, or read the full version below.

How did it feel a year ago when “Who Cares” premiered?

It felt kind of vulnerable, to be honest, at first, because it was widely disseminating my story all at one time. And there’s some personal aspects of all that I had not shared with many people before then. But I had some patients that responded very positively to seeing the documentary. And they felt that it was really great coverage of the issues. They really liked that I was transparent about my background and things like that with it, which I think was great. I didn’t really have any negative feedback at all, which I was nervous about. Any time that I think a healthcare provider divulges that they’ve had their own issues with mental health struggles or substance use stuff, there’s that moment to feel a little bit like, “Oh, I hope that people won’t take me less seriously or feel less trusting of me because of that.” But so far, I haven’t had any issues with that. 

What do you think is the importance or impact of nurses sharing their stories and being vulnerable like you were?

It’s been really special to me to see some little snippets the SHIFT team has shared from students feeling like, “Yes, I have felt really out of place while I’ve been in school, but this film was really affirming that I have a place in the nursing profession. And that even if it seems like some of us don’t maybe fit the typical image, there is a place for me that I feel like I could have a successful career.” That’s one of the aspects that I was hoping the film would bring into play, that Indigenous people considering or contemplating a career in nursing would see how just how perfect of a fit it would be, and how our traditions and values are so aligned with nursing traditions and values. That’s been something that’s been really special for me to see, because I think that there’s probably a great deal of people that would be great nurses, but they don’t make it through school because they get discouraged along the way.

There’s some other nursing stories that were shared in the film that were impactful too, like when Stacey Hone talks about her experiences with working with the population that we do, the stressful parts of COVID, and Melissa Kaiser sharing about the toll that takes. That’s really important for nurses to hear that it’s super normal to get distressed by things that you see and experience, because it’s really hard work. And I hope that that those stories will be something that would encourage other people to start or continue that dialogue.

It’s also been amazing to hear from nursing schools and students that they’re using the film to teach about health equity. Have there been any further opportunities for you to share your story and speak more about health equity issues this year?

I was on the “Nursing Uncensored” podcast episode that just got put up about a month ago, which was a super fun interview to do. Another opportunity that came up that felt like an enormous opportunity to me (and that I was super nervous about, but it went well) was I presented it at University of North Dakota’s Psychiatry Grand Rounds about a couple of weeks ago on Indigenous health perspectives. I also presented before their traumatized youth collaborative on human trafficking. And in July this year, I’ve been invited to attend and speak at the International Rural Nursing Conference in Tennessee. They’ll be showing the film, and then I’ll be talking about it a little bit afterward. And in May, the Community Health Association of the Dakotas (CHAD) plans to show the film at their conference in Fargo. I’ll be speaking at that too. Community Health Association of the Dakotas is a not for profit that assists federally qualified community health centers like Family Healthcare, and I’ve been really working pretty closely with CHAD since I worked at Family Healthcare. They’re very helpful and a great resource for FQHCs. So, I’m really looking forward to that. It’ll be at the same place that we had the premiere of “Who Cares,” actually, which also happened this year, at the Fargo Theatre.

So what’s been going on outside of work?

We got a puppy! His name is Toast. It was only maybe a couple of weeks after the documentary finished filming that I went and picked him up. I also met somebody pretty incredible. We recently got engaged! My fiancé has two sons, and they’re great. They’re really cool little boys, and they get along great with my kids. We have a lot of fun together. So, we’re kind of getting started on wedding planning stuff, and I think that’s going to be great. My fiancé is from the Turtle Mountain reservation. He’s an Ojibwe from Belcourt, North Dakota. And he recently launched a project called ‘Goin Indigenous’, and I’ve been contributing to that as a blogger. It’s a project that we’re hoping to use to get some resources out there for Indigenous people and connect people to existing resources. I’m really excited, and I think it’s going to be really cool as it evolves.

I have also been doing a little bit more with art, which I don’t know that I talked a ton about on the film, but I’ve always loved art. I’m an amateur painter, and I do beadwork, which I’ve been doing a little bit more with. It’s a favorite coping skill of mine. I am actually completing my fiance’s sister’s beadwork for her general dress regalia right now. There’s a lot of time that goes into that — especially because they are Ojibwe, so I’ve had to learn that style that’s new to me.

And what else? Recently, we’ve had a little less upbeat news, but I do think it’s worth mentioning because it relates to health equity issues like we discuss in the film.

Are you okay? What’s been going on?

Around the time that we got engaged, I had had a positive pregnancy test. Unfortunately, the pregnancy was ectopic, and I did have to have a medical abortion. It wasn’t anything about a lack of desire or ability to care for another child or anything like that. The situation, though, was that pregnancy was never going to be viable. It was an imminent danger to my safety and well-being if I actually continued with the pregnancy. I know a few people who have almost died from ruptured ectopic pregnancies, and mine was, the doctor said, about 24 hours from rupturing. So, it was quite advanced by the time that it was found. It was hard, and it wasn’t an easy ordeal. It was a major surgery to have. However, I am really happy that the surgery was able to happen in the amount of time that the surgeon felt was appropriate and warranted. I went into the ER at about 2 o’clock on a Thursday afternoon, then I signed the consent for surgery about an hour and a half later because they felt it was such an urgent need.

The major hospitals up here are on the North Dakota side, where there are more restrictive laws around abortion. If this happened a few months further down the road, I might have had to have my provider make sure that they were going to be able to have the procedure reviewed in a timely manner so that they wouldn’t be a subject to any legal penalties for performing that surgery, and that I wouldn’t be at risk for any legal penalties for consenting to it either. If those boxes weren’t able to be checked, then the alternative probably would have been to get loaded up and drive three or four hours to one of the hospitals on the Minnesota side and go have the procedure done. And those are all things that in that situation are already really difficult. I mean, we had told our families and everyone, and our kids, that we were pregnant. And so already, we were feeling the emotion of the realization that this is not going to happen, and but also we got to hurry up and get this surgery done so that it’s not harmful to me. Ectopic pregnancies have a very high rate of death and serious injury when they rupture, which is always going to happen. Again, these are not viable pregnancies, and they can’t ever be. So it’s not a matter of waiting it out or anything like that. It’s a matter of things always happen this way.

With all of that already happening, I’m glad I didn’t also have to worry about whether I could have the surgery that night or not, or whether my physician would be granted permission to do the surgery or not, or whether I’d have to go find somewhere else to do it. And I felt very fortunate to not have to consider all those things when I was already very emotional. That was the first time I’d ever had surgery. I’ve never had surgery other than have my wisdom teeth out. So I was already nervous about that and all of those things happening so quickly. I’m glad I didn’t have to think about whether I could have the procedure on top of those other things. This experience deepened my concern in a very personal way to what things are going to look like as these restrictive laws take effect, for sure. A lot of healthcare professionals have concerns about some of the restrictive abortion laws that are going into place for this reason, and I don’t know that state legislators understand or realize the gravity of those laws. Because in my situation, we very, very much wanted that pregnancy, but continuing it would’ve been a threat to my life.

What’s interesting is that same week I learned I passed my perinatal psychiatry certification exam, which was something I felt was really necessary to address another equity area. I don’t think that the area of women’s health is well enough covered in specific ways. That definitely includes the mental health services that women receive during and even before and after pregnancy, too. So, I’m glad to be able to offer that specialty that is needed very much in this area right now.