College of Nursing’s INCATS program boosts Indigenous health care
The program, now in its sixth year, encourages Native American students to become nurses and work in tribal areas.
Brianna Hosteen (left) says the University of Arizona College of Nursing’s Indians in Nursing: Career Advancement and Transition Scholars Program is making it possible to pursue her dream of becoming a certified midwife.
Photo by Noelle Haro-Gomez, U of A Health Sciences Office of Communications
(From left) Angela Acuna, Brianna Hosteen, Tohono O’odham Community College student Ariel Pereira, INCATS graduate Jolynn Robbins and INCATS director Timian Godfrey, DNP, spoke at the third annual INCATS Tribal Academic Practice Partnership Summit last month.
Photo by Noelle Haro-Gomez, U of A Health Sciences Office of Communications
Brianna Hosteen has her mother to thank for her career choice.
She has the University of Arizona College of Nursing’s Indians in Nursing: Career Advancement and Transition Scholars Program, better known as INCATS, for making that dream — to become a midwife — happen.
“It’s nothing short of amazing what they do, because of the community INCATS creates and the opportunities it opens to us,” said Hosteen, a junior in the college’s Bachelor of Science in Nursing-Integrative Health Pathway based in Gilbert, Arizona.
INCATS, which began in 2019, is an Indigenous nursing education program that not only provides financial support for students — covering tuition, fees and living expenses — but offers them culturally relevant peer and faculty mentoring, professional skills development and preparation for licensure, as well as creating community in a field where very few people come from Native American backgrounds.
“American Indian and Alaska Native nurses still constitute less than 1% of the overall nursing workforce in the United States,” Brian Ahn, PhD, dean of the U of A College of Nursing and a member of the BIO5 Institute, said at the third annual INCATS Tribal Academic Practice Partnership Summit last month. “This underrepresentation significantly impacts health outcomes and access to culturally appropriate care. The INCATS program is one way we are changing that narrative — one nurse, one student and one community at a time.”
Pursuing a dream
Hosteen, the oldest of four kids, was in the delivery room for each of her younger siblings’ births. It was an amazing experience for the inquisitive 9-year-old as she awaited her first little brother’s birth.
“The midwives and the nurses were such a great team for my mom, and they really took the time to explain everything they were doing,” said Hosteen, who even got to cut her brother’s umbilical cord. “I was all up in my mom’s business. I was asking the midwives and the nurses hundreds of questions. I was asking what all the tools were and what that weird, gushy thing that just came out of my mom was, which was the placenta. It was just super fascinating to me.”
It still is.
Hosteen is going through clinical rotations and recently had the opportunity to observe three C-sections at Banner University Medical Center – Phoenix.
“It was so beautiful, talking to the patients before,” she said. “Some of them were nervous. I was nervous. But I said we were going to get through it together.”
At the INCATS summit last month, Hosteen, who is Diné, shared the story of how she came from Tuba City, Arizona, the largest community on the Navajo Nation, to the U of A to study nursing. The annual event is a chance to bring together nursing faculty members, students and tribal and clinical partners from across the state to discuss ways to grow and sustain a tribal nursing workforce. Arizona is home to 22 federally recognized tribal nations.
A shortage of health care professionals exists throughout the United States, but the deficit is more acute in Native American communities.
After graduation, INCATS requires students to work two years in tribal settings for every year of school funded by the program. Hosteen said that was always part of the plan.
“I want to go back and work for my community because of the lack of resources that we have,” said Hosteen, who intends to work a few years before going to graduate school to become a certified nurse midwife.
Angela Acuna (center) seen here at her graduation from the U of A College of Nursing with Sharon Hom, PhD, (left) and Timian Godfrey, DNP, (right), works as a registered nurse and said that INCATS was integral to her college success.
Photo by Kris Hanning, U of A Office of Research and Partnerships
Moving forward and making progress
When INCATS began six years ago, the idea was to fund a program to increase the number of highly trained and skilled Native American nurses in tribal health care facilities for five years. Last year, the U.S. Department of Health and Human Services’ Indian Health Service awarded the college an additional $1.6 million to continue the program for another five years.
Emily Shoteen Si’al, INCATS program coordinator, said that thanks to the second round of funding, even more opportunities for students exist. Tohono O’odham Community College pre-nursing students who meet eligibility requirements receive guaranteed admission to the U of A, thanks to a partnership with the College of Nursing, the Wassaja Carlos Montezuma Center for Native American Health at the U of A College of Medicine – Tucson and the community college. The renewed funding also allows INCATS to support summer outreach programs for Native American youths and create culturally rooted continuing education courses for nursing career resiliency. INCATS continues to fund four to five students each year.
U of A College of Nursing graduate Angela Acuna, a member of the Tohono O’odham Nation, said INCATS played a huge role in her college success. As someone who struggled with exams, Acuna said she benefited from help with a success coach and had a professor who proved an invaluable mentor. Acuna called Sharon Hom, PhD, her “most valuable asset.”
“She recognized my needs, my background and the circumstances that I was going through,” said Acuna, who graduated in 2022 and works as a registered nurse with Tohono O’odham Nation Health Care. “She always validated my goals, and when I set goals or plans, she was there to partner in this and help me empower myself to reach those goals and plans.”
Acuna said the program’s ability to weave in Indigenous identities created strong bonds with her fellow students and a sense of belonging.
“INCATS played a huge role in my college success by having many resources that were available to us to prepare, maintain and prosper throughout nursing school,” Acuna said. “I will forever be grateful for the INCATS program.”