After traveling to the Rosebud Reservation, I found it eye-opening to the cases presented in the Indian Health Services outpatient clinic. One patient who was out of the ordinary for me was a man who arrived with a fractured tibia or fibula, as he had a cast that was applied within 72 hours of his visit to the Indian Health Services outpatient clinic. I was unable to collect the requested information because fingerprinting was not approved. The patient had common signs of compartment syndrome. The interventions suggested to the hospital staff were not completely completed. Interventions provided during case presentation consisted of assessment of the six Ps, swelling, and vital signs. I took the patient's vital signs and the nurse logged them into their system. The patient's blood pressure was not within normal limits, so the blood pressure was completed manually. Manual blood pressure was still elevated. An increase in blood pressure may indicate pain, swelling, and impaired blood flow to the extremities. When I was with the nurse, she sent the patient for an x-ray. Additionally, the nurse should have assessed what the patient was doing and instructed him how to raise the leg above the heart. Many people do not know the scientific rationale and location of the elevation of the extremities above the heart. The nurse should also have assessed the patient's expectations for pain relief, as his current medication (ibuprofen) was not working to his expectations. This is the moment we left the hall; therefore, I could not discuss the patient's care with the nurse. The nurse simply asked the patient some of the six Ps of compartment syndrome and did not complete the assessment...... middle of paper ....../www. nursingcenter. com/pdf. asp?AID=636579.Marshall III, J. M. (2001). The Lakota Way: Stories and Lessons for Living Native American Wisdom on Ethics and Character. . New York, NY: Penguin Group.Nebraska Department of Health and Human Services, Licensing and Regulation. (2011). Licensed Vocational Nurse/Practical Nurse: Continuing Education. Retrieved from http://www. hhs. state. no. us/crl/nursing/rn-lpn/ce. htm.Pearse, M. F., & Nanchahal, J. (2008). Compartment syndrome: reducing the risk. Clinical Risks, 14(3), 114-118. doi: 10. 1258/cr. 2008. 080019.Soeng, N., & Chinitz, J. (2010). Northwest Federation of Community Organizations. Underfunded Native healthcare and unfulfilled promises: The importance of investing in the Indian Health Service. Retrieved from http://www. nnaapc. org/publications/20100814NativeHealthUnderfunded.pdf.