A huge elk-hide drum about two feet in diameter sat in the corner of the Wyoming Medical Center's main lobby.

Three men and one boy gathered around it with long poles ready to strike the drum.

As Darrell Lonebear told the audience of doctors, nurses and patients about the grand entry, about 15 American Indian dancers entered the lobby. Each one showed off a brightly-colored garment. The drummers created a beat and sang.

Some dancers wore eagle feathers while others donned porcupine-needle headdresses Streamers hung from sleeves and pants. Some outfits jingled.

Lonebear narrates the dances for the Wind River Dancers, made up mostly of Eastern Shoshone and Northern Arapaho tribe members.

They performed traditional American Indian dances for a packed lobby at the hospital Friday afternoon.

Spoonhunter danced the women's jingle dress dance with another woman. Many rolled chewing tobacco can lids hung from their skirts and jingled at the slightest movements. Each woman held a feathered fan.

Some of the dances symbolized animals and others nature. One dance described a warrior's battle while another a medicine man's dream.

Children as young as 2 participated in the dancing. The dance group travels all over the country performing.

The dancers helped the hospital raise awareness among its staff about the variety of cultures it serves every day, including the American Indians.

Improving cultural competency is one of the hospital's strategic goals, said clinical nurse specialist Sandra Conklin.

"Culture is not something we talk about all the time," Conklin said. "When we are sick, our customs and heritage come out."

For a patient to get better, the hospital must recognize a person's heritage and history, she said.

About two years ago, the hospital began its cultural competency program by celebrating the four federally recognized heritage months: Black History Month in February, Asian-Pacific American Heritage Month in May, Native American Heritage Month in November and Hispanic Heritage Month, which includes parts of September and October.

Conklin said the hospital has a tertiary contract with the Wind River Reservation, which enables reservation residents to receive specialized care at the medical center.

When an American Indian patient comes in, Conklin said they have certain practices and beliefs that a staff member must recognize.

Many American Indians burn cedar when someone is sick. They see the wood as having healing properties. The hospital allows patients to burn this in their rooms, the chapel or outside.

Performer Harmony Spoonhunter said it is good that the hospital is beginning to recognize cedar burning and the spirituality of the American Indians.

Staff must be aware of medicine bundles, necklaces made by medicine men containing natural substances. Staff have been told that these necklaces must stay with the patient if possible.

Hair is sacred to American Indians, Conklin said. If an American Indian has neurosurgery and it must be cut, staff will save it and return it to the patient. The staff has also been trained how to approach American Indians about organ donation.

Conklin said a group of nurses visited the Wind River Reservation and spoke with a medicine man about some of these practices and beliefs.

"It's a better experience for our Wind River patients," Conklin said.

Spoonhunter agreed. She works for Indian Health Services on the reservation.

"A lot of tribal members come to Casper to receive services," Spoonhunter said. "It's good they are increasing awareness and taking that step to try to understand."

Spoonhunter spoke to the crowd about the story of Sacajawea, best known for accompanying Meriwether Lewis and William Clark on their explorations of the western United States.

"My grandfather used to tell us stories of Sacajawea when we were growing up," Spoonhunter told the group.

She also said her grandfather showed her pictures of Sacajawea and family trees that included the Shoshone Indian. Spoonhunter said she is a direct descendant of Sacajawea.

A sculpture of Sacajawea made by Casper resident Rose Cash was presented at the ceremony. Funds from the Wyoming Medical Center Foundation were used to purchase the sculpture from Cash and to be displayed in the hospital.

"I don't have the dark brown eyes or the dark brown skin," Cash said. "But it is in my heart."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.