Richie Richards remembers gathering with 20 of his relatives to visit their dying cousin in 2016.
The group helped Joseph Marshal stand up next to his bed at the Regional Health hospice before moving burning sage over his body and passing it around to the entire group.
Being able to smudge "meant the world for us" because it helped Marshal on his way to the next world while also comforting the relatives, the Rapid City journalist said.
Medical staff, patients and family members like Richards all say that smudging is a meaningful and beneficial ritual for Native Americans at local hospitals.
People at Regional Health facilities have been smudging — burning sage or other plants to physically, spiritually and emotionally purify people and spaces — nearly every day since 2006 or 2007, when Regional Health created a cultural policy, said patient advocate Shary Haag.
"Smudging is a huge part of Native American culture due to their strong religious belief," and 33 percent of our Rapid City patients are indigenous, said Haag. "It’s a purification ritual and cleanses negative energy, it heals, blesses, creates balance, purity and calmness. Patients smudge their amputations and areas of pain and illness to cleanse and heal."
Richards said that he and his family were so overwhelmed when they visited the hospice that they didn't even think about whether they were allowed to smudge.
"The staff themselves were the ones who opened up the offer, and that was nice for us," the 44-year-old said.
Richards returned to the hospice facility this summer to visit his brother Crayton White Eyes. He smudged his brother three times the week before he died from cancer, and then again one he passed away.
Most patients at Regional Health like to smudge in their room, but they can also do it in the hospital's non-denominational chapel, said nurse Marcia Taylor. They'll also soon be able to smudge in a new circular spiritual room.
All patients have to do is tell their nurse they'd like to smudge and the nurse works with the hospital coordinator and plant operations to turn off the local smoke detectors.
In rooms with "smart" smoke detectors, the device can be programmed to shut down and automatically turn back on after a certain amount of time, said hospital spokesman Dan Daly. In rooms without smart smoke detectors, staff cover up the detector or call the alert monitoring company to tell them to temporarily ignore any alarm.
If patients don't have their own materials, they're provided with a "smudge kit" with sage, sweet grass, cedar and an abalone shell, Haag said.
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"It's really something that can be done anywhere," including in the intensive care unit, Taylor said. "It's really a time of mediation and prayer, which in itself calms the body."
Taylor and Haag said patients have never complained or became sick from smudging. There's not much smoke and most of it stays within the abalone shell, Taylor said.
Patients who don't wan to burn sage can instead rub and smell the plants in their hands.
Smudging is also allowed at VA facilities in the Black Hills and Indian Health Service facilities across the state. The spokesman for the Oyate Health Center did not return a request for comment.
Procedures differ depending on specific facility designs, said IHS spokesman Joshua Barnett. He said some locations require patients to use a spiritual room while others allow the ceremony to be conducted anywhere.
Patients who want to smudge at their bedside coordinate the ceremony with a chaplain and the VA Fire Department will temporarily deactivate smoke detectors in the area, said spokeswoman Teresa Forbes.
Daniel Bear Runner, a Navy veteran who served in Iraq, stayed at the Regional Health Hospital and at the VA in Fort Meade when he developed sepsis a few years ago.
Bear Runner, a 51-year-old from Rockyford, brought spiritual leaders to Regional Health to conduct a smudging ceremony due to his "pretty serious" diagnosis.
"It was very instrumental in helping me to understand that everything was going to be OK," he said.
Bear Runner was later transferred to the VA and was happy when nurses reached out and asked if he wanted to do any smudging, which he chose to do outside the hospital.
Wayne Weston said it was "very comforting" to be able to burn sage over his nephew, who died at the Rapid City intensive care unit three years ago.
The 60-year-old from Rapid City said a nurse temporarily turned off his nephew's oxygen as they purified him "to make his journey into the spirit world."
Weston, who works at the University of South Dakota Center for Disabilities and conducts diversity and disability trainings, said there needs to be more education about the purpose of smudging so there aren't misunderstandings.
He said hospitals allowing smudging is a form of education since it mans all staff and many visitors learn about it.
— Contact Arielle Zionts at email@example.com.