NUR 513 Identify a population that you will likely serve as an advanced registered nurse that you think is particularly vulnerable to issues of health disparity/inequity

NUR 513 Identify a population that you will likely serve as an advanced registered nurse that you think is particularly vulnerable to issues of health disparity/inequity

As a nurse educator, I will most likely be pursuing an instructor position for nursing students. Students can be particularly vulnerable to health disparities and/or inequities. Nursing school is no easy task, and the teaching about selfcare and daily health habits must be incorporated into the curriculum for optimal performance within the classroom and clinical settings. Facilitating learning in a healthy environment can help set up the nursing student with a positive vantage point to pursue high quality patient care.

The nurse educator helps encourage and lead nursing students through their rigorous journey of learning the art of nursing.  As a team, the nurse educator and student care for patients in many different areas of nursing specialties. Exposure to a multitude of health disparities and/or inequities has a significant impact on the nursing student’s perception and recognition of the community’s wellbeing and unique needs. These experiences may help the students critically think about what their individual journey and specific passions as a nurse will develop into.

Homelessness is one of the main inequities I have witnessed throughout my journey as nurse. It is crucial for the nurse educator to cultivate respect and consideration for health disparities within the nursing students’ clinical experiences. Addressing underlying causes of the circumstances and providing therapeutic touch and communication can create as sense of hope and renewed perseverance within this displaced population. Creating a focus surrounding the different resources and solutions to help with the situation can initiate positive change and create opportunities of progress towards prosperity (Flaubert, 2021).

The majority of the homeless population has often times experienced problems with mental illness, trauma, substance abuse, and impoverished living.  The nature of society and the social policies that influence levels of household income classes lead to harmful stigmas and roadblocks associated with decreased chances of success and achievements for the underdog. Strengthening policy development and supporting community outreach initiatives can help with this severely underserved community (Institute of Global Homelessness, 2019).

Flaubert J.L., Le Menestrel S., Williams D.R., (2021). The Role of Nurses in Improving Health Equity. National Academies of Sciences, Engineering, and Medicine; Washington (DC): National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573898/

Institute of Global Homelessness. (2019). https://ighomelessness.org/about-us/ 

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, I could not agree more when you stated that the “majority of the homeless population has often times experienced problems with mental illness, trauma, substance abuse, and impoverished living.” The reason I think it is so important that this is highlighted at the introductory level of nursing school is that it is critical for nursing students to understand that the patient did not become like this overnight. In my experience with working in women and family homeless shelters, I have observed that much of what a person experiences has evolved as early as childhood. So often homeless people are judged by the outward and labeled as such instead of viewed as human beings which have deep pain and needs which outreach the physical. Someone once said the following statement to me which I never forgot, ‘No one starts out from childhood hoping they will grow up and become homeless, an addict, alcoholic, or losing their children to the state.” This statement helped shape how I viewed people in the field of nursing. No one sets out to destroy their body, however, when homelessness or addictions takeover, they destroy the individual from the inside out. It important that the nurse educator help the student see this truth. What I found as an eye opener, but not surprising is that women rank higher in percentage of homelessness than men. Women are at a disadvantage as compared to men, due to a combination of factors including childbearing, shattered family support, childcare obligations, wage differences, and job discrimination as compared to men (DeNisco & Barker, 2019).

Reference

DeNisco, S. M., & Barker, A. M. (Eds.). (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124

Cancer is a disease that is no respecter of persons. Every gender, race and financial status is affected by cancer, but certain groups are more affected than others. One example is African American women and breast cancer. Triple negative breast cancer (TNBC) is arguably the worst type of breast cancer due to the aggressiveness of the disease and the limited options for successful treatment (American Cancer Society, 2022). African American (AA) women have a higher rate of diagnosis of TNBC and poorer prognosis with worse survival rates than European American women (EA), resulting in AA women having a 65% higher chance of dying from TNBC then EA women (Prakash, 2020). These statistics are both fascinating and saddening. What is the cause of this health disparity in African American women? As an advanced registered nurse, I plan to join the group of researchers and practitioners that are studying the biologic and non-biologic factors that may be contributing to this racial disparity (Prakash, 2020). As with all types of cancer, early detection is key to improving prognosis. The specialty of Public Health nursing is in a strong position to contribute to educating the population on the importance of mammography and self- examination.  

Breast cancer is not the only cancer type that has a higher incidence and poorer prognosis in the African American population. Per the National Cancer Institute (2016), “Blacks/African Americans have higher death rates than all other racial/ethnic groups for many, although not all, cancer types.” There are many theories as to what the contributing factors of cancer disparities in this population are, including but not limited to, environmental, socioeconomic status, education levels, access to quality care and screening, and systemic racism.  

References: 

American Cancer Society. (2022) Triple-negative breast cancer | details, diagnosis, and signs. Retrieved from https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/triple-negative.html 

National Cancer Institute. (2016). Cancer disparities. Retrieved from https://www.cancer.gov/about-cancer/understanding/disparities 

Prakash O, Hossain F, Danos D, Lassak A, Scribner R, Miele L. (2020, December 22). Racial disparities in triple negative breast cancer: A review of the role of biologic and non-biologic factors. Front Public Health. https://doi.org/10.3389/fpubh.2020.576964

A population I will likely serve as an advanced registered nurse that I think is particularly vulnerable to issues of health disparity/inequity is those with physical and intellectual disabilities. This is a subject that is rather close to my heart as my mother and a couple other of my family members have physical and intellectual disabilities. Examples of these disabilities would be Cerebral Palsy, Spina Bifida, spinal cord injuries, Downs Syndrome, and autism to name a few. Right now, I work in oncology but a way that I can contribute to health promotion and disease prevention for those with physical and intellectual disabilities is taking special consideration when education them about the disease and treatment plan as well as making sure they have access to plenty of resources. Statistics show that anytime an individual with one of these disabilities is admitted to a hospital they do not receive the same level of care as someone without. The Disability Rights California agency has done research that shows people with disabilities are at least for to ten times for likely to be victims of abuse and neglect than people without disabilities (2022).

From a global perspective the United States does not provide the worst or best healthcare for those with disabilities so it could be a lot worse. Something extra special about this population is not only do these individuals have a disability but they could also fall into another category that is underserved depending on their race, economic status, sexuality, or other factors. I found a book titled Communities in Action Pathways to Health Equity and although I did not read it all I read quite a bit of it as it has a lot of good information and perspective. I really encourage everyone to go take a look if you are interested. It discusses that in America health equity and equal opportunity are linked, and the burdens of disease and poor health and the benefits of wellness and good health are inequitably distributed among groups of people (National Academies of Sciences, Engineering, and Medicine, 2017). In one of the chapters, they use the analogy of a fishbowl when describing the relationship between an individual and the conditions in which one lives (National Academies of Sciences, Engineering, and Medicine, 2017). If the bowl is dirty or cracked where the fish live than the fish can never reach full health potential, no matter what effort they put in (National Academies of Sciences, Engineering, and Medicine, 2017). The same with humans that if we only address individual behaviors without considering context, they will never be able to get to their full health potential (National Academies of Sciences, Engineering, and Medicine, 2017). So whenever I take care of a patient with a disability I am not just treating their disability, I am treating them as a whole person.

References

About us disability rights california. (2022). Disability Rights California. https://www.disabilityrightsca.org/about-us

National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action pathways to health equity. National Academies Press. https://nap.nationalacademies.org/read/24624/chapter/1

Health disparities in the United States have been extensively documented. Healthy disparities emerge because of social, economic and environmental disadvantages. To the end, the African Americans form part of the disadvantaged groups, and they are vulnerable in the aspect of health disparity. Studies show that many African Americans do not have health insurance, have challenges in accessing healthcare services and are more affected by certain health conditions as compared to other groups such as the whites (Bell et al., 2020). Thus, the population that I will serve as an advanced registered nurse are the African Americans. The role that will be played in this population as a family nurse practitioner.

The population health of the country will greatly benefit if underserved persons have efficient and affordable access to primary care. Family nurse practitioners (FNPs) may be particularly important in providing people who need it most with high-quality primary care and health education. The FNP role is vast, but it also fits well with the new healthcare requirements for underprivileged populations (Ortiz et al., 2018). FNPs are prepared to provide primary care, make diagnoses, and write prescriptions for drugs as advanced practice registered nurses (APRNs). Additionally, they might be given full practice power by state law, which would allow them to operate independently without direct medical supervision. Together, a FNP’s clinical skills and the expansion of their complete practice authority are effective instruments for getting the primary care services that underserved populations require.

Furthermore, healthcare disparities have causative effects on diversity and global care perspectives. Diversity has an important role to play in the realization of health equity because of the increase in minority groups (Zhang et al., 2019). Statistics show that many groups in the society will be minorities with the African Americans being a major part of that. This therefore calls for an increase in diversity among the healthcare providers to address the issue of inequality. Moreover, the global health perspective demands that there be an increase in diversity among the healthcare providers to ensure that the diverse healthcare population can access care services without any form of prejudice. The existence of diversity and global perspectives is therefore important because it influences the development of cultural competence among healthcare providers, and this improves equity for the different minority groups such as the African Americans.

References

Bell, C. N., Sacks, T. K., Thomas Tobin, C. S., & Thorpe, R. J. (2020). Racial non-equivalence of socioeconomic status and self-rated health among African Americans and whites. SSM – Population Health, 10, 100561. https://doi.org/10.1016/j.ssmph.2020.100561

Ortiz, J., Hofler, R., Bushy, A., Lin, Y.-ling, Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare, 6(2), 65. https://doi.org/10.3390/healthcare6020065

Zhang, H., De, T., Zhong, Y., & Perera, M. A. (2019). The advantages and challenges of diversity in pharmacogenomics: Can minority populations bring us closer to implementation? Clinical Pharmacology & Therapeutics, 106(2), 338–349. https://doi.org/10.1002/cpt.1491