DISCUSSION REPLIES
Reply to at least two of your classmates that answered different questions than you did. The replies should be well thought out with strong paragraph development (minimum of five to six sentences each), citations, and APA formatting.
In your reply posts, compare and contrast your vulnerable community’s characteristics or conditions, or even your own bias, with those of your peers in relationship to the question your peer answered.
ARTICLE #! CK
Vulnerability as a concept can be applied to an individual or a group. Vulnerability is understood as susceptibility to risk of harm at any given time compared to others (De Chesnay, 2020). An underlying theme of vulnerability is the power of wealth and how it is interrelated to health. In the healthcare setting, vulnerability applies to individuals or groups at a higher risk of developing complications with their health.
Theorist Lu Ann Aday advocated that the concept of healthcare for vulnerable populations is heavily influenced by cost, quality, and access to care (De Chesnay, 2020). A qualitative study examined healthcare providers’ concerns about access to healthcare, which showed multidimensional themes of barriers to care (Coombs et al., 2022). Key themes focused on inadequate access to care for rural-specific communities due to a lack of providers to meet the population’s needs (Coombs et al., 2022). As an APRN, knowledge of barriers to care is an essential level to evaluating vulnerability. I have seen this in the community in which I grew up, where primary care doctors are stretched thin to meet the demands of the rural community. The lack of resources has led to increased costs, as 360 MedFlights occur each year from our community to provide the quality of care patients need.
Additional concepts of vulnerability within healthcare are described by author Juliann Sebastian, emphasizing the role of marginalization (De Chesnay, 2020). When caring for marginalized patients, enhanced cultural competence needs to be taken to understand the unique set of circumstances the patient is living under. Marginalized populations may have limited resources, often choosing between paying for food or medicine, which they will likely choose food (Madden et al., 2020). APRNs have the ability to address these life challenges their patients face, providing a space for engagement and understanding (Madden et al., 2020). To assist patients, APRNs may offer extended clinic hours or drop-in visits to allow patients a chance to meet outside of their scheduled work hours.
Similarly, author Jacquelyn Flaskerud highlighted access to resources as a key factor of socioeconomic and environmental vulnerability. There is evidence to support that socioeconomic status is correlated with healthcare disparities, such as quality of care, mortality rates, wait times to be seen by a provider, and proximity of care centers (Ohlson, 2020). In particular, low socioeconomic status has been shown to inhibit one’s health outcomes (Ohlson, 2020). Providing access to affordable, quality healthcare within a community center for vulnerable populations allows the APRN to change the narrative.
ARTICLE #2 JT
Vulnerable populations are those who are susceptible to adverse health outcomes due to several factors. Some of these factors include lower socioeconomic status and marginalized cultural status which contributes to limited healthcare access (De Chesnay & Anderson, 2020). The vulnerable population in my community I chose for this assignment is the immigrant families whom I serve in Massachusetts. Immigrant families are considered a vulnerable population as they are far more likely to live in high-poverty neighborhoods, have fewer resources than their white counterparts, are subject to discrimination, stigma, intolerance and subordination, and are frequently denied their human rights (Murdaugh, Parsons, & Pender, 2019).
Once a week I manage a state funded Vaccines For Children (VFC) clinic in the town where I work as a Public Health Nurse. It is through this clinic that I have met many non-English speaking families. These immigrant families are largely from Brazil, but also include families from Mexico, Guatemala, Uganda, and the Ukraine. Personally, I have witnessed this population portray several of the above-mentioned characteristics that make them vulnerable. More than 50 per cent of the families I see in my clinic do not have health insurance, many are working minimum wage jobs or cannot work because the skills and education they received from their home countries do not transfer well to the United States, and several children/adolescents have admitted to experiencing discrimination within the school system where they attend.
When working with a population such as this, Advanced Practice Registered Nurses have a responsibility to exhibit behaviors that are respectful and culturally competent. APRNs can do this is by becoming an advocate for their vulnerable communities. One way I strive to achieve this advocacy for my immigrant families is through providing education on the importance of vaccines, answering their questions, listening to their concerns, and providing the education and materials in their own language. In a recent study I reviewed, nursing challenges identified in providing care to diverse patients revealed that “as expected, communicating effectively and gaining patients’ trust were difficult when nurses did not speak the patients’ language” (Cerveny et al., 2022). Before seeing each child, I ensure that interpretation services are available by collaborating with a regional community health worker who is trilingual in English, Portuguese and Spanish. In the event that additional language interpretation is needed, I use a state funded language interpretation service to effectively communicate. In addition, APRNs can be proactive by taking language classes themselves. Currently, I am learning Portuguese and Spanish to help these families feel more at ease during their appointments and although I am far from fluent, it shows them the effort is there, hopefully helping gain their trust.
Other ways I can show respect through cultural competence is through taking a self-assessment (like the one we did this week in class) to assess my own cultural knowledge, as well as exposing any biases or cultural prejudice I have. Additionally, it encourages healthcare providers to further acquire specific knowledge about the population served. This education can also encourage APRNs to adapt to the diversity and cultural contexts surrounding them, instead of expecting families to adapt to theirs (Harkness & DeMarco, 2016). This is easier said than done, as many nurses, myself included, are not aware of their own unintentional negative and micro-racist attitudes towards specific groups of people (Cerveny et al., 2022).
Lastly, one of the most significant behaviors APRNs can adopt to show respect and provide culturally competent care is the ability to empower communities to bring about change for themselves. This can be done by working to help these families become more involved in neighborhood programs, volunteering on school boards, lobbying for policies that bring them better access to healthcare, transportation services, and work opportunities, and advocating for other needed resources, like food and clothing (Murdaugh, Parsons, & Pender, 2019).
