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Working With Vulnerable Populations as a Nurse Practitioner

Working With Vulnerable Populations as a Nurse Practitioner

Nurses stand at the forefront of providing care to vulnerable populations and addressing the repercussions of healthcare disparities. This places them in a distinct and essential position as advocates for the well-being of their patients.

The COVID-19 pandemic has underscored the long-standing healthcare inequities in the United States. Under-served populations faced higher mortality rates due to factors like inadequate working conditions, language barriers, and limited healthcare access.

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Vulnerable groups contend with health issues, escalating expenses, and barriers to timely care. These challenges exacerbate their understanding of diagnoses, treatment, and susceptibility to deteriorating health and communicable diseases.

The initial step involves identifying the various vulnerable populations that nurses, particularly nurse practitioners (NPs), encounter in their work settings or communities. Subsequently, this article elaborates on the roles NPs undertake while caring for vulnerable patients, outlining their specific responsibilities within their scope of practice.

Recognizing Vulnerable Populations

Certain populations are rendered vulnerable due to historical, socioeconomic, and medical biases, thereby impacting their engagement with the healthcare system. In the past, and in some cases even today, healthcare for under-served populations has been profoundly deficient.

Instances from the past, like the institutionalization of children with Down’s Syndrome and the involuntary hospitalization of people with mental health conditions, highlight the abysmal conditions they endured. Such patients were subjected to neglect, subpar living conditions, and harmful “treatments.”

While contemporary care is more humane, it raises concerns about the future’s judgment of present-day practices. Vulnerable groups are susceptible to healthcare inequities based on cultural, gender, racial, ethnic, health, and economic characteristics. Nursing inherently involves caring for these populations and empowers nurses to shape policies using their patient care expertise, wellness knowledge, and cost-effective solutions.

Five social determinants of health significantly influence an individual’s well-being and quality of life:

1. Economic stability
2. Healthcare access and quality
3. Social community
4. Neighborhood and environment
5. Education access and quality

These determinants stem from factors like environmental pollution, discrimination, language barriers, and food accessibility. While promoting healthy lifestyles is pivotal, it remains insufficient for vulnerable populations lacking access. These populations include but aren’t restricted to:

– Racial and ethnic minorities
– Economically disadvantaged individuals
– Uninsured or underinsured individuals
– Those with chronic health conditions (e.g., HIV, mental health conditions, obesity)
– Children and youth
– Elderly individuals
– Homeless individuals
– Disabled individuals
– Rural residents with limited access to care
– LGBTQ+ community
– Immigrants
– Prisoners
– Victims of sex trafficking and human trafficking
– Specific religious or cultural groups
– Patients with conditions deemed “incompatible with life” and their families

Interestingly, physicians also sometimes fall within these vulnerable groups. Despite having greater access to resources like education and finances, some doctors lack their own healthcare providers, rendering them susceptible to health issues and burnout.

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The AMA code of ethics discourages physicians from treating themselves or family members, yet many doctors don’t have their own physicians. This emphasizes the importance of ensuring healthcare access even for healthcare providers themselves.

Nurse practitioners have the power to influence their fellow healthcare providers, including physicians. By setting an example, NPs can encourage colleagues to prioritize their own healthcare needs.

The Role of Nurse Practitioners in Caring for Vulnerable Populations

Nurses and nurse practitioners are akin to first responders. While not facing the same physical hazards as police officers or firefighters, they respond promptly to healthcare needs. There are times, however, when advocating for vulnerable rights places nurses in conflict with societal norms.

A notable incident involved a nurse in Utah who faced handcuffing for refusing to draw blood from an unconscious patient without proper authorization. This incident underscores the importance of advocating for vulnerable patients. NPs hold a unique position to detect vulnerabilities, devise innovative interventions, and champion quality care both within patient interactions and legislative advocacy.

This is just the beginning of how NPs can protect their patient populations. Some specific strategies include:

1. Raising awareness: NPs can leverage their influence to raise awareness about vulnerable populations’ needs, driving change by engaging in public health initiatives alongside their clinical roles.

2. Educating: NPs are natural educators. Utilizing this skill, they can educate the medical establishment and society about the humanity and requirements of vulnerable populations, fostering understanding and empathy.

3. Advocating: NPs can advocate for patients’ healthcare needs with insurance companies, Medicaid, and serve on advocacy boards addressing underserved populations’ needs in schools, healthcare institutions, and communities.

4. Improving healthcare access: NPs can volunteer at community clinics, advocate for expanded patient populations within their practice, and engage in legislative efforts to enhance access for marginalized groups.

5. Enforcing ethical standards: Upholding the ethical principles of nursing care is vital, ensuring unbiased assessment and care provision regardless of patients’ backgrounds.

In Conclusion

The complexities of healthcare for vulnerable populations intersect with societal and economic factors. Nurse practitioners hold a crucial and distinct role in advocating for increased healthcare access, educating legislators with the power to enact change, and implementing systems that safeguard these populations.

Nonetheless, nurses often face overwork, low pay, and exploitation in the healthcare domain. Despite being ranked as the most trusted profession for two decades, nurses frequently lack the resources to sustain their high standard of care.

Healthcare systems must recognize the evolving roles and responsibilities of nurses and provide robust support systems. Addressing burnout, ensuring competitive salaries, and fostering professional growth contribute to enhanced patient care, community recognition, and elevated patient satisfaction.

By prioritizing the well-being of nursing staff, healthcare systems can achieve multifaceted benefits, including better patient care and operational success.

In the words of Mahatma Gandhi, “The true measure of any society can be found in how it treats its most vulnerable members.” Enhancing healthcare access for vulnerable populations propels society toward a more promising future.

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