#1 Ana Maria Miller
J.R. is trying to achieve secondary prevention when she encourages her patient population to attend blood pressure screening events. J.R. serves an urban Chinese patient population that is at high risk for hypertension. Secondary prevention helps treat medical conditions and diseases in the early stages to prevent further complications. Secondary prevention guidelines have been developed that recommend lifestyle changes for ongoing management of cardiovascular risk factors, including a healthier diet (reduction of salt, eating more fruits and vegetables), regular physical activity, medications, and cessation of tobacco use and harmful intake of alcohol (Talevski et al, 2023). Primary prevention aims to prevent disease or illness of individuals at risk of developing it. An example of primary intervention is getting vaccinations as a child to prevent diseases in the future. Another example is for high-risk women in the US, FDA-approved primary prevention strategies include surgical removal of the breasts and/or ovaries and the use of anti-estrogen therapies (Zaluzec, & Sempere, 2024). Tertiary prevention is used for people who have a disease or medical condition already and trying to prevent further complications. An example of this would be a common screening that I perform at work as a registered nurse. Patients who have diabetes mellitus are at risk for diabetic foot ulcers. When diabetic patients come to the hospital with a diabetic foot ulcer, I can educate the patient on managing their ulcer to prevent further complications such as infection or gangrene. I will also perform wound care and offload the foot to help heal the wound. Many of my patients have benefited from this teaching as they were not aware of possible complications such as amputation. It is challenging to educate some diabetic patients as my hospital has many readmissions of non-compliant patients even when education and resources are provided at discharge.
Identify the Different Roles and Responsibilities of the Nurse
The nurse in this case study is responsible for the health and well-being of this patient population. The nurse is responsible for staying up to date on evidence-based research when providing care and educating patients. The nurse still has to provide preventative education on healthcare even though she encounters difficulty educating this patient population as they do not adhere to their treatment regimens because of mistrust of Western medicine. The nurse can try to collaborate with the patients’ traditional healer if they have one for the benefit of the community’s healthcare. The nurse can try to incorporate safe medications into the patient’s treatment plan that do not affect the homeopathic treatments they learned in China as children and the Chinese herbs they prefer to take.
Please discuss the challenges you anticipate facing when fulfilling the various roles of a nurse practitioner. How would you work to improve your weaknesses? Identify your strengths.
The challenges I anticipate facing when fulfilling the various roles of a nurse practitioner are to have my patients comply with the treatment plan prescribed and prevent readmissions. As mentioned, my community hospital has many readmissions, and I am from a small town that is now developing more. Many of the patients at risk for readmission I see at work are people who poorly manage their blood pressure, diabetes, weight, and congestive heart failure (CHF). I hope to help these members of my community with thorough education and a strong emphasis on disease management and lifestyle changes.
Which patient population is most likely to experience health disparities and why?
The patient population that is most likely to experience health disparities is the people who live in poverty. Their home environment may not be safe, and they may not have necessities for life such as shelter, food, and clean water. These patients may present as malnourished and dehydrated. Providing resources for them at discharge is a priority. Their socioeconomic status may prevent them from obtaining healthcare regularly and may present to the healthcare provider with serious health problems. Their living conditions make them more susceptible to communicable diseases and health risk behaviors such as excessive alcohol, tobacco, or drug use. Increased risk for chronic conditions is likely due to factors such as unhealthy eating patterns from cheaper processed foods. The healthcare provider must assess a patient from this population with understanding and compassion to build a trusting relationship so that open communication can be used.
#2 Leslie Perez
L.W. is a nurse practitioner in an urban community. Many of her clients recently immigrated to the United States from various countries. She is challenged by the many different cultures she encounters and the different values and beliefs they hold toward Western medicine.
She is determined to earn her clients’ trust. She does this by providing health care services that are respectful of each client’s health beliefs and practices and cultural needs. She knows she must set aside her own values and beliefs to focus on what is important to her clients in order for them to have successful outcomes.
Give at least two examples of emerging populations in the United States and describe their cultural characteristics that might interfere with their healthcare.
In the United States, there are two emerging populations that providers should become more familiar with, which are refugee, immigrant, and migrant, or RIM, populations and lesbian, gay, bisexual, transgender, and queer, or LGBTQ, populations. These two groups are becoming more prevalent in the United States and both have cultural needs and characteristics that should be considered when attending to their healthcare.
The RIM population struggles with many disparities that interferes with their healthcare. Members of this population come from other countries that may struggle with violence, brutality, and prosecution, leading to fear of the government and thus, fear of seeking out healthcare as it could lead to deportation. This population also struggles with language barriers and financial security, leading to difficulties navigating the system of a foreign country in order to obtain the healthcare they need.
It is important to consider the health issues many patients within the RIM population struggle with. This includes, but is not limited to, communicable diseases such as tuberculosis and hepatitis, anxiety, depression, and post traumatic stress disorder, and diabetes, hypertension, and high cholesterol. These health issues are likely linked to their financial status, the healthcare available in their native country, and the work they are able to do in the United States. In order to bridge the gap and assist this population, providers should ensure patients have access to an interpreter, educational materials in their native language, access to healthcare and community resources to address any disparities related to their finances and housing (Daniels et al., 2022).
The LGBTQ community has always been prevalent, but the visibility of this population has changed drastically as attitudes have shifted to be more accepting. The LGBTQ population has dealt with many health disparities due to discrimination and lack of safe spaces. However, in recent decades, there has been more research done to consider the needs and characteristics of this population in order to provide adequate healthcare to meet their needs. Members of this population often struggle finding healthcare that is unbiased, affirming, and educational in a way that is specific to their needs.
When treating LGBTQ patients, providers must consider the health issues specific to this population. It is important to note that this population is diverse and is comprised of people from all walks of life, therefore, it is key to listen to the patient and get a full understanding of their needs rather than simply putting them into a box based off of their sexual orientation or gender identity. This population struggles with accessing gender affirming care due to laws set in place that will either restrict access or ban it. Additionally, this population tends to live alone and can benefit from support systems within their community. Sexually transmitted diseases, including HIV/AIDs, are also important to consider. Mental health is of utmost importance for this population as many patients struggle with anxiety, depression, and suicidal ideation due to the discrimination they may face. Providers can help this population by offering LGBTQ friendly resources, such as clinics for this population specifically, free and accessible STD testing, and conducting more research. There is a huge gap in what we know about health disparities in the LGBTQ population due to the lack of research within this field (Kuzma et al., 2019).
Identify the different roles and responsibilities of the nurse.
The nurse has many roles and responsibilities including communicating effectively, respecting the patient and their space, fully assessing the patient and their needs, ensuring the patient receives proper care, reducing harm as much as possible, and educating the patient to ensure they are aware about their diagnosis, treatment, and at home care.
Please discuss the challenges you anticipate facing when fulfilling the various roles of a nurse practitioner. How would you work to improve your weaknesses? Identify your strengths.
As a nurse practitioner, the biggest challenge I anticipate facing is diagnosing my patient. I believe this to be a challenge in that I want to ensure I do not overlook something that could lead to harm. I would improve my weakness by consulting with the provider in the event I have any doubts or concerns. I have strong communication skills and I am not afraid to speak up when I feel that something is missing or off.
Which patient population is most likely to experience health disparities and why?
The LGBTQ population is most likely to experience health disparities due to the lack of research we have pertaining to this population. It is also such a wide spectrum which allows for plenty of areas to learn about. Finally, there is still discrimination all around us, including laws banning or preventing affirming care, which deters this population from seeking healthcare as often as they should.
