Please answer each part separately with 2 citations each. Answer the discussion post then do to peer responses. Each section should be at least one paragraph. Below are the 2 peers to respond to.
This week’s discussion provides an opportunity for you to reflect on what you have learned in this class as it applies to global health nursing and your professional goals.
Personal Reflections
Initial Post:
Part 1: Write a paragraph discussing professional collaboration in the promotion of healthy communities. What strikes you about the value of multidisciplinary collaboration and global participation in health care? Should one professional group be “in charge?” If so, which one and why do you think so? If not, how does one design a model where the talents and expertise of all are used in a coordinated and collaborative manner? Use at least one article from the NLN reading to support your position.
Part 2: Talk about two things in this class that had the most impact and why. Has your perspective on nursing’s role as a global health care provider changed? How might this influence your role as a nursing educator?
Response Posts: Provide a relevant response to at least two of your peers. Do you agree or disagree with his or her conclusions about multidisciplinary health care? Discussing any potential challenges to the implementation of a global health project based on their recommendation. How might you overcome these challenges?
1. Christian
PART 1:
Is one discipline uniquely qualified to lead over another with regards to global health?
In order to answer this question, you first have to define “global health”. The National League for Nursing (NLN) defines global health as “an area [of] … practice that places a priority on improving health … for all people worldwide … involving many disciplines within and beyond the health sciences … [that includes] population based prevention with individual-level clinical care [emphasis added]” (NLN, 2017, p. 3 as cited in Koplan et al., 2009, p. 1995).
The next question is: what positions are actually considered part of global health? Jacobsen does a great job at describing the actual process of how foreign aid makes its way to its intended recipients. First you have a donor (usually a rich country or foundation) that provides the funding/aid to an international organization (eg. UN), INGO (eg. Oxfam) or government agency (eg. USAID) (Jacobsen, 2022). This organization or agency is referred to as a first-level recipient (essentially a middle man) (Jacobsen, 2022). The first-level recipient then channels the money to various smaller organizations (such as NGOs or private sector contractors), termed second-level recipients (Jacobsen, 2022). The second-level recipients usually have a presence in the region to be served; they are the ones that actually use the money to purchase needed supplies (medicines, food, water, vaccines, etc.) and employ the staff needed to provide or administer those supplies (nurses, doctors, construction workers, etc.) (Jacobsen, 2022). Arguably, any person involved in this process, from those working for first-level recipient organizations to those working for second-level recipients, as well as those actually providing direct patient care, can be considered global health sector employees.
With this information, I would argue that, whether one discipline should lead or not depends on what role they are playing in the global health system. If we are talking about direct patient care, then I do believe doctors or advanced practice providers (APPs) should be in charge, since they have the requisite education and training to diagnose conditions and order treatment. RNs, as we all know, are the ones that follow those orders and do the actual physical work (assuming the order seems reasonable and the doctor is not totally incompetent). However, if we are talking about someone working for a first or second-level recipient organization that uses their contacts and know-how to direct the money or purchase needed supplies, then that position can be performed by anyone who knows this process. That can be either an RN, APP, MD or even someone beyond the health sciences (as the NLN mentions in their definition of global health). Moreover, many of these positions require broad policy decision-making; nurses are uniquely suited for this role because they are the ones on the front-lines who actually “see, hear and know how policy and politics affects patients and communities” (Salvage & White, 2019, p. 148). They should be feeding that knowledge into policy-making” (Salvage & White, 2019, p. 148). In my leadership position I have enacted policies and procedures that have garnered wide praise by nurse colleagues as well as administrators; the primary reason for this is because, as a staff nurse, I was able to see which policies and procedures worked on which didn’t. Our skill set as nurses makes us qualified to hold both microscopic and macroscopic positions in global health.
The global health sector/process is so large and complicated that I agree with the NLN that there should be more in-depth educational opportunities available to people who want to pursue careers in that sector. It’s a mix of health care, politics, business and economics, just to name a few disciplines. One class in an undergraduate or graduate level program is a great introduction to the field, but a separate graduate program focusing just on global health should be available to those that really want to pursue careers in this field.
PART 2:
The two most impactful things I learned in this class are as follows: (1) the abysmal quality of life in certain African countries, most notably the Democratic Republic of the Congo where numerous armed rebel groups slaughter indiscriminately; and (2) how brave some of these health care workers are, especially those working with Doctors Without Borders, to continue operations in these regions despite these conditions. I was already aware of the dangers and struggles faced by many African peoples, but the level of violence some have to deal with on a daily basis is just horrible. As for the health care workers who place themselves in immediate danger to provide direct patient care, I can say these people are true heroes. The term hero has been thrown around a lot lately, many times undeservingly, but a person that puts their life in jeopardy to help another truly deserves that title.
As for whether my perspective of nursing’s role as a global health care provider has changed, I would say it hasn’t because I already knew that nursing played the predominant role in global health. I would argue that nurses play the predominant role in all forms of health care, not just global health. We are the ones that do the actual work, and we are the ones that know the patient the best and see when something goes wrong that needs to be addressed. Not to downplay MDs, but direct care is a nurse’s forte and the people in these nations need direct care more than anything else. However, I don’t think what I’ve learned in this class will really influence my role as an educator simply because I intend to be an ICU, hospital-level educator and not a classroom educator. The focus of my education is teaching nurses how to manage patients on ECMO, Impella, and IABPs, or how to take care of post-op heart surgery patients in a local setting, which doesn’t involve global health. That being said, I thoroughly enjoyed this class and strongly believe that, in order to open your mind, it’s important to learn about the struggles of others in remote regions of the world.
This was a long one. If you made it this far thanks!
Christian
2. Krista
I found my time in this class learning about the country of Burundi to be very interesting. For one, I had never heard of the country up until this point and two I learned the biggest thing we can do as nurses is to educate. I had always known educating our patients was very important. However, learning about this country I have seen just how important it is. This country has made strides in its improvement to better its people however the people are not utilizing these resources. Something as simple as placing an insecticide-infused net over their sleeping child or setting aside time to take their family to a health clinic to receive free vaccinations is not being done. While some of this can be attributed to individual’s mindsets and priorities, with proper education we can inform and realign their thought process to be one of prevention. Koplan et al. (2009) developed an agreed-upon definition of global health that incorporated principles of public health and medicine. Global health refers to:
“…an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global health emphasizes transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population-based prevention with individual-level clinical care, (p.1995).” It is valuable to have professional collaboration in the promotion of healthy communities. These collaborations help government-sponsored and non-government-sponsored organizations to combine their skills and resources to better meet the needs of the community. They can come together to exchange ideas, knowledge, and perspectives. I do not believe that one group should be directly in charge. As the saying goes, “Two heads are better than one.” If we allow one group this power we may not receive the best possible outcome for the people. “Increasing threats of infectious diseases, disasters, poverty, conflicts, and oppression generate migrants, immigrants, and refugees, providing U.S. local communities with many opportunities to care for resettled peoples from around the world. These opportunities require significant changes in health care delivery and the educational preparation of nurses: global becomes local.”(Lenz, B.K., & Warner, S., 2011).
