The Environment Of Nursing Practice

. Addressing health inequalities and health care is not only important from the point of view of social justice, but also to improving the health of all Americans by improving the quality of care and health of their children. People. Moreover, the difference in health is expensive. An analysis estimates that about 30% of total direct medical expenses for blacks, Hispanics and Asians are excessive costs due to inequalities in health. The difference also leads to economic losses due to indirect costs related to loss of productivity and premature mortality. (Artiga,

Although most American citizens today associate racial and ethnic disparities in public health care quality with socioeconomic status, a majority of studies performed conclude that these discrepancies are still highly prevalent when the factor of one’s socioeconomic status is taken out of the equation. Health disparities for a certain minority result in a higher number of illness, injury, and even mortality for that race or ethnicity in comparison to white Americans; therefore, health care disparities can be defined as differences between groups in health coverage, specifically focusing on both the quality and access to care. The Office of Management and Budget has created two ethnic categories for all American citizens to fit into, being either

Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an

Although the United States is a leader in healthcare innovation and spends more money on health care than any other industrialized nation, not all people in the United State benefit equally from this progress as a health care disparity exists between racial and ethnic minorities and white Americans. Health care disparity is defined as “a particular type of health difference that is closely linked with social or economic disadvantage…adversely affecting groups of people who have systematically experienced greater social and/or economic obstacles to health and/or clean environment based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion” (National Partnership for Action to End Health Disparities [NPAEHD], 2011, p. 3). Overwhelming evidence shows that racial and ethnic minorities receive inferior quality health care compared to white Americans, and multiple factors contribute to these disparities, including geography, lack of access to adequate health coverage, communication difficulties between patients and providers, cultural barriers, and lack of access to providers (American College of Physicians,

In today’s society, there is still a great struggle with health care disparities and many lives are affected by the lack of this fundamental program in our society. There are millions of people who die each year because they are unable to afford quality healthcare. The debate still continues about healthcare inequalities, what causes this disparity and who are affected by it. Health care is more of a necessity rather than a luxury and even though skeptics may argue to the latter, it only underlines the importance of the need for the wellbeing and care of individuals. There are several factors that could contribute to the lack of health care in the United States which ranges from but not limited to race, gender, socio- economic status, and lack of insurance coverage. The truth is there is a great disproportion between who can really afford quality healthcare as appose to individuals who have it. One would imagine that an employed individual would easily afford quality healthcare but we could be no further from the truth, since one’s economic status is an essential determinant to its affordability.

The U.S. healthcare has been dealing with disparities for centuries. These disparities can be racial, social, or economical. The disparities are easier to see when compared to other reference points, such as policies, procedure or protocol. Williams & Torrens, 2008 list several disparities when it comes to patient care, such as minorities are less likely to get diagnosed with cancer verses whites, patients with lower socioeconomic statuses are less likely to received diabetic services, and many more. In order to eliminate some there disparities it must first be recognized by others that it is a serious problem. These problems have been around for years; therefore the public must put pressure on the policymakers to promote change. In order

Diversity within the United States has been growing progressively within the past century. About 36 percent of the U.S. population is a part of a minority group, according to the 2010 U.S. Census (CDC, 2017). According to the U.S. Census, a “majority-minority” country is projected by the middle of 21st century, resulting in the white population becoming less than 50% of the population (Elchoufani, 2018). Overall, the life expectancy and child mortality in the U.S. has bettered; however, the minority undergo unequal distribution of illness, disease, disability, and death in comparison to non-minority (CDC, 2017). According to the U.S. Department of Health and Human Services (HHS), even with all the attempts help diminish health care disparities for minorities, the minorities continue to face these unequal disparities (BLH, 2015).

For decades, a person’s socioeconomic status or SES has affected the healthcare that people receive due to race and “wealth”. This problem has plagued American society because of these factors leading to many receiving inadequate healthcare. All of these factors for someone’s SES has changed a lot in the healthcare domain that is unfair to many who are not the “ideal”. Due to this the perception, experiences with healthcare waver and are different between the stages of these SES’s. No matter the status of a person they should receive the same amount of care, treatment, and closer.

The Common Wealth Fund is an organization that encompasses studies on racial and ethnic health disparities amongst blacks, Hispanics, Native Americans, Asians and other ethnic minorities. The main results from the research are that adequate and intensive health care is not as predominant in these ethnic groups as it is for white individuals. Moreover, these conclusions are independent of the patient’s age, income, level of education and insurance membership. In order to pinpoint the upstream causes of these disparities, researchers have examined other factors that may contribute to the quality of treatment, such as the patient-provider relationship and perceptions of Medicaid managed care. The Asian American community is a subject group that has recently gained attention from the scientific community as their experiences in the healthcare setting have not been documented, despite being “one of the fastest-growing ethnic groups” in the United States.

In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary

Access to quality healthcare has a direct correlation to an individual’s economic, social, and physical environment. However, within the United States, it is an individual’s social status that plays the biggest role in their lives as a patient. Some social determinants such as education level, employment, racial group, and type of the family play crucial role in the health of the patient. The difference in social status contributes to a huge disparity in access to quality healthcare services in the USA and the world at large. Patients with strong positive social status such as being white, have a high level of education and are well-off have an increased chance of accessing quality healthcare.

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

Ethical principals are the seed of which nursing flourishes from. Many ethical principals were involved and dishonored in this case such as, justice, autonomy, beneficence, non-maleficence, confidentiality and fidelity (Burkhardt et al., 2014). I believe justice was the main principal involved as the entire ethical predicament was revolved around unjust behavior and treatment of the residents. The residents were treated poorly and given unequal rights as a causation of their illnesses. Autonomy, an essential piece of human rights was also being violated in this ethical dilemma. The residents did not have any choice or independence in their care or how they were being treated. Beneficence and non-maleficence are significant dynamics of this ethical situation, as the health care providers needed to reflect on how they can have the maximum benefit while diminishing possible damage to the residents (Burkhardt et al., 2014). Our actions as nurses should always be beneficent and non maleficent, continuously being kind, compassionate and doing what is in their best interest as well a removing and preventing harm. Confidentiality is a key component of nursing and it was blatantly being violated as the health care

Changes in access to health care across different populations are the chief reason for current disparities in health care provision. These changes occur for several reasons, and some of the main factors that contribute to the problem in the United States are: Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance coverage in comparison with people who can afford healthcare insurance. The majority of these individuals are likely to put off health care or go without the necessary healthcare and medication that is needed. Lack of financial resources – Lack of accessibility to funding is a barrier to health care for a lot of people living in the United States

Nursing, in my view, has always been a field in which moral courage was inherent. Nursing is one of the few fields in which individuals disregard their own personal wellbeing in favor of other people’s health. Moral courage is an elusive topic to define, as it is such an intangible concept. According to Murray, “moral courage is considered to be the pinnacle of ethical behavior; it requires a steadfast commitment to fundamental ethical principles despite potential risks, such as threats to reputation, shame, emotional anxiety, isolation from colleagues, retaliation, and loss of employment (2010.) To exemplify this issue, Murray continued to give an example of moral courage with a novice nurse named Emily.