Article Nursing Code Of Ethics (Part 2)

The dilemma for communities, however is that the taxes are typically paid to federal government, whereas the services the immigrants use are paid for by the states and localities. Although federal matching funds for medical are not available to the states for immigrants, some states have decided to use their own funds to cover pregnant women, the disabled, and older adults (Lillie-Blanton and Hudman, 2001). This state have found compelling public health reason to provide some care to high-risk immigran populations.

In addition to financial constraints on the provision of health care for immigrants, others serious factors such as the following examples need to be considered :
·         Language barriers
·         Differences in social, religious, and cultural background between the immigrant and the health care provider
·         Providers” lack of knowledge about high risk diseases in the specific immigrant groups for whom they care
·         The fact that many immigrants rely on traditional healing or folk health care practices that may be unfamiliar to their U.S health care providers.

When working with immigrant populations, nurses should take into account that their own background, beliefs, and knowledge may be significantly different from those of the people receiving they care. Language barriers may interfere with efforts to provide assistance. Community members may be excellent resources as translators. Not only of the actual words but also of the cultural beliefs, expectations, and use of nontraditional health practices.

Nurses need to know if there are specific risk factor for a given immigrant population. For example, Southeast Asians are often at risk for hepatitis B (with its attendant effects on the liver), tuberculosis, intestinal parasites, and visual, hearing, and dental problems. Most of this conditions, are either preventable or treatable if manage correctly (Riedel, 1998).

Nurse need to understand the nontraditional healing practices that their clients use. Many of these treatments have proved effective and can be blended with traditional western medicine. The key is to know wwhat practices are being used so the blending can be knowledgeable done. Community members are excellent sources of this information, and nurses working with immigrant populations should use the community assessment, group work, and family techniques described in other chapter.

Often children and adolescents adjust to the new culture more easily than their elders do. This can lead to family conflict and, at times, violence. Be alert for warning signs of family stress and tension. On the other hand, family members can help translate their culture, religion, beliefs, practices, support systems, and risk factors for the health care provider. They also can assist with decision making and provide support to enable the person or group seeking care to change behaviors to become more health conscious. Nurse need to understand the role of the family in immigrant populations and to treat individuals in the context of the families from which the immigrants come.

Similarly,  the role of the community in the care of immigrants is important. Communicaties can help patients (and these providers) with communication, explanation, crisis intervention, emotional and other forms of support, and housing. Nurses need to carefully assess the community and learn what strengths, resources, and talents are available.

Horowitz (1998) has identified the following six steps that clinicians can take to more effectively work with immigrant populations :
1.       Know your self : providers, like clients, are influenced by culture, values, language.
2.       Get to know the families and their health seeking behaviors. You try using a simple genogram, which places family members on diagram. Ask who the family members are, where they live, and who is missing or dead. You might also ask them to talk about holidays: who comes, who is missing, what do they do?
3.       Get to know communities common to your setting: read about them, take a course, get involved (e.d, volunteer to give talks), hold forums with free-flowing and two-way communication, learn who the formal and informal resources are.
4.       Get to know some of the traditional practices and remedies used by families and communities so you can work with, not against, them.
5.       Learn how community deals with common illnesses or events.
6.       Try to see things from the viewpoint of the patient family, or community.

Special note should be made about refugees. Unlike many of the immigrants, refugees may have left their homes as a result of a disaster and this might have lead to physical or psychological consequences. Some may have been tortured; other may have lost family members in horrible ways. Still other may have lived in camps and lost all or most of their personal possessions. Some will have come from poor countries. And much of American culture will be alien to them. Sensitivity on the part of the nurse is essential as well as skill in finding resources to both help understand them and their needs an than meet those needs (Plumb, 2003)

BRIEFLY NOTED

Definition for immigrant differ, and immigrants may be legal or illegal. They come from all parts of the world and bring with them unique cultural. Health care, and religious backgrounds.
·         Access to health care may be limited because of immigrants lack of benefits, resources, language ability, and transportation.
·         Nurse need to be astute in considering the cultural backgrounds of their immigrant clients and populations.