Part 1: 

Identify a vulnerable population in your own community. Describe the characteristics of this group—what makes them vulnerable—and utilize at least three scholarly resources to answer one of the following questions for your initial post. 

1. Paraphrase concepts/theories specific to healthcare disparities as related to vulnerability; provide at least three applications of concepts/theories that could be implemented within your community.
2. As an APRN, how can you advocate for this identified vulnerable population within your community? List and discuss at least three ways in which you can advocate.
3. How does what you learned about your own cultural competency affect how you might approach your role as an advocate? Did you find that you had bias? Were you aware of your bias prior to this exercise?
4. As an APRN, how will you strive to be culturally competent and respectful to those you serve? List and discuss at least three behaviors/characteristics of a culturally competent and respectful APRN.

Note: Evaluate your APA proficiency and make sure you address each of the required elements for this discussion. Utilizing headings for each aspect of the question is a great way to know that you covered the elements of the question.

Part 2: 

Respond to two classmates discussion regarding the same topic. In your reply posts, compare and contrast your vulnerable community’s characteristics or conditions, or even your own bias, with those of your peers in relationship to the question your peer answered.

Classmate 1 (Micheal): As an APRN we will see a wide range of patients throughout our career. Specially those of the substance abuse population.  An article written by  Green & Khokhar, (2019) stated that  “there  is a converging line of evidence to support  a shared vulnerability for substance abuse in patients patients with and in those at risk for schizophrenia.” These patients are part of the vulnerable population because of many factors that affect their ability to care for themselves properly. Those of us who studied public health, understand that each neighborhood, city and town have residents with vulnerabilities. These vulnerabilities can range from food insecurity, substance abuse, psych disorders to name a few. Those with substance abuse  problems require attention and someone who is willing to understand their needs. They see the only way to coping with their issues with drugs. The book mentions many ways to assist in caring for the vulnerable population. They mention to prioritized research in the areas of quality of life, patient-doctor relationship, special needs, access, and comparing approaches”(Chesnay & Anderson, 2020). It is important to develop a relationship with your patients as one of the key ways to advocate for them.  According to an article by Winters et al., (2020) “empathy is the ability to take in social information in order to connect with others’ perspectives and emotional states without confusing person’s emotions for one’s own.” This is important as a provider in order to connect to your patients level so you can fully understand their needs and their struggles. Secondly helping provide access to services is important way to help advocate for your patient, ensuring they receive the help they need to continue on the path to recovery. Access has been and will always be a public health issue due to socioeconomic status. It is important to realize what your patient is capable of doing and what resources they have nearby in their living situations. A third way to advocate is by treating each individual patient differently with approaches to treatment. Many programs do not offer what Martin et al., (2022) called “adopting a gender-informed approach.” The article stated that “a gender-informed approach to substance abuse care is vital to effective public health strategies that target the expansion of treatment capacity and the reduction of barriers to treatment engagement”(Martin et al., 2022). All these methods can assist myself as an APRN in developing a greater understanding in my patients needs especially those with substance abuse disorders. These vulnerable populations need someone to advocate for them so that they can continue to live their lives, and ensure sobriety is in their future.

Classmate 2 (Julia)

Vulnerable populations are those that have a greater than average risk of developing health problems which includes but is not limited to the homeless population (DeChesnay & Anderson, 2016). Homeless individuals are located everywhere around the world and unfortunately face health care disparities on a daily basis. While homelessness can be chronic, temporary, or anywhere in between – it is an issue that hundreds and thousands of people in the United States face on a given night (CDC, 2020). As an APRN, it is our goal to be culturally competent and respectful to these individuals. Individuals who are defined as homeless are those who physically lack a home, and oftentimes struggle to find resources such as food, water, and basic healthcare – things that are required for survival on a day to day basis. Healthcare needs may not be med due to limited resources/transportation, lack of insurance, and lack of money (CDC, 2020). Homelessness in the United States is a pubic health concern that is being addressed, and an APRN has the ability to help these individuals by possessing the following characteristics:

1. Open-mindedness
2. Effective communication 
3. Advocacy/Referrals

Open-mindedness refers to the ability to walk into any patient room and take the situation for what it is – with an open mind. Being open-minded should diminish all prior injustices or biases that exist. When an individual is open to any scenario, they can take the situation for what it is without creating false judgement This allows the APRN to truly evaluate the needs of the individual and accept them and the situation they state they are in. Practicing with an open-mind allows for appropriate and safe decision making when creating a patient’s treatment plan. Those who act closed-minded risk and restrict autonomous practice and have a great potential to cause harm (Sellman, 2003). 

Being an effective communicator is another characteristic that is essential in an APRN’s practice. This goes hand in hand with being open-minded. Using effective communication, one can communicate and recognize the needs of another. This allows for the development of a positive provider-patient experience (Fakhr-Movahedia, Rahnavard, Salsali & Negarandeh, 2016). You can use communication both verbally and non-verbally to evaluate a patient’s condition. Subtle nods of the head, or saying “okay” when a patient is talking, allows the patient to feel that the APRN is truly engaged in the conversation. Providers who are off-putting and do not engage in conversation with their patients are more likely to make inappropriate or invalid treatment plans, thus resulting in more stress and injury to the patient. This is super important in the homeless population, where lack of education may be present and methods of communication may be more difficult (especially when language barriers come into play). It is the responsibility of the APRN to overcome these barriers in order to appropriately and safely communicate with and treat the patient.

Lastly, being a patient advocate is the most important characteristic the APRN can possess. When advocating for a patient, we are advocating for their safety and overall appropriate treatment. On the frontlines as nurses, we are doing this on a daily basis; however, the responsibility continues to grow as an APRN when you are the one making treatment plans, prescribing medications, and truly dictating the health of this individual. Being a patient advocate has saved lives, “ensured the quality and care of patients, quick recover[ies] and minimized burdens on the healthcare system” (Nsiah, Siakwa, Ninnoni, 2019, pg.1132). As an APRN if the appropriate treatment can not be given, continuity of care should exist as the APRN makes referrals to appropriate practices and colleagues that can better serve the patients needs. With the homeless population, there are several resources that may be needed including: addiction counseling/rehab, chronic illness treatment (diabetes, hypertension, obesity, etc.), domestic violence resources, mental health providers/therapy, and much more. Given that an APRN has a broad understanding and practice, there may be instances where specialty assistance is required and should be sought out to better assist this patient.

Overall, the homeless population is a great example of a vulnerable population that can benefit from the care an APRN can provide. Given these three qualities, the APRN will be able to provide safe and effective care to these patients. These qualities allow the APRN to be culturally competent, aware, and respectful to patient’s of all backgrounds, needs, and ethnicities.