What can you do to begin working on the problems of health disparities in your community?

Situation

E.M., a 47-yr-old Mexican American woman living with type 2

diabetes mellitus, comes to the clinic to have her blood glucose

measured. It has been 12 months since her last visit. At that time, the

nurse asked that she bring along her glucometer and strips to show

how she checks her blood glucose because her glucose values were

high at her previous visits.

When you check E.M.’s equipment and glucose strips, you find that

the strips are for a different machine and they expired more than 2

years ago. When you inquire about the situation, E.M. explains that

she cannot afford to come to the clinic or to buy new equipment and

supplies to check her blood glucose level. During the day, E.M. cares

for her 3 grandchildren so her daughter can work. E.M. spends most

of her income on food for her family, so she has little money left for

her health care.

Ethical/Legal Points for Consideration

• Ethnic minorities and other vulnerable or disadvantaged groups

experience certain chronic illnesses at higher rates. Limited access

to high-quality, accessible, and affordable health care services is

associated with an increased incidence of illness and

complications, as well as a reduced life span.

• People with certain health problems such as diabetes may have

difficulty obtaining health care insurance. Consider these issues

in the broader context of social justice.

• In many states, the legal definition of the role of the professional

nurse includes patient advocacy. Advocacy includes the

obligation to provide adequate follow-up care for all patients,

especially those who are experiencing health care disparities.

• A nurse who observes disparities must consider the possibility of

discrimination and abuse. Professional nurses are legally and

ethically responsible for patient advocacy. The nurse may incur

legal liability if failure to fulfill this obligation results in patient

harm.

Discussion Questions

1. How would you work with E.M. to help her obtain the

necessary resources and knowledge to care for her diabetes?

2. What can you do to begin working on the problems of health

disparities in your community?

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