The vulnerable population of teenage illicit drug users receive discrimination even in health care sector, the impact of the discrimination by the care provider effects their care outcomes on multiple levels. The marginalized groups in the society experience inequitable health care accessibility due to various different circumstances such as socio-economic position, discrimination and social stigmatization, even the approach of health care providers. The case study describes the scenario where an alleged shooter has performed a massacre in a shopping centre injuring different population groups. The chosen target population for this assignment is the teenage illicit substance abusers who are one of the victims of the massacre in the shopping centre. The impact of stigmatization on the target group chosen has the potential to impact the care outcomes for this population. This essay will attempt to discover the effect of stigmatization by the health care staff on the chosen marginalized groups, the possible restrictions associated health literacy and the challenges of successful discharge information dissemination, and relevant nursing strategies that can be implemented to overcome the detrimental impact of the considerable stigmatization on the marginalized group. Lastly, the essay will also focus on the dilemma and moral judgment faced by health care staff when caring for the alleged shooter in this scenario.
The effect of stigmatisation by health care staff on the chosen patient group and the relevant nursing strategies:
As discussed by the Miller-Day et al. (2014), the people that are associated with illicit addiction and the stigma and social taboo that these populations have to face from the various different sectors of the society has direct links with the health outcomes of the patients under consideration. Lack of any social support from the different social structures are another considerable challenge that further complicates the physical and mental health status of the teenagers with illicit drug abuse as well (Chang et al., 2016, pp. 513-525). The very foundation of the care services provided to the patients is based on the caring and nurturing the health and safety of the sick and ailing. However, when the concepts of stigmatization is integrated with the caring for the vulnerable populations such as the teenagers that are associated with illicit drug abuse, the quality of the care will drastically reduce and this might harm the patient groups as well. Lack of public awareness and literacy regarding the fact that substance abuse is also a sickness and not a lifestyle choice is the main contributor to the existing stigmatization and bullying. As argued by Potter et al. (2017, pp. 185-190), this social convention has been reported to cloud the judgment of the care staff as well and as a result their behaviour towards these vulnerable populations when they are seeking out physical or mental health care. On the other hand, there is mounting evidence that the most of the nursing care staff still perceive the illicit drug abusers to be dangerous and unpredictable (Sainam, Putsis & Zauberman, 2018, pp. 317-324). The lack of proper knowledge and training for managing the illicit drug users is reflected in the care staff avoiding to interact to engage with the patients, converting the care approach to non-compassionate, labelling and discriminating them and in general not meeting the patient centred compassionate care principles. The result of the cumulative stigmatization from the care providers who are expected to be nurturing and understanding from the patient perspectives leads to the development of self-stigma which in turn convinces the teenagers with drug addiction of their lack of self-worth, lack of confidence and might lead to self-harming and suicidal tendencies among the illicit drug abusers (Manhica et al., 2017, pp. 526-534).
The strategies that can help improve the experience of hospice stay of this marginalized group can be multiple. Taking a completely impartial and non-judgmental approach to communication and care for the illicit drug abusers with the rest of the victims can be an extreme help for improving the experience and the physical environment of the illicit drug abusers. As discussed by Reisner et al. (2015, pp. 243-256), the communication and patient engagement has a significant impact on the care experience that the patients attain. Most importantly for the, vulnerable populations, the impact of the communication and engagement has a profound role in overall health and wellbeing of these patient groups. Hence, another considerable strategy will be to engage and effectively communicate with the target group taking attention to incorporate a non-judgmental and accepting approach to communication and care (Carpenter, McClellan & Rees, 2017, pp. 63-72). The third strategy which will enhance their emotional wellbeing while staying in the hospital facility for the care delivery is the incorporation of their family members in the care planning so that they can feel a sense of belonging and are not feeling lonely while staying in the facility.
The challenges of health literacy for the patient group when offering discharge information and nursing strategies to promote health literacy:
The stigmatization, bullying and belittlement of the teenagers that are stuck in the web of illicit drug usage has affected the services they can find from the health care context as well, which affects both their physical and mental health status (Li et al., 2018, pp.277-285). I have chosen the teenager with illicit drug abuse as the marginalized group to focus on for this paper. It has to be mentioned in this context that for the vulnerable population groups with considerable amount of social isolation and stigmatization, the aspect of optimal health literacy is also extremely limited, it has to be mentioned in this context that health literacy plays a fundamental part in understanding the need for health care and also understanding the health promotional and preventative behaviours during the discharge planning. For the vulnerable health population that has been chosen for the assignment, the teenage illicit drug users also have very limited health literacy and hence the limited health literacy of this population can be a considerable challenge for the discharge planning and patient education. As mentioned by Miller-Day et al. (2014), the introduction of the illicit drugs at an early age, discontinuing education, and mixing with the wrong peers are considered to be considerable aspects associated with lack of or low health literacy in the teenage illicit drug users. This lack of health literacy on the other hand can cause significant difficulties in disseminating the discharge information.
As discussed by Rosenberg et al. (2017, pp. 93-99), the nursing staff addressing to the teenage illicit drug abusers have to deal with aggression, disengagement, confusion, irritability and overall lack of co-operation from the target population. In most cases, the impact of the this lack of co-operation is reflected in the success of the patient education session during the discharge planning via the means of the target population not understanding the content of the information disseminated to them, not being able to process the information, not being able to adhere to the lifestyle changes or health promotional behaviours and lastly not interpreting the need for any health promotional activities being followed or any changes being implemented. In this case, a few considerable nursing strategies that can be implemented in this case to overcome the mentioned challenges include therapeutic communication, digitally assisted patient education, teach back method, one to one counselling, and implementation of regular messaging service which will keep reminding the teenagers with illicit drug use (World Health Organization, 2016). On a more elaborative note, the aid of therapeutic communication and one to one counselling will help the nurses be able to gain the full attention of the patient and administer clear information to the patients. The digitally assisted patient education will help also in attracting the attention of the addiction victims and help them understand the instructions in easy and simple animated format. The teach back method will help the nurses ensure that target patients have clearly understood and interpreted the information that has been disseminated to them. Lastly, the impact of prolonged drug usage has significant impact on cognitive abilities, and hence, remembering to follow certain instructions such as medication regimen and wound management. The regular messaging service will act like a reminder helping the target group deal attain recovery successfully (Tucker, Cheong & Chandler, 2016, pp. 539-545)
Moral judgment by health care professionals when treating the alleged offender:
The impact of the belittlement affects their senses of belonging and also targets their social identity which in turn has been reported to impact the help seeking behaviour among these disadvantaged marginalized groups (Wen, Hockenberry & Cummings, 2015, pp 64-80). Moral judgment plays a fundamental role in understanding and evaluating the care decision making of the health care professionals. It has to be mentioned in this context that the health care professional are faced with considerable moral dilemma which imparts a significant impact on not just the care approach taken by the target patient groups but also the behaviour of the care provider as well. Similarly, this case situation involves an alleged offender who had carried out a mass shooting at a shopping mall at unsuspecting innocent crowd. While treating the perpetrator of such a terrorizing criminal activity, the personal grudge or displeasure can easily affect the approach and nature of the health care professional while treating the patient. This moral dilemma is associated with various overlapping ethical principles which has to be taken into consideration (Austin, 2016, pp. 131-133). It has to be mentioned that the health care staff are not above human flaws by any means, the natural reaction to someone committing a crime that resulted in a blood bath is undoubtedly going to implement a very negative behavioural approach to the conscience of the nurses that are addressing the mentioned patient. Similarly, as the nurses in this case have also been attending to the victims of the crime scene as well. This ensures the nurses developing a stronger emotional connection with the victims of the crime scene and as a result a sense of animosity might develop in the care professionals against the alleged shooter when attending to him. However, the impact of the personal sense of justice and anger or animosity can affect the care approach of the care professional and also cloud the clinical decision making power (Gallagher, Webster & Aschengrau, 2017, p. 26).
Considering moral judgment, the health care professionals use both reason and emotion while making decisions regarding the moral dilemma. The moral judgment undoubtedly is a fundamental right of each and every human being. However, for the nursing professionals the moral judgment or personal thoughts needs to be managed carefully so that it does not affect their caring responsibilities and job roles. It has to be acknowledged in this case that primary principle of nursing care is to prioritizing the needs of the patient. Each and every individual has an equal right to medical care. Along with that, in this case, while attending to the alleged offender, the ethical principles of nursing will have to be considered as well (Baggio et al., 2016, pp. 485-490). According to the principle of beneficence and nonmaleficence, the nurses are required to provide care that is safe, effective care interventions which only benefits the patient and is not associated with taking interventions that will not lead to any harm to the patient (Parahoo, 2014). In this case as well, even though the alleged offender has committed a crime, the nurses will have to provide care intervention to help restore optimal health to adhere to the ethical principle of nursing and the fundamental right to medical care of all individuals.
On a concluding note, healthcare is not just limited to diagnosis, treatment, prevention or management of the disease, health care is also associated with preserving and enhancing the physical as well as mental wellbeing of the patients. Hence, undoubtedly health care is one of the greatest requirements of the patients, each and every individual living in this society deserve equal access to the health care services. The vulnerable population that has been chosen for this assignment had been teenage illicit drug users who had been the victim of a crime. Stigmatization by the health care providers is a huge burden on the already stigmatized populations, and in this case after being affected by the trauma of such a situation the need for the care intervention and approach of the care professionals to be non-judgmental and compassionate is optimal. This essay had been successful in exploring the challenges faced while caring for vulnerable population and illustrated achievable strategies that can be implemented to overcome the challenges in caring and discharge planning. Lastly, moral judgment while attending to the alleged shooter that the care professional might face is also discussed in detail as well.
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