Vulnerable Populations Community Health Nursing; ethical and legal issues and leadership strategies in community health nursing
Community health nurses encounter numerous ethical and legal issues when caring for the elderly. The issues encountered emanate from ethical and legal conflicts inherent in the health care delivery system (Ulrich et al., 2013). According to Choe, Kim and Lee (2015) social justice and ethics are central components in public or community health nursing. Thus, community health nurses have a duty to integrate justice, morality, and ethics in their practice. To comply with this requirement, community health nurses must be adequately conversant with diverse human rights such as non-discrimination and equality. One of the ethical issues encountered in caring for the old relates to prevalence of stereotyping against the elderly. Hindle and Coates (2011) assert that some people might be of the opinion that elderly people are incontinent and have no contribution to the society. This stereotypic labeling might limit the extent to which the community appreciates the role of community health nurses in caring for the elderly. Ludwick and Silva (2004) posit that ‘nurses are not immune to stereotyping and thus must examine their own beliefs and values about aging’ (p.1). This approach is critical in countering the stereotypic perception on aging. Through this approach is critical in ensuring that the community health nurses do not discriminate the elderly in the process of providing care. Wilson, Whitaker and Whitford (2012) assert that discriminating against patients on the basis of their personal characteristics in the delivery of health care is not only unethical but also illegal.
Community health nurses further encounter ethical dilemma in providing end-of-life care to the elderly for example with reference to making decisions on provision of care or treatment against the elderly patient’s wish (Mayberry et al., 2015). In addition to the above ethical and legal issues, community health nurses are increasingly operating in an environment that has become culturally diverse. Cultural diversity is a potential source of work stress amongst the community health nurses (McSherry, McSherry & Watson, 2012). Irrespective of the cultural diversity, community health nurses are obliged to be ethical and to be culturally sensitive in working in unfamiliar environment characterized by different cultural norms and values. Cang-Wong, Murphy and Adelman (2009) assert that community health nurses have a duty to respect diverse cultural norms in caring for the old.
Leadership strategies in delivering health care to the elderly
Irrespective of the ethical and legal issues encountered, community health nurses have a duty to provide quality care to elderly. This goal can be achieved through integration of effective leadership approaches. Wilson, Whitaker and Whitford (2012) assert that some of the leadership roles that community health nurses should focus on relate to formulation of health care policies, planning and optimal provision of quality care. Offering effective health care services to the elderly requires a collaborative approach between the community health nurses, doctors, nurses and the family members, which presents a mixed team (Maurer & Smith, 2013). Community health nurses should entrench transformational leadership in leading the mixed team. The transformational leadership can be entrenched by providing all the parties an opportunity to share their opinion on the mode of care (McSherry, McSherry & Watson, 2012). Additionally, community health nurses should consider adopting patient-centered and need-based approaches in leading teams charged with the responsibility of caring for the elderly.
In summary, adoption of these approaches will enable the community health nurses to succeed in entrenching evidence-based interventions in offering health care. The outcome of these leadership approaches is that the community health nurses will succeed in transforming the health care system by promoting seamless, affordable and provision of quality care to the elderly.
References
Cang-Wong, C., Murphy, S., & Adelman, T. (2009). ‘Nursing responses to trans-cultural
encounters; what nurses draw on when faced with a patient from another culture’, Permanente Journal, 13 (3), 31-37.
Choe, K., Kim, K., & Lee, K. (2015). ‘Ethical concerns of visiting nurses caring for older
people in the community’, Nursing Ethics, 22 (6), 700-710.
Hindle, A., & Coates, A. (2011). Nursing care for older people. Oxford: Oxford University
Press.
Ludwick, R., & Silva, M. (2003). ‘Ethics; ethical challenges in the care of elderly persons’, The Online Journal of Issues in Nursing, 9(1).
Mayberry, R., Nicewander, D., Qin, H., & Ballard, D. (2006). ‘Improving quality and
reducing inequities; a challenge in achieving best care’, PMC, 19 (2), 103-118.
McSherry, W., McSherry, R., & Watson, R. (2012). Care in nursing; principles, values and
skills. Oxford: Oxford University Press.
Maurer, F., & Smith, C. (2013). Community/public health nursing practice; health for
families and populations. St. Louis, Mo.: Elsevier.
Ulrich, C., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2013).
‘Everyday ethics; ethical issues and stress in nursing practice’, Journal of Advanced Nursing, 66(11).
Wilson, A., Whitaker, N., & Whitford, D. (2012). ‘Rising to the challenge of health care
reform with entrepreneurial nursing initiative’, The Online Journal of Issues In Nursing, 17 (2).
