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In order to radically change nursing industry and provision of nursing practice to patients and populations, I believe the biggest contributor will be two things: education and embrace of technology and an expansion of education for social determinants of health (SDOH). As a nurse who works in the intersection of public health, education, and patient care/coordination, I have a unique perspective of how changes, additions, or disruptions to a system can contribute to the health or unhealth of individuals. Most, if not all, nurses who worked and continue to work through the COVID pandemic can attest to the blatant disparities of populations and how they were affected by not only the disease process of COVID but the effects of public health policy that were put into place.
Technology within nursing, like using, data analytics” …to analyze trends, identify disparities, and guide policy decisions” (National Academies of Sciences, Engineering, and Medicine, 2021, p. 210) uses the foundation of the nursing process: assessment. As technology advances, nurses need to be well prepared to use these technologies in the spectrum of opportunities to gather data from bedside to population to policy. One such way I use technology in my practice is to look at the health of my population of students via vaccination reports. It is Minnnesota State Law that students be up to date (or documented exempted) with their vaccination records. I would not be able to see trends in where there are holes in vaccinations if I were not versed in how to run vaccination reports. One such trend that I am seeing is a down tick in varicella vaccinations in incoming kindergarteners, a trend that is true across our district and in neighboring districts.
Technology will not only be a tool in itself for nurses to learn but its application to SDOH .As for education nurses on social determinants of health, one such example I have seen in my own practice is obvious through the COVID pandemic. from a disease process standpoint, there were many that understood that COVID had a more severe disease process for individuals within the BIPOC community. But unless you were working in public health, what one didn’t see was how COVID affected the community themselves, the family systems, and the trickledown effects of COVID of those within the family.
One such highlight of how there were disparities in these populations of people was not just that they were at greater risk of severe illness but people in these communities were at higher risk of exposure; they typically did not hold jobs where they could work from home, they lived in cramped or overcrowded multi-family housing; the access to education was lessened compared to other populations; access to technology for those that were school age was limited or completely unavailable whether because there was no internet or no device to access schoolwork. This population was also at greater financial risk because if the primary bread winner were to become ill, it was two weeks of isolation or quarantine without pay and if a decision needed to be made on whether to pay for rent or for internet, one can guess what would be the priority.
As students returned to the classroom, the impact of the disparity was clear: low income, BIPOC, and special education students were farther behind academically and socially than their peers. Although technology has been a boon to those who can access it, it can also “exacerbate the existing disparities” (National Academies of Sciences, Engineering, and Medicine, 2021, p. 206) in health and education as seen in my experience with my student population.
A common theme that I see within this report is education specifically to SDOH. I completely agree that this is a direction nursing education, and the role of Advanced Practiced Nursing, needs to go in order to meet the needs of patients and populations. I was drawn to public health nursing with the idea of root cause analysis: why is this happening? It is one thing to notice that low income and BIPOC individuals were at greater risk for severe illness and to treat them as they showed up in the hospital but it is another thing to recognize the why behind it and remedy the underserved and vulnerable population to prevent it from happening therefore preventing a trickledown of mutli-faceted negative health and educational outcomes to the individ
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