Vulnerable Groups of the Population: Alcoholics Drug Addicts Homeless People

Nursing is a widespread profession that stretches across the world. One part of nursing includes the community. Everyone is impacted by the community in one way or another whether it is through screenings or events (feeding the homeless). It is important to know about the community and be able to recognize vulnerable populations that need help. These vulnerable populations include the homeless, migrants, indigent, substance abusers, and victims of violence which can include children, women, and the elderly. Within these vulnerable populations, ethical dilemmas can occur within the healthcare system especially if the nurse is having to care for a person that does not share the same beliefs or if the patient is a child abuser.

There are many different ethical principles when it comes to nursing. These principles include autonomy, nonmaleficence, beneficence, justice, veracity, and fidelity. Autonomy is the principle that is concerned about a person making their own decisions and having to face the consequences of their decisions. Autonomy is very important in nursing as a nurse is supposed to respect and honor the patient’s decisions even if the nurse does not agree to the decision (Health Management, Ethics and Research Module: 7. Principles of Healthcare Ethics). Beneficence is the act of doing good while nonmaleficence is the act of doing no harm. Both of these principles are important in nursing because the nurse is called to help the patient to get back on their feet and live a healthy lifestyle. Justice is the principle used to provide fairness to all populations and groups. This ethical principle is also very important because it entitles the nurse to be fair to all patients no matter their race, ethnicity, religion, or gender.

“Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs”(WHO, 2017). Substance abuse does not occur in a specific age, it can occur at any age and can happen to anyone. With substance abuse the person can develop a dependence to the substance. This dependency can make it hard for the person to quit and if they try to quit and they don’t slowly wean off of the substance it can cause withdrawal symptoms which can lead to coma and death. This paper will focus mainly on alcohol substance abuse.

These substance abusers can develop health problems. Some common health problems may be cardiovascular disease, cancer, stroke, HIV/AIDS, Hepatitis B and C, lung disease, and mental health disorders. According to NIAAA (2018), “in 2014, the World Health Organization reported that alcohol contributed to more than 200 diseases and injury-related health conditions, most notably DSM–IV alcohol dependence, liver cirrhosis, cancers, and injuries.” If a woman is pregnant Fetal Alcohol Syndrome can also occur. A study done in 2009 stated that in the US 1 in 3 liver transplants were due to alcohol related liver disease (NIAAA, 2018). In college students, 1,825 die from alcohol related unintentional injuries such as motor vehicle crashes (NIAAA, 2018). Alcohol can lead to other things that could cause harm to the client such as rape and violence. According to NIAAA (2018), alcohol abuse is the third leading preventable cause of death. According to the CDC (2013), the top leading harmful effects of alcohol abuse are motor vehicle traffic crashes accounting for 313 people, alcoholic liver disease which accounts for 224 people, and homicide accounting for 158 people. These statistics help people to see exactly what can happen due to alcohol abuse and allows for nurses to think of how they can help this vulnerable population.

When assessing the statistics on mortality of substance abusers, motor vehicle traffic crashes seems to be the most prevalent which would be our priority health problem. When identifying this health problem, it is the nurse’s responsibility to develop a plan or goal of prevention and treatment of this health problem. The nurse can accomplish this by discussing the three levels of prevention.

The first level of prevention includes primary prevention which focuses on the prevention of motor vehicle traffic related accidents. In order to meet the first level of prevention we should educate the public about the dangers and risks of alcohol abuse and provide primary prevention is to develop programs that fight against alcohol abuse such as MADD (Mothers Against Drunk Driving) (Wissman & Knippa, 2016). This program allows for mothers and to discuss their experiences and their plans to prevent drunk driving.

Secondary prevention includes early detection. With secondary prevention, the nurse should identify at-risk individuals. A nurse can dig deeper and figure out what is causing these people to drink or what caused them to drink in the first place. Examples of reasons that people drink and then become dependent on it are because of pain, stress, loss of a job, death of a family member, and financial difficulties. Once we explore why the people are drinking then maybe we can help them the best way that we can. Another way to reduce alcohol abuse is to screen individuals for substance abuse disorders (Wissman & Knippa, 2016). This screening allows us to figure out who is abusing alcohol and try to help them before it progresses and leads to a motor vehicle accident.

The last stage of prevention is tertiary prevention which involves the treatment to help these people with alcohol abuse. Through tertiary prevention a nurse can refer these clients to support groups such as Alcoholics Anonymous (AA) (Wissman & Knippa, 2016). Another thing that a nurse can do is provide emotional support to these clients and their families as they go through this journey of deciding to quit drinking alcohol (2016). Another tool that can help decrease alcohol abuse is for the doctor to prescribe medications that will make you sick if you are to drink alcohol again and after a few times the client gets it in their head that they don’t want to drink because they don’t want to get sick. When tertiary prevention is used to treat these individuals that abuse alcohol then it will in turn prevent motor vehicle traffic accidents related to alcohol abuse.

When caring for a patient that is a substance abuser the nurse may encounter many ethical issues. One that would be big with this population deals with autonomy. Autonomy can be an issue with this population because the nurse knows that the patient can make their own decisions and are responsible for their actions, but the nurse still wants to imply what they should do or tells the client how they are wrong. This ethic dilemma can also be included with justice because the nurse could treat the client differently because she knows that the patient abuses alcohol. Nurses need to discover their own biases and put them on the back burner so that they can provide adequate care to every patient even if they abuse alcohol. Nurses have to remember that everyone goes through a tough patch and sometime people turn to alcohol, the nurse is supposed to be there to help these patients to increase their health and well-being.

According to ATI, alcohol use is the most commonly used substance in the US. When someone drinks alcohol consistently they develop a tolerance, which causes an increased requirement for alcohol to achieve the desired effect (Wissman & Knippa, 2016). This tolerance of alcohol can lead to dependence and further lead to alcohol abuse. According to the NCLEX test plan, alcohol abuse can be covered under psychosocial integrity. Under psychosocial integrity “the nurse provides and directs nursing care that promotes and supports the emotional, mental, and social well-being of the client experiencing stressful events, as well as clients with acute or chronic mental illnesses” (NCSBN, 2016). This vulnerable population is covered under the BSN Essentials VII and VIII. Essential VII states that a nurse is to be an advocate for social justice for clients in vulnerable populations and VIII involves the ethical behaviors in nursing (American Association of Colleges of Nursing, 2008). These essentials are important to relate to the vulnerable population to link all the information that is gathered on this population to the community.

The purpose of this paper was to explore a vulnerable population and all the aspects of the vulnerable population. As discussed before your vulnerable populations are an important aspect of the community and the health of the community. The vulnerable populations help to shape the community and provide insight to things that can be done to help and support them. The more that can be done for the vulnerable populations then the more that can be done for the community as a whole.

References

1. American Association of Colleges of Nursing. (2008, October 20). American Association of Colleges of Nursing (AACN) Home. Retrieved October 13, 2018, from https://www.aacnnursing.org/
2. CDC. (2013). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Retrieved October 13, 2018, from https://nccd.cdc.gov/DPH_ARDI/default/Report.aspx?T=AAM&P=e69412c2-5afd-44c0-8fe0-2b39499e2019&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=29DE512B-FD31-48FA-B9FD-CF2820758194&F=&D=
3. Health Management, Ethics and Research Module: 7. Principles of Healthcare Ethics. (n.d.). Retrieved from http://www.open.edu/openlearncreate/mod/oucontent/view.php?id=225&printable=1
4. National Institute on Drug Abuse. (2018, July). Addiction and Health. Retrieved October 13, 2018, from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health
5. NCSBN. (2016). Test Plans. Retrieved October 13, 2018, from https://www.ncsbn.org/testplans.htm
6. NIAAA. (2018, August). Alcohol Facts and Statistics. Retrieved October 13, 2018, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
7. WHO. (2014). Global Status Report on Alcohol and Health, 2014. Retrieved October 13, 2018, from https://books.google.com/books?hl=en&lr=&id=HbQXDAAAQBAJ&oi=fnd&pg=PR2&dq=statisticsonhealthrelatedproblemswithsubstanceabuse&ots=PbqFEeS1wK&sig=GjmVvZEEsaVLzZOq00CMI9teRlU#v=onepage&q=statisticsonhealthrelatedproblemswithsubstanceabuse&f=false
8. WHO. (2017, October 05). Substance abuse. Retrieved from http://www.who.int/topics/substance_abuse/en/
9. Wissman, J., & Knippa, A. (2016). RN community health nursing review module (7.0th ed.). Stiwell, KS: Assessment Technologies Institute.
10. Women’s Health Care Physicians. (2015, June). Retrieved October 13, 2018, from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Ethics/Alcohol-Abuse-and-Other-Substance-Use-Disorders-Ethical-Issues-in-Obstetric-and-Gynecologic-Practice

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