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Clinical problem for which an NP could advocate for an evidence-based change that is client-focused

Identify a clinical problem for which an NP could advocate for an evidence-based change that is client-focused. Avoid topics that are related to full practice authority, staffing, or burnout. The problem should be centered around clients and the care nurse practitioners provide for the population.
Describe the scope and impact of the problem.
Discuss the role of the NP in addressing the problem.
Explain why the problem is of interest to you.

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Sample Answer

 

 

 

Intersectionality recognizes that individuals experience multiple forms of discrimination and oppression based on their intersecting social identities, such as race/ethnicity, social class, religion, sexual orientation, and gender identity. These intersecting identities can significantly impact an individual’s risk for developing a substance use disorder.  

For example:

  • Race/Ethnicity: Individuals from marginalized racial and ethnic groups may experience systemic discrimination in housing, employment, and healthcare, increasing their risk of poverty, stress, and trauma, which can increase vulnerability to substance use.  
  • Gender: Gender roles and expectations can influence substance use patterns. For example, women may be more likely to use substances to cope with trauma or abuse, while men may face pressure to conform to masculine ideals that may involve substance use.  
  • Sexual Orientation/Gender Identity: LGBTQ+ individuals may experience discrimination and stigma, leading to increased stress, mental health challenges, and a higher risk of substance use.  

Full Answer Section

 

 

 

 

  • Social Class: Poverty and socioeconomic disadvantage can increase access to substances, limit access to treatment, and increase exposure to stressors that can contribute to substance use.  
  • Religion: Religious beliefs and practices can influence attitudes towards substance use, but religious discrimination and marginalization can also increase vulnerability.

Stigma further compounds these issues. Stigma associated with substance use disorders can lead to:  

  • Internalized stigma: Individuals may internalize negative stereotypes about themselves, leading to low self-esteem, shame, and decreased motivation for recovery.  
  • Discrimination: Individuals may face discrimination in employment, housing, and social interactions, further marginalizing them and increasing their risk of relapse.
  • Barriers to treatment: Stigma can deter individuals from seeking treatment due to fear of judgment and discrimination.  

Addressing Intersectionality in Treatment:

  1. Conduct a Cultural Humility Assessment:

    • Acknowledge and address the unique experiences and challenges faced by individuals from diverse backgrounds.
    • Assess your own biases and assumptions and strive to provide culturally sensitive and culturally competent care.
    • Incorporate the client’s cultural values, beliefs, and preferences into the treatment plan.

  2. Address Systemic Issues:

    • Advocate for policies and programs that address systemic inequalities and reduce barriers to access to healthcare and social services.  
    • Work with community organizations to address social determinants of health, such as poverty, discrimination, and lack of access to resources.

Holistic and Strength-Based Approach:

When working with clients with substance use disorders, it is crucial to adopt a holistic and strength-based approach that:

  • Addresses the whole person: Considers the client’s physical, emotional, social, and spiritual needs.  
  • Focuses on strengths and resilience: Identifies and builds upon the client’s strengths, coping mechanisms, and support systems.
  • Promotes self-determination: Empowers clients to make informed decisions about their treatment and recovery.
  • Reduces stigma and discrimination: Challenges negative stereotypes and promotes a compassionate and non-judgmental approach to treatment.

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