SOME STEPS TO ADVANCE HEALTH 1
Some
Steps to Advance Health
Karen
Leh
University
of Colorado School of Nursing
SOME STEPS TO ADVANCE HEALTH 2
Karen Leh
Professor Susan Strobel
NURS 3277 Health Promotion I
13 September 2015
Some Steps To Advance
Health
In order to serve the public—not just
adequately but with excellence—a nurse must naturally be highly skilled. But
skill also incorporates certain intangibles: having a clear idea of what
“health” means, possessing a thorough knowledge of national health goals, and
understanding the larger context of the patient. To this end, a truly skilled
nurse is someone who comprehends the aims of documents such as Healthy People 2020, grappling with how
to meet its objectives, which would include trying to mitigate the negative
impacts of various social determinants of health.
For me, the word “health” is best framed by
Carole Edelman (2014), who describes it as “. . . a state of physical, mental,
spiritual, and social functioning that realizes a person’s potential and is
experienced within a developmental context” (p. 5). The other definitions—in
the lectures and the videos—lacked succinctness, did not feel thorough, or took
a too sharp trajectory policy-wise, in my opinion. And still, I find this definition
somewhat lacking. Personally, I’d want to add “dynamic” in there (e.g., a dynamic state) to acknowledge that sense
that health is often changing, and the physical, mental, spiritual, and social
elements shift, tugging a person’s health in and out balance.
But the definition is certainly sufficient,
and it is broad enough that applying it to any one of the topics and objectives
of Healthy People 2020 would present
the nurse with a great challenge. As I looked through this document, one of the
topics that most interested me was labeled “Disability and Health,” and within
that category, objective DH-16 stood out: “Increase employment among people
with disabilities” (U.S. Department of Health and Human Services, 2014).
There is a large population of people with
disabilities who are unemployed—I have many contacts with individuals in this
population and have witnessed their struggle first-hand. So many of them have
sharp minds, but those with cognitive impairment can bring such joy and
dedication to whatever they do, so it’s exasperating to see them parked, solo,
in front of a television or video games all day, not participating in or
contributing to society as fully as they might.
Meaningful employment enlarges people’s
world in unexpected ways. It encourages intellectual growth, adaptability, refinement
of gross and fine motor skills, problem-solving, and—finally—friendship. That’s
the other side of this particular issue: what do we, the non-disabled, lose when
we fail to employ the disabled? Considering the definition of health I chose,
the well-being of both the abled and disabled communities would be bettered if
we fulfilled this objective. Perhaps for the disabled person there’s a more
thorough health advancement in terms of the physical and mental aspects of
health, but the growth in the spiritual and social realms would be advanced for
all. Employment would certainly aid a disabled person in reaching their
potential (a concern encompassed within the definition of health that I
selected). And because work is the expected next step when school is completed,
this employment objective also addresses the “developmental context” of the
disabled employee (Edelman, 2014). In other words, there is synchrony between
Edelman’s definition of health and this Healthy
People 2020 objective.
That said, fulfilling the goal would be
challenging. One of the difficulties would be addressing the many social
determinants of health, those underlying issues that are often silently but powerfully
limiting people’s access to health care and, therefore, employment. These
include things such as income, education, race and ethnicity, transportation,
housing, insurance, food access, and complex health needs.
Looking at the objective I chose as my
focus, I could see many if not all of the social determinants of health needing
to be addressed. What I would do as a clinician is to create for myself very
measureable goals. For instance, my first job would be to uncover the resources
already out there that would make my work easier and solve or at least address
many of the potential problems. For instance, Boulder County’s developmental
disabilities center, Imagine!, probably already has a list of employment
resources, which would create a starting point. I’d need then to talk with the
organizations Imagine! had identified so as to understand their approaches and
the extent of their services.
One resource Imagine! would likely refer me
to is Workforce, whose whole aim is to match people with businesses. I would
need to call them and ask how many disabled people they have placed in jobs;
how many of those situations worked out well; do they have an “employment
closet” where people with little money can find proper clothing for the
workplace or do they know of one; have they had success setting up carpools for
workers without automobiles, money for the bus, or the skills to access public
transportation; do they have placements for people who have multiple deficits;
have they had success placing disabled folks who do not communicate well verbally,
or whose first language is not English?
Once I had compiled a list of resources and
spoken with their representatives, the next step would be to contact the case
worker for the person I sought to help, discuss a plan specific to that client
and any ways I could be of service. I’d then go on to create a new goal around
a social determinant of health that was not being given adequate attention
through the agencies I’d contacted.
I think going step by step like this, developing
measurable goals to address the whole of the social determinants and then
chipping away at the rest, would bring me great satisfaction. If I did this,
I’d be helping others to find the definition of health advanced by Edelman’s
textbook. I might also increase the percentage of disabled persons being
employed and so assist the nation in meeting the Healthy People 2020 goals. And that would, by my own
definition, make me a highly skilled nurse.
References
Edelman,
Carole E., Kudzma, Elizabeth C., Mandle, Carol L. (2014). Health promotion throughout the life span (8th Ed.). St.
Louis, MO: Elsevier.
U.S.
Department of Health and Human Services (2014). Healthy people 2020. Retrieved from http://www.healthypeople.gov/2020/topics-objectives
