As per Markwick et al. (2019), the people of Aboriginal and Torres Strait Islander face interpersonal and social racism. This is the reason that they have a low socio-economic status in the world. Racism is a type of social determinant that affects the health of the people of Aboriginal and Torres Strait Islander. These people do not have enough healthcare facilities and healthcare professionals. The patient, Bill is a twenty year old aboriginal man suffering from type 1 diabetes. Although he was diagnosed with diabetes at 12 years of age but still he was unable to manage his disease effectively. A number of factors have affected patient's disease management skill, for example, his place of birth. Patient was born in a place where there was scarcity of healthcare services, hospitals, opportunities and a high population of diseased people. The other factor that affects patient's ability of disease management is health literacy, which acts as a foundation for successful disease management (Pourseslami, 2016). Patient is illiterate which implies that he has least knowledge of health literacy, type 1 diabetes and the management of this disease. Patient's current circumstances are also non-supportive for disease management, for example, low income, no growth opportunities, social pressure and no permanent home. As per Zhao et al. (2019), social support is a crucial external factor for diabetes care and management , however the patient has no social support which has affected his diabetes management abilities. Thus, both personal and social factors have impacted patient's ability of diabetes management.
Nurse Unit Manager of the Rehabilitation centre took a very impulsive decision of discharging the patient. A number of factors influence his decision, such as less resources. The Nurse Unit Manager was under pressure to clear the patient's beds to accommodate more number of new patients. The number of patients suffering from chronic diseases are much more than the healthcare professional. As a result, the healthcare industries of various countries are not having enough resources and services for the patients. Moreover, the budget for healthcare industry is also fixed by all countries of the World that implies that healthcare professionals have a limited budget to treat a high population of diseased patients. The second factor that influences the decision of Nurse Unit Manager is unfinished business. As per (Scott, Harvey and Felzmann, 2018), around 50 to 90 percent of the registered nurses discharge the patients with unfinished care. It is one of the emerging concerns of the healthcare world that affects the long-term recovery of the patients.
Moreover, the team of nursing staff, physiotherapist, occupational therapist and doctor used multidisciplinary model for treating the patient. They did not conducted any team meeting due to which they were unable to discuss patient's case deeply. As a result, they did not detected any other health complications in the patient and these complications were left untreated. This is also a factor that influenced the decision of Nursing Unit Manager to discharge the patient quickly. The medical experts of the Rehabilitation Centre did not collected any additional information from the Neurology Ward of the Acute Hospital, due to which they were unable to detect other health complications of the patient. They just treated the neurological symptoms of the patients such as loss of balance, difficulties in ambulating and body coordination. The misinformation and communication gap between the Rehabilitation Centre and Neurology Ward of Acute Hospital have also influence the intuitive decision of Nursing Unit Manager. This is because the medical experts team of Neurology Ward were aware of patient's diabetic conditions but they were not able to inform this to the health professionals of the Rehabilitation Centre. As a result of this, proper care was not provided to the patient by the medical experts of the Rehabilitation Centre. All these are the factors that have influenced the intuitive decision of Nursing Unit Manager to discharge the patient at an early basis.
Markwick, A., Ansari, Z., Clinch, D. & McNeil, J. (2019). Experiences of racism among Aboriginal and Torres Strait islander adults living in the Australian state of Victoria: a cross-sectional population-based study.BMC Public Health,19(1), 309. doi: https://doi.org/10.1186/s12889-019-6614-7.
Poureslam, I., Nimmon, L., Rootman, I. & Fitzgerald, J. M. (2016). Health literacy and chronic disease management: drawing from expert knowledge to set an agenda. Health Promotion International, 32 (4), 743–754. doi: https://doi.org/10.1093/heapro/daw003
Zhao , F. Suhonen, R., Katajisto, J. & Leino?Kilpi, H. (2019). Factors associated with subsequent diabetes?related self?care activities: The role of social support and optimism. Nursing Open, 7(1), 195-205. doi: 10.1002/nop2.379
Scott, A. P., Harvey, C. & Felzmann, H. (2018). Resource allocation and rationing in nursing care: A discussion paper. Nursing Ethics, 26(5), 1528-1539. doi: 10.1177/0969733018759831
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