Group Problems with Access to Health Care

Systemic problems often require more than just advocating for an individual patient. When a similar type of problem presents itself over and over again, the nurse is responsible for asking himself or herself, "What are the underlying conditions that make this issue a recurring one and what can I do to address them?" Some political activism on the part of the nurse, in collaboration with other nurses, health care professionals, and members of the public may be necessary. Groups that advocate for the elderly such as the Gray Panthers and The American Association of Retired Persons (AARP) may be helpful.

This is a responsibility of the nurse as outlined both in the Code of Ethics for Nurses (ANA, 2001) and the ANA's Social Policy Statement (1995). The ANA's Social Policy Statement (1995) asserts that, "Nurses help people to identify both short and long-term health goals and act as advocates for people dealing with barriers encountered in obtaining health care" (p. 3). It also supports the idea that a nurse's advocacy responsibilities may be broad and include social activism.

Nurses working with the elderly are often in the best position to propose changes in the environment and in the provision of health care resources. Such action addresses foreseeable problems in advance and constitutes preventive ethics. For example, changes in prescription benefits that will cost the elderly more out-of-pocket expenses are liable to affect their health in a number of ways. To pay for their prescriptions, elders may cut back on their use of food or heat, reduce their daily medication dosage, or "share" medicines with their spouse. Social activism, on the part of the nurse, will help to address this problem in the public arena.