Globalization can be defined as the process of integration and interaction between governments, companies and people across the world (Lechner, 2009). It has grown owing to the advances in technology in communication and transportation. It is regarded as a primary economic process of integration and interaction that is associated with cultural and social aspects (Steger, 2010). Therefore, this assignment will focus on identifying a specific role within an NGO and include the geographical region. It will evaluate the function and role of an Australian nurse working in a developing country setting or in a refugee centre outside of Australia and discuss possible challenges and benefits the nurses may encounter working in the chosen context.
The Role and Function of a Nurse
Nursing is a science and art at the same time (Tschudin & Davis, 2008). It is not only a demanding work but also a stimulating and joyful mission that in cooperates professional performance and willingness to assist people and working in interest of their benefits. The main tasks of NGOs in the health system include providing services and health advocacy (Ekeh, 2016). The provision of services includes medical, integration activities, psychological and social services, material and financial support, care and nursing information services and educational training. On the other hand, heath advocacy is a combination of social and individual actions designed to draw policy support, political commitment, social acceptance as well as systems support for a given health goal or program.
The United Nations High Commissioner for Refugees (UNHCR) has adopted a healthcare program that targets refugees for medical services across the world. Therefore, an Australian nurse like any other nurse is tasked with either provision of healthcare services or health advocacy or both. In this case, the major focus will be on service provision. There is a refugee camp in the village of Dobova in Slovenia filled with migrants from Afghanistan, Syrian and Iraq. An approximate of 3000-5000 refugees cross the Slovenia-Croatian border every day. Assessment of the patient forms the cornerstone of nursing with an aim of ensuring an integrated and systematic review in healthcare (Leininger., 2005). An Australian nurse is expected to apply their advanced experience and knowledge and cooperate with Trans disciplinary and multidisciplinary teams in the medical field in the refugee camp. One of their important role is to ensure accurate assessment of outcomes (Kingma, 2006). They carry out frequent nursing diagnoses on the migrants. This is because majority of the refugees suffer from hyperthermia, acute pain, diarrhea, fatigue, lack of sleep, impaired skin integrity, impaired gait and drained volume of body fluids. In regards to the diagnosis of acute pain, the most common problem is neck, headache, lower limb and abdomen pain. In such a case, the nurse is required to administer the respective painkillers to the patients.
The diagnosis impaired verbal communication basically means language barrier experienced in the refugee camp. In their nursing assessment, the nurses are charged with the responsibility of measuring basic vital signs such as pulse, O2 saturation, blood pressure and body temperature and blood glucose (Cohen, 2013). They treat the wounded patients with both major and minor injuries suffered as they try crossing the border to the refugee camp. The duty of the nurse is to ensure hydration of the refugees by administering the necessary medication to the patients. Sometimes majority of the patients develop infection of the ears and eyes hence the Australian nurse is expected to administer the respective drugs orally. It can also be administered through intramuscular injections, subcutaneous (insulin) or provide infusion therapy. The personal nursing interventions are supposed to be carried out either in collaboration with a doctor or on the basis of indications.
There are common nursing diagnosis associated with psychological problems such as helplessness and hopelessness (Eckenwiler, 2012). They result mainly from difficult life situations. Other non-infectious diseases associated with long-term stress and common among the migrants include hypertension, diabetes, insomnia, depression, total exhaustion of the body and neuropsychiatric disorder (Upvall & Leffers, 2014). The nurse plays the role of offering guidance and counselling to the patients. They professionally charge the patients’ emotions positively by connecting and identifying with them. This act helps to deal with the trauma that majority of the refugees suffer from considering that they are victims of civil war. Others may have lost their loved ones in their home country. Children being the most vulnerable are left homeless and orphans. Therefore, the nurses play this vital role of getting the patients through the healing process, emotionally (Carpenito-Moyet, 2008). It is much easy for the patients to open up about their physical and emotional problems to the nurses as a way of seeking medical assistance. It helps to rejuvenate hope in their lives and accept their new way of life as refugees for the period they are hosted at Dobova camp. Through the caring and nursing services provided by the nurses, the patient refugees are deeply convinced that they are not helpless anymore.
The nurse also provide educational training on self-management, patient activation and self-care (Bastable, 2005). The three aspects are closely related hence aims at building on the strengths and capacity of the patients and their cares to uphold their independence and maintain and improve their health (Bastable, Nurse as educator : principles of teaching and learning for nursing practice, 2017). It is important to note that patient activation describes the skills and confidence of patients in regards to managing their own health and healthcare. The nurse is charged with the role of conducting a risk stratification that helps identify groups of persons with long term conditions, low knowledge and skills and confidence who happen to be at the risk of contracting diseases. Such people are present in the refugee camp thus the need to support them achieve lifestyle changes like improving diet, increasing activity levels gently, drinking sensibly and stop smoking. The nurses are ideally positioned in the refugee camp to support the patient to make these changes in order to improve their health and wellbeing (Falvo, 2011). They also train the patients on the importance of maintaining personal body hygiene such as proper use of latrines, cleaning hands before having meals, washing food stuffs like fruits before consuming them among other things.
The nurses accrue some benefits as much as the patient does. For instance, a nurse working in a refugee camp is able to find new creative approaches in regards to the provision of nursing care (Young, 2012). A nurse also gains new experience within the healthcare profession under the contemporary nursing featured in a relief setting. This is because in a relief context, the patients come from diversified backgrounds with different kinds of illnesses, both infectious and non-infectious. Therefore, the nurse is exposed to many forms of medical problems that require varying medical interventions. By doing this, their experiences grow every step of the way. Nurses always find great satisfaction in doing their work besides being paid well. They get excellent pay and benefits. For instance, they are paid overtime and given hardship allowances when working in a foreign and relief context. They also benefit from job security, always assured of their jobs. Working in a relief setting provides them with unlimited opportunities for advancement. The nurses are also able to develop new and unique methods of providing the needed medical services. The adverse environment in the refugee camp trains them on how to adapt to any other equivalent context much easier, either physically or emotionally. They are hardened by the challenges they face in a relief setting.
The nurses sometimes face various challenges while delivering their nursing services in a refugee camp like in Dobova (Slovenia). For instance, there is the problem of language barrier. Since the refugees have come from different countries, they speak unique languages. The refugees in Dobova in Slovenia come from Iraq, Afghanistan and Syria. Therefore, the nurses may not be Arabic speakers hence constraining any possible communication between them and the Arabic refugees. For a while now, the issue of language barrier has been a major problem in delivering nursing services in such a setting (DeLaet & DeLaet, 2015). Others may also be illiterate which makes it difficult for the nurses to understand their health problems that otherwise would have made it easy to treat them.
There is also some cases of hostile patients who are not willing to get any healthcare services from the nurses for various reasons. For instance, some may be in denial and feeling dissolution. Therefore, it becomes a challenge to approach these patients for treatment. Majority of patients do not show kindness to their nurses. This is because during moments of illness, individuals tend to be angry and may decide to unleash their anger on the closest person. However, the nurse must find a way to work through her own emotions and feelings in order to be able to assist her patients, which sometimes can be challenging especially when patients seem to be directing their anger at the nurse. The other challenge is insufficient medical resources provided in a relief setting (Callara, 2008). This results to strained nursing efforts in the camp. It means that some patients will likely lack access to medical services. This constraint maybe tragic in case there is an outbreak of a contagious disease that requires urgent and comprehensive healthcare approach because it can spread very quickly in a relief context. Another problem is insecurity due to the large numbers of refugees in camps who pose a security threat. There may be inadequate guards set to protect the people in the camp because of the overwhelming population of the refugees who keep on flowing in every day fleeing from civil wars and economic crisis.
The nurse workforce also experience the problem of policy impediments which vary from one country to another. For example, they may be required to have an operating permit from the foreign nation. Sometimes it may take long to process and acquire such documents and this discourages the nurses already on the ground and those interested in moving to those foreign nations.
The issue of refugees should be perceived as a new social phenomenon that requires special attention of both health and social workers. It is imperative to acknowledge the noble role played by the nurses as a multidisciplinary team that appreciates patient with his/ her values, religious beliefs, and customs. Therefore, in the setting of volunteering and migration, multicultural nursing is quickly gaining prominence. The mobility and migration of nurses will require healthcare organizations, both local and International and nations to continue with the efforts towards better understanding of workforce models and integration, employment, regulation and assimilation of an international nursing labor force. The most essential aspects remain which include the cultural, technical and quality/ safety competences required by the nurses to enable them work across borders.
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