Identification of the Underlying Issue
In July 2014, two American citizens named Dr. Paul Gingrey (a retired obstetrician and gynecologist and a former member of the congress in the United States) and Linda Poon (a staff writer at CityLab Bloomberg) have both illustrated their perspective on the healthcare policy in regard to immigration. Poon (2014) wrote an article on the National Public Radio (NPR) after Dr. Gingrey wrote a formal letter to the Centers for Disease Control and Prevention or CDC. In the letter that Dr. Gingrey wrote, he was informing the CDC about the epidemic diseases that the immigrants might potentially bring and spread to America. On the other hand, Poon pointed out that immigration is linked to physical trauma and mental health issue which are more of a humanitarian problem than a public health issue. The two polarizing ideologies that were discussed in this argument about immigration policy would be the liberal and the conservative view.
Immigration has shared a huge contribution on the history of how the United States of America have become a nation. In other words, the United States have evolved into what it is today due to the people who have migrated from different parts of the world and have brought their own culture. However, these people are constantly facing politics about an underlying issue of immigration policy that may incorporate the need to accommodate their health as well as their safety. Therefore, the role of the nurses is to deliver the proper service for every individual by advocating what is best for their overall wellbeing regardless of this policy.
Immigration Policy from the Lens of the Liberal and the Conservative
To this date, two of the major polarizing ideologies that are instituted in the United States will be liberalism and conservativism. Liberalism is a political ideology that recognizes the core values of freedom and human rights. It combines the ideas of freedom, democracy, equality, and equity with support for justice, solidarity, solidarity, and a mixed economy (Muschek, 2015). Economically, liberalism opposes cuts in social welfare spending. It also supports the role of government in reducing inequality, providing access to education and health care, regulating economic activity, and protecting the environment. In the realm of culture and ideology, liberalism advocates pluralism – the recognition of the right to different views, tastes, and opinions. Also, according to this current, individual freedom is not opposed to the interests of society, but on the contrary, is the main driving force of social development.
Conservatism is also a political ideology; it recognizes the central values of tradition and order, the state system, and religion. Conservatives in politics advocate the preservation of everything as it was before, that is, against reforms and changes. They often support social inequality, seeing it as natural and inherent in human nature. In economics, supporters of this movement support national manufacturers and advocate protectionism. In the realm of culture and ideology, conservatives are always in favor of the dominance of one state-sanctioned current. According to representatives of both currents, one of the main factors that immigration policy affects and is affected by in response is electoral change.
The Liberal View
Formerly, when the world consisted of national economies, political and economic borders fell, and economies were relatively self-sufficient; neither imports, foreign capital, nor immigration were thought to be crucial. At the same time, the national product, which does not arise globally, is the product of global interactions, and no government can claim self-sufficiency in goods, services, and capital. Instead, every government is concerned with managing flows that begin and end beyond the government’s power and often beyond its knowledge. Such a system requires more and more mobility-businessmen, students, tourists, consultants.
According to liberals, it is almost impossible to identify those who want to work without permission in this multitude. In the field of labor, approaches inherited from old methods of using the national labor force and based on the self-sufficiency of the local labor supply come into conflict with economic growth initiatives (Fitzgerald et al., 2016). In the most profound sense, the forced departure of temporary migrants means the desire to protect one’s right to work. This is why, according to liberalism, there is a need to move toward more open approaches and thus toward more accessible employment policies for immigrants.
The Conservative View
From the point of view of conservatives, the liberal approach to immigration suffers from all the shortcomings of central planning. The unforeseen fluctuations that arise in a dynamic economy cannot be accommodated. The delays and costs inherent in bureaucratic processes are well known. The latest revival came in the form of support for education and training policies. These policies aim to make the immigration of highly skilled workers unnecessary. An essential feature of this policy is that it treats options as alternatives (one can either exempt native-born education or encourage immigration) rather than as complementary actions. For example, software companies should be required to pay the state dearly for hiring immigrant workers to make this move effective. According to conservatives, the money raised in this way should be used to fund the training of appropriate U.S.-born students.
Nursing View
It is important to understand that most of the cultures that were brought here in the United States are mutually shared and respected by most of individuals here now in several ways. Besides the politics or policy that people comply with, some examples of the practices that the people contribute to are the way of cooking, how an individual dresses, the values, the traditions, and many more (Bazzano et al., 2016). All of these things mingle with our culture and become an integral part of it. That is why my views are much closer to a liberal approach to immigration that welcomes diversity and does not see migrants as a threat to the economy or culture. I completely agree with those who support the liberal ideology regarding immigration policy in that everyone has the right to work and live freely in the country they like. My position is consistent with the fundamental question that migrants are constantly confronted by politicians who restrict their rights. In this case, I believe that the role of nurses is to ensure maximum equality for all people, regardless of the immigration policy of the country.
This issue nevertheless systematically affects nursing practice. For example, in the U.S., illegal immigrants are not provided with public health care until they are officially registered (Sorrell, 2017). At the same time, if a person in a condition requires emergency or regular medical care, he or she cannot receive support from the state. On the other hand, nurses who are committed to providing equal care to all must provide medical services regardless of a person’s civil status (Chen & Gill, 2015). This is a matter of personal choice by medical personnel as well as the policies of certain medical institutions. My position on this issue also correlates with the nursing code of ethics. One of its provisions states that a nurse must treat her patients equally and provide the same quality of care (Cesario, 2017). This is correct in terms of the ethical treatment of people and non-discrimination in health care settings. Provision number three of the nursing code of ethics states that “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (Goodwin University, 2020). This also means protecting the rights of immigrants to access health care.
In my practice as a nursing student, there have also been instances that confirm the ethics of this approach. One of our professors told us about a case in which a middle-aged woman was admitted to the hospital with severe inflammation of appendicitis. She was operated on, but because the woman did not have official citizenship or a certificate of registration, the hospital charged her a lengthy bill for her services. The woman did not have that kind of money, so one of the nurses helped her pay the bill. According to ethical rules, this was not a normal situation, but the nurse helped the patient get the service at the same price as U.S. citizens.
There are many other practical situations in which nurses can be involved in ethics, advocacy, and policy development. For example, they can suggest to the clinic management that they offer individualized services for migrants who have not yet been certified at a reduced cost. In this way, nurses can help these people get affordable, citizen-level care (Nwankwo & Funnell, 2017). In addition, through such offers, nurses can participate in the overall development of clinic policies and keep them up to date.
References
Bazzano, L. A., Green, T., Harrison, T. N., & Reynolds, K. (2016). Dietary approaches to prevent hypertension. U.S. National Library of Medicine National Institutes of Health, 15(6), 694-702. doi: 10.1007/s11906-013-0390-z
Cesario, S. K. (2017). Immigration basics for nurses. Nursing for Women’s Health, 21(6), 499-505. Doi: 10.1016/j.nwh.2017.10.004. PMID: 29223213.
Chen, A., & Gill, J. (2015). Unaccompanied children and the U.S. immigration system: Challenges and reforms. Journal of International Affairs, 68(1), 115-131.
Goodwin University. (2020). The Nursing Code of Ethics and what it means for prospective nurses. Goodwin University.
Fitzgerald, E. M., Myers, J. G., & Clark, P. (2016). Nurses need not be guilty bystanders: Caring for vulnerable immigrant populations. Online Journal of Issues in Nursing, 22(1), 8.
Muschek, A. G. (2015). The impact of undocumented immigrants on the healthcare infrastructure of the United States. The Journal of Social, Political, and Economic Studies, 40(4), 329-351. Web.
Nwankwo, R., & Funnell, M. (2017). What’s new in nutrition for adults with diabetes? Home Healthcare Now, 35(7), 386–390. Doi: 10.1097/NHH.0000000000000576
Poon, L. (2014). The immigrant kids have health issues — but not the ones you’d think. Goats and Soda.
Sorrell, J. M. (2017) Ethics of advocacy for undocumented patients. The Online Journal of Issues in Nursing, 22(3), 1-34. Doi: 10.3912/OJIN.Vol22No03EthCol01