Ael 667 group project


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  • Immigration is one of the factors involved in the debate of reform: Are we the people too crowded to respond generously to non-citizens?Today we want to take the debate into our classroom for discussion with this critical debate question:
  • Immigration is one of the factors involved in the debate of reform: Are we the people too crowded to respond generously to non-citizens?Today we want to take the debate into our classroom for discussion with this critical debate question:
  • Each of you take out a sheet of paper. On the top of the sheet of paper write which side of the debate at this point you would support, the pro side: healthcare and nursing in the United States must provide medical services to all people no matter their citizenship through whatever means available or the con side: as U.S. citizens and healthcare workers, we have an obligation to implement financial regulations within our system to limit free care in order to stop the rising healthcare cost for those contributing to the tax system. Do these 5 critical concepts contribute to your decision? As the debate is presented, instead of agreeing with the initial side you have written, jot down thought, ideas or references to argue the opposite of what you have written. This is the objectives:
  • The US Department of Homeland Security (2011) published a derived estimate of over 10 million illegal aliens residing in the United States. These individuals are not eligible for citizenship or federal or state benefits, but are not always denied local educational and public health clinics and hospital services for their families with proof of residency. They may “borrow “ social security cards in order to obtain employment and thus subsidize federal and state programs and others' benefits.
  •,,id=129236,00.htmlImmigration stats from department of Homeland Security as derived numbersCurrent annual legal immigration quotas are 226,000 family based and 140,000 employment based slots, 55,000 green card lottery winners, 90,000 refugees ( ½ European, need financial sponsor), 10,000 special status. These are Lawful Permanent Residents( LPR), hold a green card and a social security number and pay state, federal income and social security taxes. Immediate family members who travel to the US together may also be granted LPR status, thus increasing the effective annual legal immigration quotas to approximately 1 million per year. The estimated total LPR living in the United States were 12.6 million in January, 2010. They are not eligible for federal benefits such as Medicare and Social Security retirement and disability benefits. The process toward citizenship is variable and may be lengthy. These families work legally, and if well-employed may hold work-related health insurance benefits and are eligible for public health and educational services in most states.The US Department of Homeland Security (2011) published a derived estimate of over 10 million illegal aliens residing in the United States. These individuals are not eligible for citizenship or federal or state benefits, but are not always denied local educational and public health clinics and hospital services for their families with proof of residency. They may “borrow “ social security cards in order to obtain employment and thus subsidize federal and state programs and others' benefits.
  • What is your role as a nurse? Who must you treat? How must you treat them? These are some of the questions you should ask yourself as a professional and a person. Some topics as a nurse are difficult to address. There are times when you may feel a heavy burden with employer demands, patient demands, and societal demands of you and it is easy to become cynical and hard. But in order to maintain the professionalism of nursing, not reverting back to the days that nurses were not afforded an education, only training as a trade, we must analyze our role in our society. We must know why we do what we do and remember to practice an art of diminishing human suffering. Self reflection and realizing your stance in the healthcare system should be a part of your professional career.
  • Ael 667 group project

    2. 2. PRO CON Our national identity of generosity to  The reality of radical inequality of those less fortunate; human kindness , healthcare costs and access for U.S. national philosophy “Give me your citizens---basic healthcare is not even a tired, your poor” right of citizenship Prevention of public health issues and  The recent economic crisis has strained costs of disease from lack of taxpayers who are contributing the immunizations and safe, healthy most to support healthcare costs housing for thousands of residents who through high taxes and health are not eligible in some states insurance premiums Retail tax income from healthy,  Lack of income tax and business taxes motivated employees to support health services directly for Increased healthy labor pool as illegal residents essential for some businesses to thrive  Flood the country with immigrants To deny healthcare to immigrants needing healthcare displays racism and classism  The national debt and obligation to Structural Violence through bringing protect those already here immigrants in to work the fields and  A breech in national security work in nursing, but denying help to others
    3. 3. •To learn about immigration laws and healthcare cost•To better understand how social, political and structuralsystems affect healthcare systems•To learn how to engage in both sides of a debate anddiscover evidence for your own nursing practice•To develop a true sense of holistic care•To address your own thoughts and feelings aboutracism, classism, structural violence, nationalism and silenceand how these pertain to your role as a nurse
    4. 4. 5 Critical Concepts: Take out a sheet of paper. WriteNationalism Classism which side of the debate at this point you would Structural support. Silence Violence Which of these 5 critical Racism concepts contribute to your decision?
    5. 5. Legal Immigration: Lawful Illegal Immigration: Permanent Resident  An individual who is not (LPR) a U.S. citizen or U.S. Immediate Relatives national and resides in the U. S. without legal Family-Based status Employment-Based  As defined by Refugees Government Student Visa Regulation: Illegal Aliens
    6. 6. Estimated at ~ 11 Million About 27 % increase in past decade Of all unauthorized immigrants living in the U. S. in 2010 39 % entered in 2000 or later, and 62 % were from Mexico.
    7. 7. Immigrant LawfulPermanent Resident~ 12 Million with immediatefamily members also eligibleThe process toward citizenshipis variable and may be lengthyand expensive.work legally, have a “greencard” and if well-employedmay hold work-related healthinsurance benefits.Regardless of employmentthey are eligible for publichealth and educationalservices.Annual Quotas include226,000 family-based, 140,000employment-based, 90,000refugee, and 10,000 specialstatus for a total expectedlawful immigration of ~1 millionper year
    8. 8.  Labor migration is a significant phenomenon throughout the world, from the most vulnerable illegals through the most educated STEM professionals (Farmer, 2005; and-Labor/Workforce.aspx, 2011) Mexico’s minimum wage is a little over $4.00 per day. (
    9. 9.  Agribusiness and manufacturing have long used immigrant labor to reduce costs and increase cooperation of employees when U.S. workers were not willing to tolerate minimum wage for hard labor without health insurance or other benefits. U. S. businesses have legally relocated a portion of these jobs in other countries through NAFTA (Farmer, 2005, Loewen, 2007 ). Some jobs have been taken to the other countries through NAFTA ( and-Labor/Workforce.aspx ).
    10. 10. The belief that races have distinctive cultural characteristics determined by hereditary factors and that this endows some races with an intrinsic superiority over others.Racism. (n.d.). Collins English Dictionary - Complete &Unabridged 10th Edition. Retrieved November 29, 2011,from :
    11. 11. Barbee (1993), described three types of racism, based upon theworks of Jones, (1972). Individual Racism emphasizes discriminatory acts directed towards individuals because of visible biological characteristics. Cultural Racism involves individual and institutional expression of the superiority of one’s cultural heritage over that of others. Institutional Racism the intentional or unintentional manipulation or toleration of institutional policies that unfairly restrict the opportunities of particular groups.
    12. 12. o ~10 million migrant farm laborers in the U.S. Extremely poor health status of migrant workers is often the result of structural racism and anti-immigrant practices.o Migrant worker job assignments often made based upon perceived biological/racial attributes and differences (e.g. height).o Clinicians and migrant workers rarely question the racism practices because they are considered natural and NOT social – societal normalizingo Only 5% of migrant farm workers have health insurance (84%, U.S. citizens with health insurance)Holmes, S. (2006). An ethnographic study of the social context of migrant health in the united states. Plos Medicine, 3 (10), 1776- 1793.
    13. 13. The article we read by Holmes points out thedisparities between race, class and social positionin provision of healthcare. Facts that stand out: • Latino children have twice the death and hospitalization rates from pedestrian injury than do white children in the U.S. • Latino adults have lower rates of preventive medicine screening. • Latino immigrants face medical deportation on a daily basis by clinicians and healthcare workers who deem them as unworthy of assistance. (Holmes, 2006).
    14. 14.  Connections between public health policies and the development of long- lasting representations of Mexicans as disease carriers are demonstrated by the response to a 1916 typhus outbreak in Los Angeles County. The disease spread from person to person, spurring the creation of local policies derived from the premise that all Mexicans spread disease (Molina, 2011). Medical deportations were not uncommon.
    15. 15. Formal Letter of Complaint :Dear Sir: Due to the difficult circumstances we find ourselves in this foreign country, we look to you asking for help in this case. We are enclosing a copy of the severe law that the railroad line has imposed on us Mexicans who work on the track, which we do not see as a just thing, but only offensive and humiliating. When we crossed the border into this country, the health inspector inspected us. If the railroad line needs or wants to take such precautions it is not necessary that they treat us in this manner. For this, they would need health inspectors who assisted every individual with medical care and give us 2 rooms to live, one to sleep in and one to cook in, and also to pay a fair wage to obtain a change of clothes and a bar of soap. This wage they set is not enough for the nourishment of one person. Health comes from this and these precautions are the basis for achieving sanitation. Health we have. What we need is liberty and the opportunity to achieve it. We need a bathroom in each section of camp and that the toilets that are now next to the sleeping quarters be moved. Many times their bad smell has prevented us from even eating our simple meal. Furthermore, we can disclose many other details which compromise our good health and personal hygiene With no further ado, we remain yours, graciously and devotedly, your attentive and faithful servants. We thank you in advance for what you may be able to do for us.Felipe Vaiz, José Martinez, Felipe Martinez, Adolfo Robles,Alejandro Gómez, Alberto Esquivel.[12]
    16. 16. Inequalities in Global Market: The nursing shortage of the 2000’s caused hospitals to recruit foreign nurses as a means to provide fill the gap in trained professional nurses Hospitals employed companies to go to developing countries and seek out nurses to come to the US by offering them wages that sounded great but were actually much less than American born nurses were making. Foreign nurses are recruited from poor developing countries depleting their healthcare labor force
    17. 17.  Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the U.K. and the US. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labor. This tendency is currently exacerbated by nursing shortages in developed countries (Ross, Polsky & Sochalsky, 2005). Countries that provide most nurses are highly populated poorer nations (Ross et al, 2005).
    18. 18.  Overcoming language barriers Dealing with discrimination Adopting U.S. nursing practices Adjusting to U.S. social customs Becoming accustomed to U.S. culture Reconciling work ethics. (Lin, 2009)
    19. 19. Why do immigrants fail to seek healthservices on a regular basis?Social Barriers › lack of social support › limited English proficiency › immigration status › fearHealth Care Delivery Barriers › financial cost › lack of child care › lack of transportation › lack of time
    20. 20. › Immigrants use the language of silence to express themselves.› Parin Dossa (2003) tells us that silence does not rule out speech. She tells us that much can be "said" through the silent gaps between words.› In her Migratory Tale of Social Suffering and Witnessing, Dossa shows how Zahra uses the silent language of the body (her symptoms) to tell her story.› Witnessing makes it necessary for us to listen to the language of silence.
    21. 21.  Audre Lorde (1980) says that "silence and invisibility gohand in hand with powerlessness.“Many immigrants keep silent in hopes of staying "invisible"and not stirring up any questions, especially if they are illegal.In research about postpartum depression (PPD) in Hispanicwomen, it was found that most of them will not admit to oracknowledge the fact that they are experiencing any formof depression. Hispanic women feel ashamed and thatdepression should be kept silent. There are many women thatsimply wont say anything. Many female immigrants keep silent out of fear. Fear ofauthority, deportation, or in many cases their husbands(depending on their culture.) A PERSONAL STORY
    22. 22.  Is it ethical to entice nurses from poorer countries to come to developed countries to practice nursing? What produces the most tension in the debate of issues of immigration ? What is the regulatory meaning and description of immigration in the U.S? What is the historical healthcare experience of immigrants, both legal and illegal, in the U.S.? What is the best role of the nursing profession in serving the immigrant population?
    23. 23.  Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual, and an intuitive sense of ethics, and of the appropriateness of action taken. ~ Myrtle Aydelotte We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering ~ Elisabeth Kubler-Ross
    24. 24. Barbee, E. (1993). Racism, gender, class, and health. Medical Anthropology Quarterly, 7 (4), 346-362.Callister, L.C., Beckstrand, R.L., & Corbett, C., (2011). Postpartum Depression and Help-Seeking Behaviors in Immigrant Hispanic Women. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(4), 440-449.Dossa, P. (2003). The Body Remembers, A Migratory Tale of Social Suffering and Witnessing. International Journal of Mental Health, 32(3), 50-73.Farmer, P. ( 2005). Pathologies of power: Health, human rights, and the new war on the poor. Berkley, CA: The University of California Press.Holmes, S. (2006). An ethnographic study of the social context of migrant health in the United States. PLOS Medicine (3) 10. p 1776-1793.Lin, L. (2009). A synthesis of the literature on Asian nurses work experiences in the United States. Research & Theory for Nursing Practice, 23(3) p 230-45.Loewen, J.( 2007). Lies my teacher told me. New York, NY: The New Press.Lorde, A. (1980). The Transformation of Silence into Language and Action. J. Pinkvoss & S. Brawn (Eds.), The Cancer Journals (pp. 16-22). San Francisco: aunt lute books.Molina, N. (2011). Borders, laborers, and racialized medicalization: Mexican immigration and US public health practices in the 20th century. American Journal of Public Health. 101(6).National Manufacturer’s Association ( 2011). Retrieved from Labor/Workforce.aspxRacism. (n.d.). Collins English Dictionary - Complete & Unabridged 10th Edition. Retrieved November 29, 2011, from, S., Polsky, D. & Sochalsky, J. (2005). Nursing shortages and international nurse migration. International Nursing Review. 52(4) 253-62