Use The Allegory of the Orchard to discuss how the political determinants of health negatively impact the health outcomes of a group of patients for whom you care. Why are you, as a nurse, the right person to become politically involved in addressing these determinants?
As a nurse, I am the right person to become politically involved in addressing these determinants because our profession's core principles and daily experiences uniquely position us for this role.
Front-line Witness: Nurses are at the bedside, witnessing firsthand the devastating effects of political and social determinants on health. We see how a patient's asthma is exacerbated by a nearby factory, how their diabetes is worsened by a lack of access to healthy food, or how their recovery is stalled by unstable housing. We connect the dots between policy and pathology in a way that policymakers often cannot.
Patient Advocate: Advocacy is a fundamental tenet of nursing. While we advocate for individual patients in clinical settings, our professional responsibility extends to advocating for entire populations. Political involvement is a natural extension of this role—it's advocating on a macro level to change the systems that make our patients sick in the first place.
Credible and Trusted Voice: Nurses consistently rank among the most trusted professions. When we speak out on health issues, our message carries significant weight and credibility with the public and with legislators. We are seen as knowledgeable, compassionate, and focused on patient well-being, not on a political agenda.
Holistic Perspective: The nursing model of care is holistic, considering the patient's entire life context—physical, emotional, social, and environmental factors. This perspective naturally leads us to see the bigger picture and recognize that health is not just the absence of disease but the presence of conditions that support well-being. Engaging in political action allows us to address these conditions directly.
In essence, while others may be able to treat the "sick fruit" in the orchard, the nurse's role is to go to the root of the problem and advocate for better "soil" and "sun"—the political determinants that affect everyone's health.
Based on "The Allegory of the Orchard," political determinants of health negatively impact patient outcomes by controlling the fundamental resources and conditions that shape well-being. The "Orchard" represents the health of a community. The "soil" and "sun" symbolize the political and economic systems that influence everything from access to healthcare to clean air and safe housing. When these systems are controlled by those who prioritize profit or political power over public health, the "fruit" (the health of the people) suffers.
In my practice, a group of patients—those with chronic respiratory illnesses like asthma and COPD—are severely impacted by these determinants. They live in a low-income community located near a major industrial park. The political determinants at play here are the lax environmental regulations and zoning policies that allow these factories to operate with minimal oversight, spewing pollutants into the air. The patients' health issues are directly linked to the poor air quality, but the root cause isn't a lack of medical care; it's the political decisions that prioritize corporate interests over public health. My clinic can provide inhalers and oxygen tanks, but it cannot change the polluted air they breathe every day. The political decisions—or lack thereof—in creating and enforcing environmental policies are what truly dictate their health outcomes.