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Case:
J.R. is a nurse practitioner who serves an urban Chinese community. The challenges she faces daily include coordinating health care for the community members, fostering compliance with treatment regimens, and teaching the community about health prevention and early detection of diseases and conditions.
J.R. has learned that one of the main reasons the community members do not adhere to their treatment regimens is because of mistrust of Western medicine. Many of the patients are older adults who rely on homeopathic treatments they learned in China as children. These patients prefer to take Chinese herbs in lieu of prescription medications. Additionally, these patients do not like to attend health screenings or take part in immunization clinics because they do not believe these measures are beneficial to their health.
L.W. is a nurse practitioner in an urban community. Many of her clients recently immigrated to the United States from various countries. She is challenged by the many different cultures she encounters and the different values and beliefs they hold toward Western medicine.
She is determined to earn her clients’ trust. She does this by providing health care services that are respectful of each client’s health beliefs and practices and cultural needs. She knows she must set aside her own values and beliefs to focus on what is important to her clients in order for them to have successful outcomes.
D.H. is a nurse administrator at a large primary practice. His duties include maintaining the nurses’ schedules to keep within the facility’s budget; overseeing the hiring and training of nurses; ensuring that the work environment for the nurses is safe; and resolving any employment issues with the nurses that require disciplinary action, termination, or reporting adverse nursing care to the state board.
One of his primary initiatives during the nurses’ orientation is to reiterate the importance of incorporating the goals of Healthy People 2020 into the nurses’ care.
Questions for the case 
What type of prevention J.R. is trying to achieve when she encourages her patient population to attend the blood pressure screening events?
Please elaborate your answer; compare prevention types, give examples and share similar challenges you might have faced during your practice.
Identify the different roles and responsibilities of the nurse.
Please discuss the challenges you anticipate facing when fulfilling the various roles of a nurse practitioner. How would you work to improve your weaknesses? Identify your strengths.
Which patient population is most likely to experience health disparities and why?

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