Reflecting on your journey since graduating from your origin ✓ Solved

Reflecting on your journey since graduating from your original nursing program ( during Covid in 2020), consider how nursing has evolved over time. Additionally, contemplate whether nursing today aligns with your initial expectations upon entering nursing education. In your response, also address the ethical considerations inherent in immigration, migration, and their intersection with healthcare. How do these considerations contribute to the complexities of nursing practice and influence the delivery of patient-centered care in diverse healthcare settings? post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources. Submit your initial post as a Word document to this assignment. must receive a Turnitin similarity report and AI that is less than or equal to 20% in order to post to the Discussion board. Refresh and check your Turnitin score.

Paper for above instructions

Introduction
Graduating from nursing school during the COVID-19 pandemic in 2020 placed new nurses on the frontlines of an unprecedented global crisis. The transition from student to practicing nurse was profoundly shaped by emergency conditions, rapidly evolving protocols, and heightened emotional and ethical demands. Four years later, the landscape of nursing has continued to shift in response to technological advancements, workforce shortages, expanded scopes of practice, and shifting patient demographics driven by immigration and migration. This reflective essay explores how nursing has evolved since 2020, examines whether the profession aligns with initial expectations, and analyzes the ethical complexities associated with migration, immigration, and culturally diverse care. These considerations highlight the dynamic and multifaceted nature of modern nursing practice while emphasizing the importance of patient-centered care in a changing healthcare environment.

Nursing Evolution Since 2020

The COVID-19 pandemic catalyzed rapid changes within nursing practice. In 2020, new graduates entered a system under intense strain, with overwhelmed hospitals, insufficient staffing, and evolving guidelines. Nurses were required to master telehealth platforms, infection control protocols, and crisis standards of care within weeks. Today, many of these innovations have become permanent fixtures in healthcare delivery.

1. Increased Use of Telehealth and Digital Tools
Telehealth utilization expanded dramatically as healthcare systems sought to minimize exposure risk and maintain continuity of care. According to Rutledge et al. (2021), telehealth services increased by more than 1,000% during the early pandemic months, and nurses became essential in virtual triage, remote monitoring, and health education. The ongoing integration of digital health technologies—such as virtual visits, patient portals, and wearable monitoring devices—has transformed nursing workflows and patient engagement.

2. Expanded Scope of Practice for Nurses
During the pandemic, states temporarily broadened scope-of-practice regulations, enabling nurses and advanced practice providers to function autonomously in areas such as testing, vaccination, and management of acute conditions. This contributed to greater recognition of nurses as critical decision makers—a trend that has continued as organizations reconsider the value of nurse-led care models (Bosse et al., 2022).

3. Workforce Shortages and Burnout
Nursing shortages have worsened since 2020, driven by burnout, retirement, and increased job demands. The American Nurses Association (2023) reports that more than 100,000 nurses left the profession during the pandemic, citing exhaustion, moral distress, and staffing concerns. This shortage has intensified workloads for remaining staff and created a renewed emphasis on resilience, mental health support, and organizational well‑being initiatives.

4. Greater Emphasis on Public Health Preparedness
Nurses today operate with a deeper awareness of emergency preparedness, population health, and infection control. The lessons of COVID‑19 reinforced the importance of surveillance, early identification of outbreaks, and rapid mobilization of resources. Nursing curricula and practice have adapted to include greater focus on epidemiology, crisis management, and community-based care.

Does Nursing Today Align with Initial Expectations?

Many nurses who entered the profession in 2020 expected a collaborative, structured environment focused on patient care. Instead, they encountered crisis conditions, inconsistent guidance, and emotional trauma. Looking back, some aspects of nursing have aligned with early expectations—such as meaningful patient relationships and advocacy—but other aspects, such as chronic understaffing and administrative burdens, have been more challenging than anticipated.

1. The Reality of High-Stress Environments
Nurses often imagined steady workflows and supportive staffing. Instead, many units operated with crisis ratios for extended periods, shifting expectations around productivity and adaptability. Although staffing has improved in some settings, high workload continues to challenge the profession.

2. The Growth of the Nurse’s Voice
One unexpected development is the increased recognition of the nurse’s voice in policy-making, public health, and interdisciplinary decision making. Throughout the pandemic, nurses became trusted public figures, shaping vaccination campaigns, community safety messaging, and system‑level recommendations.

3. Deeper Understanding of Moral and Ethical Complexity
Nurses anticipated caregiving challenges, but many did not expect the level of moral distress experienced during crisis conditions, including resource allocation, visitor restrictions, and witnessing patient suffering in isolation. These experiences reshaped many nurses’ understanding of ethical practice and personal resilience.

Overall, nursing today is more complex, technology-driven, and ethically layered than the pre-pandemic profession many envisioned. Yet, it also continues to offer rewarding opportunities for impact, growth, and meaningful human connection.

Ethical Considerations in Immigration, Migration, and Healthcare

Immigration and migration significantly impact healthcare delivery, shaping patient demographics, health disparities, and ethical considerations. Nurses frequently care for individuals from diverse cultural, linguistic, and socio-political backgrounds, each presenting unique challenges and opportunities for patient-centered care.

1. Access to Healthcare
Many immigrants—particularly undocumented individuals—face substantial barriers to care, including lack of insurance, fear of deportation, language barriers, and limited transportation. Ethical nursing practice requires advocating for equitable access, respecting human dignity regardless of citizenship status, and providing culturally informed care. According to Page et al. (2020), nurses play a critical advocacy role in ensuring fair access to screenings, preventive services, and chronic disease management for migrant populations.

2. Cultural and Linguistic Competence
Migration increases cultural diversity within healthcare settings, making cultural competence essential. Nurses must understand cultural beliefs, health practices, and communication preferences that influence patient decisions. Language access services, including interpreters and bilingual staff, are critical for reducing miscommunication and ensuring informed consent (Flores, 2021).

3. Ethical Responsibility to Vulnerable Populations
Migrants often experience trauma, occupational hazards, discrimination, or social isolation. Nurses must provide trauma‑informed care, recognize psychosocial needs, and uphold principles of justice and beneficence. These ethical responsibilities complicate nursing practice but are essential for achieving equitable outcomes.

4. Policy and Advocacy
Immigration policies deeply affect health outcomes. Restrictive policies may deter individuals from seeking care, while supportive policies enhance community health. Nurses must stay informed about legal frameworks, confidentiality protections, and immigrant rights to ensure ethically sound care (De Mendoza et al., 2022).

Impact on Patient-Centered Care

The intersection of migration, cultural diversity, and health inequities expands the complexity of patient-centered care. Nurses must:

  • Develop awareness of cultural health beliefs and practices.
  • Use interpreters to support shared decision making.
  • Address social determinants such as housing, food security, and employment.
  • Acknowledge trauma histories related to migration journeys.
  • Advocate for inclusive policies and equitable care delivery.

These considerations reinforce that patient-centered care must go beyond clinical interventions to include cultural respect, compassion, advocacy, and a commitment to health equity.

Conclusion

Reflecting on the journey since graduating during the COVID-19 pandemic reveals how dramatically nursing has evolved—from crisis-driven practice to a more technologically advanced, ethically complex, and culturally diverse profession. While aspects of nursing today differ from initial expectations, the core values of compassion, advocacy, and patient-centered care remain unchanged. Ethical considerations related to immigration and migration further highlight the importance of cultural humility, equity, and justice in modern nursing practice. As healthcare continues to evolve, nurses must remain adaptable, informed, and committed to providing safe, equitable, and culturally responsive care to all individuals, regardless of their background or immigration status.

References

  1. American Nurses Association. (2023). Nursing workforce trends and challenges.
  2. Bosse, J., May, S., & Dempsey, A. (2022). Expanding scope-of-practice and advanced nursing roles. Journal of Nursing Regulation.
  3. De Mendoza, V., Torres, M., & Medina, G. (2022). Immigration policy and health disparities. Health Equity Journal.
  4. Flores, G. (2021). Language barriers and interpreter use in clinical care. Pediatrics.
  5. Page, K., Polk, S., & Choi, T. (2020). Health care access for immigrant populations. American Journal of Public Health.
  6. Rutledge, C. et al. (2021). Telehealth in nursing practice post‑COVID‑19. Journal of Telemedicine and Telecare.
  7. American Association of Colleges of Nursing. (2021). The impact of COVID‑19 on the nursing workforce.
  8. World Health Organization. (2023). Migration, health equity, and global nursing.
  9. Johnson, A. & Davis, P. (2022). Moral distress among nurses in crisis conditions. Nursing Ethics.
  10. Smith, R. & Allen, L. (2021). Cultural competence in primary care nursing. Journal of Transcultural Nursing.