. 60). During this period, tuberculosis has become increasingly drug resistant causing treatment to be less effective and control to become more difficult (Gebhart, 1992, pp. 37-41). Tuberculosis is most prevalent in the nation's inner cities (Skelly, 1993, pp. 11-14). The increase in immigration from developing areas of the world over the past 15 years has contributed to the problem, as a significant proportion of these individuals arrive in the United States already suffering from serious illnesses such as AIDS (acquired immunity deficiency syndrome) and tuberculosis. AIDS and tuberculosis are frequently found in the same patient.
While tuberculosis is contagious, the disease is not easily contracted through casual and infrequent contact with infected individuals. Lengthy and repeated contact with an individual infected with tuberculosis is required to produce a tuberculosis infection, particularly among individuals whose immune function is impaired. The conditions required for tuberculosis infection, unfortunately, frequently are found among the homeless and other economically disadvantaged population groups.
Some nurses question the requirement that they provide treatment for tuberculosis patients who do not comply with treatment regimens. Other nurses question a requirement for them to deliver care to inner city populations where the incidence of such diseases as tuberculosis and AIDS is the highest.
Social issues also affect the attitudes of some nurses toward the delivery of care. Abortion, do not resuscitate orders, and a patient's right to die are three such issues confronting nurses in the contemporary period. Research has found that a decision to abort or not to abort is difficult for a woman, regardless of the circumstances and the nature of the decision (Hall, 1990, pp. 32-35). Research has also found that many women experience difficulty in verbally expressing their feeling with respect to a decision ...