NUR 306 Module 3 Project One Vulnerable Population Profile Example

Project One: Lobster Crew Members of Pell Harbor as a Vulnerable Population

[Student Name]

Southern New Hampshire University

NUR 306: Nursing in the Community

Project One

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Project One: Lobster Crew Members of Pell Harbor as a Vulnerable Population

A vulnerable population is a group whose shared circumstances place its members at higher risk of poor health than the general population. In Pell Harbor, a composite lobstering town on the Maine coast, the most visible such group is not defined by age, income or diagnosis but by work. This profile describes the town's lobster crews, the captains and sternmen who fish from small boats, and argues that their vulnerability comes from a chain of linked risks: a dangerous job produces injuries, injuries produce pain that must be managed while the season is still running, and a seasonal income with limited coverage makes both harder to treat. The profile ends by selecting one priority problem for community nursing intervention.

Defining the Population

Pell Harbor has about 140 licensed commercial lobster harvesters and roughly 90 sternmen who work for them during the season, which runs heavily from late spring through late fall. Most boats carry one or two people. Crew members range from teenagers working summers to captains in their seventies, and most are men. Many families have fished for generations, and the town's fishermen's cooperative buys most of the catch. These figures are composite estimates for a town of this size; in practice, a nurse would confirm them with the cooperative and the state licensing office. The population boundary used here is anyone who worked on a Pell Harbor lobster boat during the last season, including part-time and seasonal crew, since injuries and pain do not respect job titles.

Occupational Injury

Commercial fishing is among the most dangerous occupations in the United States. Its 2016 work-related death rate was about 23 times the rate for all U.S. workers, and falls overboard accounted for 27.0% of fishing deaths from 2000 through 2016 (Case et al., 2018). East Coast lobster was among the fisheries with the most fatal falls. Nonfatal injuries are far more common. Interviewing randomly selected lobster captains from two New England states every quarter, Fulmer et al. (2016) found acute injuries at a rate of 49.7 per 100 full-time equivalents per year, with 15.0 per 100 requiring treatment, rates much higher than those drawn from Coast Guard reports. The work combines hauling heavy traps, repetitive lifting, wet decks, moving lines and long hours, so hand, back and shoulder injuries are part of ordinary seasons rather than rare events.

Pain, Opioids and Overdose Risk

Injuries in a seasonal job create pressure to keep working. A sternman with a shoulder injury in July may lose his place on the boat if he stops, and a captain may lose the income that has to last the winter. That pressure makes pain management a central health issue. Hawkins et al. (2019) coded industry and occupation on death certificates for all opioid-related overdose deaths in Massachusetts from 2011 to 2015 and found that construction and fishing workers had rates many times higher than the average for all workers. The authors also found that occupations with more work injuries, more job insecurity and less access to paid sick leave had higher overdose death rates. Lobstering has all three features. For Pell Harbor, this means that a fall on deck and an overdose death are not separate problems; they may be two points on the same path.

Income, Coverage and Access to Care

Lobster crews are often self-employed or paid by a share of the catch, which means income arrives unevenly and is concentrated in a few months. Coverage varies: some captains buy marketplace plans, some sternmen qualify for Medicaid in the off-season but not at the height of summer, and some go without. Access is thin even with coverage. The town's health center is open two days a week, the hospital is 35 minutes away, and crews leave the harbor before dawn and return in the afternoon, when most offices are closing. Healthy People 2030 identifies economic stability and health care access and quality as two of five domains of social determinants (U.S. Department of Health and Human Services, n.d.), and both apply directly to this group's pattern of delayed care.

Strengths and Resources

The population also has real strengths. Crews are tightly connected through family, the cooperative and the harbor, and news travels quickly on the wharf. Fishermen have deep practical knowledge of weather, boats and the sea, and they have a long tradition of helping one another in emergencies. The cooperative already organizes safety equipment purchases and could host health events, and the harbor master and the local fire department have trained in water rescue. Any intervention should build on these assets rather than bring in outside programs that ignore them.

Priority Problem

Several problems could justify intervention, including injury, pain and overdose risk, and access. The priority chosen for the Project Two intervention is drowning after a fall overboard. The reasons are practical. It is the most lethal event in the chain, it is highly preventable, and the key protective behavior, wearing a personal flotation device on deck, is rare: none of the 204 fishermen who died after falling overboard from 2000 to 2016 was wearing one (Case et al., 2018). It is also a problem the crews themselves recognize, which makes it a credible starting point for a community nurse who wants to earn trust before taking on harder topics such as pain and opioid use.

This choice has costs. Drowning prevention does not address the more common nonfatal injuries or the overdose risk described above, and those deserve attention in later work, ideally through partnerships with the regional recovery coalition and the health center. Starting where the community is ready, however, is itself a principle of community health practice.

Conclusion

Pell Harbor's lobster crews are vulnerable not because of any individual weakness but because of the conditions of their work: dangerous decks, pressure to fish through injury, uneven income and care that is hard to reach at the hours they are free. Their strengths, close ties, practical knowledge and an established cooperative, give a community nurse a way in. The intervention that follows will begin with the most preventable death in the harbor.

References

Case, S. L., Lincoln, J. M., & Lucas, D. L. (2018). Fatal falls overboard in commercial fishing: United States, 2000-2016. Morbidity and Mortality Weekly Report, 67(16), 465-469. https://doi.org/10.15585/mmwr.mm6716a2

Fulmer, S., Buchholz, B., Jenkins, P., & Scribani, M. (2016). Work-time exposure and acute injuries in inshore lobstermen of the Northeast United States. Journal of Agromedicine, 21(2), 190-199. https://doi.org/10.1080/1059924X.2016.1143431

Hawkins, D., Roelofs, C., Laing, J., & Davis, L. (2019). Opioid-related overdose deaths by industry and occupation: Massachusetts, 2011-2015. American Journal of Industrial Medicine, 62(10), 815-825. https://doi.org/10.1002/ajim.23029

U.S. Department of Health and Human Services. (n.d.). Social determinants of health. Healthy People 2030. https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health