" (May 2008, p. 779) it is actually surprtising that there are as many people in th world as there are who believe that the poor are those who do not work, given the current state of the economy and that fact that the majority of people who seek health care but are unable to pay for it are members of the working poor, class, a group that works full or greater than full time but has no or little opportunity to achieve economic independence. Part of non-maleficence is seeking to offer intervention and preventative care to those who need it so they may not have to face costly life saving care. Nurses and other front line health care workers feel fidelity with those they serve and seek to demonstrate this through active participation in the development of ethical standards that are inclusive of the disadvantaged, acting within their political arena to make changes, on an institutional or local level, some even acting in a more global way to advocate for change on a national level. (Wold, Brown, Chastain, Griffis & Wingate, October/December 2008, pp. 171-178) Wold et. al. stress there are cases, that should be seen as templates to change, where groups of student nurses and nurses have banded together to help create a healthier community through the attempt to solve a specific health related problem, in the case of this review to assist in a rural southern community who had a significant lack of dental care for the poor. These types of social change constitute a living example of how nurses at all levels can and often do advocate for change within the confines of their profession.

The response of institutions has largely been to attempt to isolate nurses and other workers from the collections end of the business, while still professing to maintain high standards of access. Keeping this in mind many nurses have sought to answer the question of equal access for the poor by stepping outside institutions and seeking to develop model programs that serve the needs of those least likely to be served inside their own workplace. Some have even gone so far as to become political advocates for access laws and taken extreme pay and working condition demotions to work for this cause in an environment that better serves the needs of the poor, while this is not true of all nurses those who are willing to do so should be seen as pioneers and modeled upon.
Resources

Wray, J., Walker, L., Benedict, E. (August 2008) Student nurses' attitudes to vulnerable groups: A study examining the impact of a social inclusion module. Nurse Education Today 28(6) 779.

Wold, S.J., Brown, C.M., Chastain, C.E., Griffis, M.D. & Wingate, J. (October/December 2008) Going the Extra Mile: Beyond Health Teaching to Political Involvement, Nursing Forum, 43(4) 171-178.

Young and Uninsured," in Brief (July/August 2008) the American Nurse, 4-5.