What nurses of color want from nursing philosophers

Science of Unitary Human Beings: Toward Anti-racist Actions for Human Environment Wellbecoming

Rogers' Science of Unitary Human Beings (SUHB) and several theories that emanate from Rogers' work contain foundational concepts that may lend themselves toward nursing actions to address important social justice mandates, to advocate and to act for equity, and to uproot systems of oppression and racism in nursing. However, at the same time, theoretical concepts such as power arising from ascendant theories of SUHB are often used with little to no critical reflection for past and present-day histories of racism and power inequities in nursing and in society writ large. Using concepts related to SUHB such as integrality, turbulence, power, and patterning, we critically explore the potential of developing anti-racism reflections and actions through 3 theories: Barrett's Knowing Participation in Change; Butcher's Kaleidoscoping in Life's Turbulence; and Smith's Turbulence-Ease in the Rhythmic Flow of Patterning. We acknowledge that SUHB was/is largely developed within a framework of whiteness by scholars who were/are working from academic positions and social identities of societal safety and privilege. This requires nurses to reflect on how that history shapes SUHB. We also acknowledge the urgent need for ongoing anti-racism and justice work by nurses. As a call to action, we suggest a start by critically building upon existing theoretical foundations in SUHB to develop a more explicit anti-racist theorizing-praxis in nursing for the wellbecoming of humans and nonhumans alike.

Addressing diversity, equity, and inclusion: A response of professional nursing organizations to the future of nursing: 2020-2030 recommendations

One way in which professional nursing organizations have chosen to address the social determinants of health (SDoH) is through policy work focused on diversity, health equity and anti-racism activities. The recent report, Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (FON 2020-2030), calls on professional nursing organizations and/or nursing coalitions to focus on addressing the SDoH to mitigate health inequities, including a focus on addressing racism and promoting practices to ensure the diversity of the nursing workforce. While these recommendations highlight issues of high importance to nursing and the broader society, they assume that professional nursing organizations or coalitions have not been sufficiently engaged in this work to date. Our goal was to better understand the current and/or ongoing activities of professional nursing organizations around their anti-racism work of diversity, health equity, and inclusion (DEI) activities recommended in the FON 2020-2030 report. To address this goal, we conducted a needs assessment of professional nursing organizations to document their DEI activities and the timing of these activities relevant to the recommendations in the report. The 26 responding organizations indicated they had been engaged in work addressing DEI issues for periods ranging from 4 months to 51 years. Minimal funding was the major barrier to advancing this work. Creating a vigorous shared DEI agenda across the profession, as suggested in the FON 2020-2030 report, will require input from nurses across the profession, as well as identification of resources to support this critical endeavor.

Labeled as "drug-seeking": nurses use harm reduction philosophy to reflect on mending mutual distrust between healthcare workers and people who use drugs

Introduction

Over 50 years of approaching drug use from the "War on Drugs" has led to ignoring the systemic structural and social determinants of health, enforced drug use stigma, and damaging stereotypes of people who use drugs or are labeled as "drug-seeking," and sorely failed to support those needing assistance.

On philosophy of harm reduction and power

People who use drugs are often disenfranchised and pathologized by being labeled as "a drug addict," which then serves as a rationalization for mistreatment by healthcare providers. This is in opposition to a harm-reduction approach. Harm reduction philosophy is an epistemic valuation necessary for drug use stigma and our moral obligation to reduce harm from interlocking systems of power that perpetuate harm.

On drug-seeking mistrust and human rights

We have encountered many clients who use drugs that report harmful interactions with healthcare providers. Harm reduction is an issue of health equity, social justice, and fundamental human rights. This paper presents three vignettes, the author's experiences of being labeled as-and advocating for family members labeled as "drug-seeking."

Discussion

To better serve as healthcare providers, workers must be equipped to work with people who use drugs and reinforce the social justice commitment against medical stigma, neglect, racism, and inadequate pain coverage and withdrawal treatment. Nurses and our epistemic lens can meet the challenge of complex intersectional issues affecting our use of power to develop more just and equitable health systems and advance our rebuilding of a trusting relationship with the people we serve.