Contested Practice: Political Activism in Nursing and Implications for Nursing Education

Advancing health equity in prelicensure nursing curricula: Findings from a critical review

Nurses play a crucial role in reducing health disparities and advancing health equity for individuals and communities. The future nursing workforce relies on their nursing education to prepare them to promote health equity. Nursing educators prepare students through a variety of andragogical learning strategies in the classroom and in clinical experiences and by intentionally updating and revising curricular content to address knowledge and competency gaps. This critical review aimed to determine the extent to which health equity concepts are explicitly present in prelicensure undergraduate nursing curricula globally. Of 434 articles screened, 22 articles describing 20 studies met inclusion criteria. Frequency and quantity of health equity content, concepts and topics, teaching strategies, evaluation strategies, and the overall extent of integration varied widely. Notably, only two articles described overall well-integrated explicit health equity content, and there was little attention to whether students transfer this learning into practice. A focus on individualism rather than population and community was noted, highlighting the presence of whiteness in nursing. Results from this review confirm that nursing education has room to improve with respect to health equity in the curricula.

Agendas on Nursing in South Korea Media: Natural Language Processing and Network Analysis of News From 2005 to 2022

BACKGROUND

In recent years, Korean society has increasingly recognized the importance of nurses in the context of population aging and infectious disease control. However, nurses still face difficulties with regard to policy activities that are aimed at improving the nursing workforce structure and working environment. Media coverage plays an important role in public awareness of a particular issue and can be an important strategy in policy activities.

OBJECTIVE

This study analyzed data from 18 years of news coverage on nursing-related issues. The focus of this study was to examine the drivers of the social, local, economic, and political agendas that were emphasized in the media by the analysis of main sources and their quotes. This analysis revealed which nursing media agendas were emphasized (eg, social aspects), neglected (eg, policy aspects), and negotiated.

METHODS

Descriptive analysis, natural language processing, and semantic network analysis were applied to analyze data collected from 2005 to 2022. BigKinds were used for the collection of data, automatic multi-categorization of news, named entity recognition of news sources, and extraction and topic modeling of quotes. The main news sources were identified by conducting a 1-mode network analysis with SNAnalyzer. The main agendas of nursing-related news coverage were examined through the qualitative analysis of major sources' quotes by section. The common and individual interests of the top-ranked sources were analyzed through a 2-mode network analysis using UCINET.

RESULTS

In total, 128,339 articles from 54 media outlets on nursing-related issues were analyzed. Descriptive analysis showed that nursing-related news was mainly covered in social (99,868/128,339, 77.82%) and local (48,056/128,339, 48.56%) sections, whereas it was rarely covered in economic (9439/128,339, 7.35%) and political (7301/128,339, 5.69%) sections. Furthermore, 445 sources that had made the top 20 list at least once by year and section were analyzed. Other than "nurse," the main sources for each section were "labor union," "local resident," "government," and "Moon Jae-in." "Nursing Bill" emerged as a common interest among nurses and doctors, although the topic did not garner considerable attention from the Ministry of Health and Welfare. Analyzing quotes showed that nurses were portrayed as heroes, laborers, survivors of abuse, and perpetrators. The economic section focused on employment of youth and women in nursing. In the political section, conflicts between nurses and doctors, which may have caused policy confusion, were highlighted. Policy formulation processes were not adequately reported. Media coverage of the enactment of nursing laws tended to relate to confrontations between political parties.

CONCLUSIONS

The media plays a crucial role in highlighting various aspects of nursing practice. However, policy formulation processes to solve nursing issues were not adequately reported in South Korea. This study suggests that nurses should secure policy compliance by persuading the public to understand their professional perspectives.

First-year nursing students' perceptions of health activism and social responsibility - A cross sectional study

BACKGROUND

Social responsibility and health activism both represent key concepts and professional values in nursing practice. Nevertheless, definitions in the nursing literature remain inconsistent, and little is known regarding nursing students' perceptions of these concepts or about the associations between these perceptions.

OBJECTIVES

This research explores: a) the associations between nursing students' perceptions of social responsibility and health activism; and b) the differences in nursing students' perceptions of social responsibility and health activism according to their personal characteristics.

DESIGN AND METHODS

Across-sectional survey design was conducted with a sample of 173 Israeli first-year undergraduate nursing students. Questions were uploaded in the format provided by a commercial Internet survey provider (Qualtrics.com) and distributed through social media groups.

RESULTS

Positive correlations were found between health activism and social responsibility and between health activism and philanthropic and environmental responsibility. Significant differences were found in the research variables according to the students' cultural group and voluntary service. Cultural group and social responsibility explained 25 % of students' variance in health activism.

CONCLUSIONS

Faculty and nurse educators should promote and develop nursing students' knowledge acquisition in health activism and social responsibility throughout all their years of study. It is recommended that nursing students be given meaningful opportunities to discuss, integrate, and apply health activism, guided by role models in clinical practice. Academic settings should also promote the value of social responsibility and support nursing students in taking active roles in social organizations in order to further develop and integrate the social component of their professional role.

Moving towards social dentistry: How do dentists perceive the Montreal-Toulouse model?

OBJECTIVES

This study aimed to understand the perspectives of dentists towards the Montreal-Toulouse model, an innovative approach that encompasses person-centredness and social dentistry. This model invites dentists to take three types of actions (understanding, decision-making, intervening) on three overlapping levels (individual, community, societal). This study aimed to understand (a) How dentists perceived the Montreal-Toulouse model as a framework for the practice of dentistry and (b) What parts of this model they were ready to adopt in their own practice.

METHODS

A qualitative descriptive study was conducted based on semi-structured interviews with a sample of dentists in the Province of Quebec, Canada. A combination of maximum variation and snowball sampling strategies was employed and 14 information-rich participants were recruited. The interviews were conducted and audio-recorded through Zoom and lasted approximately 1 h and a half. The interviews were transcribed verbatim and thematically analysed through a combination of inductive and deductive coding.

RESULTS

The participants explained they valued person-centred care and tried to put the individual level of the Montreal-Toulouse model into practice. However, they expressed little interest in the social dentistry aspects of the model. They acknowledged not knowing how to organize and conduct upstream interventions and were not comfortable with social and political activism. According to them, advocating for better health-related policies, while a noble act, 'was not their job'. They also highlighted the structural challenges that dentists face in fostering biopsychosocial approaches such as the Montreal-Toulouse model.

CONCLUSIONS

To promote the Montreal-Toulouse model and empower dentists to address social determinants of health, an educational and organizational 'paradigm shift' towards social accountability might be necessary. Such a shift requires curricular modifications and reconsidering traditional teaching approaches in dental schools. Moreover, dentistry's professional organization could facilitate dentists' upstream actions through proper resource allocation and openness to collaboration with them.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies

BACKGROUND

The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts.

OBJECTIVE

The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course.

DESIGN/METHODS

Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting.

CONCLUSION

Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

What if It Were Me? A Qualitative Exploratory Study of Emergency Nurses' Clinical Decision Making Related to Obstetrical Emergencies in the Context of a Post-Roe Environment

INTRODUCTION

Previous research describes a significant knowledge deficit in obstetrical care in emergency settings. In a post-Roe environment, additional medicolegal challenges are documented across the obstetrics and gynecology landscape, but an understudied care setting is the emergency department, where patients may present to a practice environment where there is limited or no obstetrical care available. It is unknown how emergency nurses make decisions around these types of presentations. The purpose of this study was to explore the clinical decision-making processes of emergency nurses in the care of patients with obstetrical emergencies in the context of limited or absent access to abortion care and the impact of those processes on patient care.

METHODS

Qualitative exploratory approach using interview data (n = 13) and situational analysis was used.

RESULTS

Situational mapping uncovered human elements comprised nurses, providers, pregnant people, and families; nonhuman elements comprised legislation, education, and legal understanding. Social worlds mapping included challenges of inexperience, conflict about clinical responsibility, uncertainty about the meaning of legislation, and passivity around implications for patient care. Positional mapping yielded both the overlapping discourses around the phenomenon of interest and the area of silence around abortion-limiting legislation.

DISCUSSION

We found that emergency nurses in states with abortion care-limiting laws had significant self-reported deficits in both education and training around the management of obstetrical emergencies. In this sample, there was a surprising lack of awareness of care-limiting legislation and the clinical, ethical, and legal implications for both emergency care staff and for patients.

Aligning Nursing Ethics With Critical and Open Pedagogy in Nursing Education: A Literature Review

BACKGROUND

There is a need to increase access to nursing education that is meaningful and socially just.

PURPOSE

To investigate the alignment of critical and open pedagogy in nursing education with nursing principles of ethics.

METHOD

Narrative thematic synthesis literature review of Canadian and American sources related to nursing education.

RESULTS

Thematic analysis of 29 full-text sources that align nursing ethical principles with critical and open pedagogy in nursing education.

CONCLUSION

Critical and open pedagogy aligns with nursing practice ethics and facilitates meaningful and socially just nursing education experiences.

Holistic Health of Two Spirit People in Canada: A Call for Nursing Action

Purpose: In response to item 7.1 from the Missing and Murdered Indigenous Women and Girls Report (2019), calling on health service providers to recognize the importance in inclusive services with and for Indigenous peoples including Two Spirit, lesbian, bisexual, transgender, queer, questioning, intersex, and asexual (2SLGBTQQIA) peoples, we undertook a review of the literature to identify the gaps in understanding and to better situate the health and resiliencies of Two Spirit people in Canada. Method: We conducted a review of 13 articles related to the health and wellness of the Canadian Two Spirit community. Overall, there was a dearth of Two Spirit specific health-related information. Results: Identified themes were grounded in the holistic Medicine Wheel teachings. These themes directly parallel holistic nursing in their demonstration that health is complex, and that there are many facets that make up an individuals’ health. Conclusion: Assessing the impact that colonization has had on the intersections of gender, race, sexuality, class, culture, and spirituality, Two Spirit people face unique health concerns. Considering the intersections of identity and structural barriers in place for this community, more research led by and in collaboration with the Two Spirit community is needed.

The Environment as a Patient: A Content Analysis of Canadian Nursing Organizations and Regulatory Bodies Policies on Environmental Health

BACKGROUND

Individual, community, and societal health is impacted by the environment, specifically by air, water and soil pollution, and climate change. Poor environmental conditions have been associated with many illness exacerbations. Although global nursing organizations have increased their environmental health focus, evidence is lacking that Canadian nurse leaders and organizations are similarly invested.

PURPOSE

The purpose of this analysis was to explore the policies of Canadian nursing regulatory bodies and associations on nursing practice specific to environmental health.

METHODS

A content analysis of nursing focused position statements and competency documents was conducted to assess Canadian nursing policies in environmental health. Publicly available position statements and competency documents regarding health and the environment were retrieved from Canadian nursing regulatory colleges and nursing associations, the Canadian Nursing Associations, and the International Council of Nurses. All documents were coded inductively and thematically analyzed.

RESULTS

In total, 22 documents were retrieved which consisted of 11 policy statements from nursing associations and 11 competency documents from nursing regulators and national associations. Four themes were generated: collaboration, language of engagement, nursing actions, and social justice.

CONCLUSION

There is a gap between nursing policies and competencies directing nursing action related to the health of the environment across Canada. There is an opportunity to improve eco-literacy within the nursing profession, undergraduate education and to produce nursing research on environmental health.

Using social media in contemporary nursing: risks and benefits

Social media has become incorporated into the practice of contemporary nursing. It must be acknowledged by the nurse and the nursing profession that social media has the power to enable the nurse to network with colleagues and share research findings through both private and open forums. However, it also has the potential to negatively influence patient care. This article discusses the use of social media and the dilemmas both ethical and legal. It highlights the need for the nurse and the nursing profession to remain vigilant regarding its use within both their personal and professional lives, to ensure that no boundaries are inadvertently crossed.

Nurses' and midwives' perspectives on participation in national policy development, review and reforms in Ghana: a qualitative study

Background

The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana.

Methods

A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures.

Results

Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raised.

Conclusion

The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00545-y.

Ampliando vozes sobre violência obstétrica: recomendações de advocacy para enfermeira(o) obstetra

Resumo Objetivos explorar as demandas das mulheres, bem como do público em geral, para melhorar a qualidade da assistência obstétrica; discutir as mudanças potenciais sugeridas pelos respondentes para tal prática assistencial. Método pesquisa multicêntrica realizada por meio da plataforma Opinio, explorando opiniões dos participantes de três cidades da região Sudeste do Brasil. Tratamento dos dados por estatística descritiva e análise temática. Resultados respondentes (n=414) na faixa etária 33-37 anos (26%), incluindo mulheres (75%) com mais de 15 anos de escolaridade, casadas (45%) e com um filho (35%), revelaram lacuna de conhecimentos sobre a violência obstétrica e os direitos da mulher. Jornal, rádio e televisão são as principais fontes de informação. O enfrentamento da violência obstétrica dar-se-ia por apoio familiar. Para a práxis renovada sugeriu-se a educação coletiva sobre direitos aos cuidados obstétricos (53,1%) e o atendimento humanizado (38,2%) mobilizando o poder profissional para consolidar a humanização. Temas analíticos centrais incluíram situação vivenciada pelas mulheres e contexto idealizado de prática. Conclusão e Implicações para a prática o debate incrementa a humanização e a governança compartilhada. Recomendações propostas para advocacy coadunam com a perspectiva global da promoção de saúde das mulheres e liderança social.

Concept analysis of nursing activism

Nursing history is firmly rooted in social and political activism; however, both the word activism and its defined actions have been minimized in modern nursing practice. This paper seeks to define activism, its uses, and importance to the nursing discipline. A concept analysis using the Walker and Avant (2019) method was conducted. Literature sources were identified through a search of PubMed, CINAHL, and PsycINFO along with hand searches of reference lists. Nursing activism is a concept that extends from within the discipline's ethical responsibilities and social contract with humanity. Activism differs from advocacy or engagement as it requires the expenditure of energy including personal, social, and/or political capital. Nursing activism is a necessary response to health inequities, social accountability, and advancement of the nursing profession.

The correlates of social determinants to ethico-moral values on professional development of Saudi nursing students

Objectives

This study determined the perceived professional values of nursing students, which are potentially correlated to their individual profiles.

Methods

This study utilized a cross-sectional design using the Nurse Professional Values Scale-Revised (NPVS-R) to determine nursing students' innate professional values. This study recruited 201 nursing students using a total enumeration sampling from Ha'il region, KSA.

Results

In the 26-item NPVS-R scale, item 1 was correlated to academic status at 0.01; item 3 was significantly correlated to gender at 0.01 and fluency in English at 0.01; item 4 was positively correlated to year level and fluency in English language at 0.00 and 0.0, respectively. Additionally, item 5 was found to be correlated to gender at 0.01; item 12 was correlated to gender at 0.01, year level (0.00), and fluency in English (0.01) and item 21 was correlated to gender and year level at 0.00 and 0.01, respectively. Finally, items 7, 22, 23, 24, 25, and 26 were significantly correlated with year level. The items with the highest correlations to the social determinants of the participants belonged to the values, justice and caring. Since nursing is a caring profession, these findings acknowledge that the values embodied by nursing students are critical. This reaffirms that nurses provide care with responsibility and accountability for its outcomes.

Conclusion

In this study, the participants recognized the protection and safety of public health as the most significant professional value. Similarly, patient confidentiality and the active involvement of nurses in professional organizations was highly valued.

Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization

There are continued challenges in achieving effective pain management for children and young people (CYP). Research has found several barriers to effective CYP pain management, which include, but are not limited to, deficiencies in knowledge among nurses and other healthcare professionals. Calls for improvements in and an increase in pain education ensue, in the expectation that an increase in knowledge will lead to an improved pain care for patients. Educational initiatives, as reported in the literature, have tended to focus on increasing empirical knowledge which has not resulted in the anticipated improvements in practice. An exploration of Carper's and Chinn & Kramer's five ways of knowing helps demonstrate why an over-reliance on empirics fails to equip nurses for the realities of clinical practice and does not facilitate knowledge mobilization or improvements in pain care for CYP. In this paper, we explore these ways of knowing to produce a model for knowledge mobilization in (pain) education. Our model puts forward a multifaceted approach to education using the active learning principles which supports and equip nurses to become effective pain practitioners.

Nursing, advocacy and public policy

This article draws attention to the nature and importance of public policy. It argues that if nurses are to influence the quality of healthcare effectively, they must be engaged with policymakers to get nursing care issues on the policy agenda. There is an ethical imperative to do so, driven by the advocacy role of the nurse and rooted in the values base of nursing. In addition, it is argued that if one takes the role of patient advocacy seriously, as core to the nursing role, two things are required of nurses: We must (a) broaden the conceptualisation of patient advocacy beyond the individual patient to the system of healthcare resourcing and provision and (b) see systemic change as important as change at the bedside.

The relevance of Xenophon's Anabasis and Plato's Meno to nursing

The current situation in which the humanities are disparaged affects all university disciplines, including nursing, in whose historical evolution the humanities have always been present in one form or another. Looking beyond this disrepute, this study proposes that nursing renew its attention to classical philosophy. Specifically, it invites a close reading of Xenophon's Anabasis and Plato's Meno, to get three related goals: to show how the use of ancient texts are very valuable tools for the philosophical initiation of nursing students and can help them reflect on their choice of nursing as a practical activity; to reflect on the problem of virtue and the nature of the good life; and to show how the interaction with ancient texts allows students to reflect on questions and issues of life, theirs and others, that are not open to investigation through a purely scientific method. Consequently, both Anabasis and Meno readings strengthen the intellectual relationship between philosophy and nursing, enabling the latter to delve deeper into the key questions of its own thought as a discipline.

Critical Social Justice: The Moral Imperative for Critical Perspectives in Nursing

There is increasing urgency to enact critical perspectives in the profession of nursing, with a resurgence of the political, a deliberative focus on social change, and a growing uneasiness with remaining neutral in the face of such pressing need. This analysis starts with a brief overview of critical perspectives, underscoring nursing’s complex positioning at the interface of witnessing peoples’ suffering, and the structural change necessary to address its root causes. Although witnessing may imply watching, or even bystanding, here it refers to historical and cultural meanings of witnessing as standing alongside in solidarity and action throughout the struggle for justice—bearing witness as a moral and a political obligation. Moral bystanding is described as a foundational barrier to achieving the moral imperative of critical perspectives. We conclude with pathways for cultivating and enacting a critical gaze, and a call for moral courage to systematically integrate critical perspectives in nursing. Throughout the discussion, we draw upon the work of nurse ethicists to provide important links about enacting critical perspectives as part of the moral foundation of nursing. Our intention is not to provide an analysis of the moral contexts of nursing, but rather to situate critical perspectives within the moral territory of social change, synthesizing key ideas that have direct salience for critical social justice in nursing. Keywords: critical perspectives in nursing, critical social justice in nursing, moral bystanding, social change