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Witness: The Canadian Journal of Critical Nursing Discourse最新文献

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Nurses Supporting Harm Reduction: How Take-Home Naloxone is Conceived in the Context of Neoliberalism 护士支持减低伤害:如何在新自由主义背景下构思 "带回家的纳洛酮
Pub Date : 2023-12-27 DOI: 10.25071/2291-5796.138
Sibelt Kusdemir, Abe Oudshoorn
Introduction – Individuals must be personally invested in their own recovery journey; however, the neoliberal perspective absolves the state of responsibility of this work and makes promotion of health merely an individual action. Naloxone distribution, as a harm reduction strategy, is presented herein as one practice engaged by nurses that demonstrates philosophical tension between neoliberalism and harm reduction. Background Literature – The research literature supporting the provision of take-home naloxone (THN), non-medically administered, is significant and broad. Discussion – The problem with neoliberal discourses of constrained healthcare resources in this case is that without broad availability of naloxone, drug poisonings will continue unchecked. There is an ethical call to nurses to support broad distribution of naloxone regardless of the costs involved. Conclusion – THN is not only a best practice to reduce the harms of substance use, but it is also a political and philosophical act to hand over the control of public health resources to the public.
导言--个人必须亲自投入到自己的康复历程中;然而,新自由主义观点免除了国家在这项工作中的责任,使促进健康仅仅成为一种个人行为。本文介绍的纳洛酮发放作为一种减少伤害的策略,是护士参与其中的一种实践,显示了新自由主义与减少伤害之间的哲学矛盾。 背景文献--支持提供非医用带回家纳洛酮(THN)的研究文献既多又广。 讨论 - 在这种情况下,新自由主义关于医疗资源有限的论述的问题在于,如果不广泛提供纳洛酮,毒品中毒事件将继续得不到控制。护士们有义务支持纳洛酮的广泛分发,而不考虑所涉及的成本。 结论 - THN 不仅是减少药物使用危害的最佳做法,也是将公共卫生资源控制权交给公众的政治和哲学行为。
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引用次数: 0
Where are they going, and what can we do to keep them? Intent to leave among nurses in British Columbia, Canada 他们要去哪里,我们怎样才能留住他们?加拿大不列颠哥伦比亚省护士的离职意向
Pub Date : 2023-12-27 DOI: 10.25071/2291-5796.155
Mycal Barrowclough, Tarya Morel, Shuyi Chua, Sandra Wu
Purpose. To identify: (1) alternate professions being considered by nurses, and (2) potential policy levers to retain them. Methods. This study describes responses to a subset of questions on a survey of nearly 15,000 nurses in British Columbia. Participants expressing intent to leave were asked what other professional options they were considering, and what changes they would need to keep them in nursing. We used thematic analysis to identify themes and sub-themes of participant responses. Results. Fewer than one in five nurses expressed intent to stay in the profession for more than two years. Participants cited a wide variety of other professional options available to them; the most commonly cited category was ‘anything but nursing’. When asked what they needed to stay in nursing, participants described improvements in compensation, safe staffing, work/life balance, workplace culture, physical and psychological safety, and opportunities for advancement.
目的。确定:(1) 护士正在考虑的其他职业,(2) 留住她们的潜在政策杠杆。方法。本研究描述了对不列颠哥伦比亚省近 15,000 名护士进行的一项调查中部分问题的回答。我们询问了表示有意离开的参与者,他们正在考虑哪些其他职业选择,以及需要哪些改变才能让他们留在护理行业。我们使用主题分析来确定参与者回答的主题和次主题。结果。只有不到五分之一的护士表示有意在护理行业工作两年以上。参与者列举了他们可以选择的各种其他职业;最常被提及的类别是 "除护理之外的任何职业"。当被问及继续从事护理工作需要哪些条件时,参与者提到了薪酬、安全人员配备、工作/生活平衡、工作场所文化、身心安全和晋升机会等方面的改善。
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引用次数: 0
White privilege and professionalization: a decolonial and critical feminist perspective on professional nursing 白人特权与专业化:从非殖民主义和批判性女权主义视角看专业护理
Pub Date : 2023-12-27 DOI: 10.25071/2291-5796.153
Natalie Stake-Doucet
This article offers a critical perspective linking invisibility with the political foundations of the dominant, Eurocentric model of modern nursing. Using critical feminist and decolonial feminist frameworks, this paper begins by analyzing gendered, reproductive labor in the centuries leading up to the industrial revolution in Britain and Europe and how the current dominant model of nursing was developed. The second part of the paper suggests a critical link between white supremacy, colonial violence and the professionalization of nursing work. Finally this paper calls on nursing scholarship to move beyond the narrow definition of nursing within the professional framework to include people who have done and continue to do the work of nursing despite being denied the title because of segregation and colonial violence.
本文提供了一个批判性视角,将隐匿性与以欧洲为中心的现代护理主导模式的政治基础联系起来。本文采用批判性女权主义和非殖民地女权主义框架,首先分析了英国和欧洲工业革命前几个世纪的性别化生殖劳动,以及当前占主导地位的护理模式是如何发展起来的。论文的第二部分提出了白人至上主义、殖民暴力和护理工作专业化之间的重要联系。最后,本文呼吁护理学术界超越专业框架内对护理工作的狭隘定义,将那些尽管因种族隔离和殖民暴力而被剥夺了护理职称,但仍然从事并继续从事护理工作的人纳入其中。
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引用次数: 0
Nursing in Canada: Broken, but not Beyond Repair 加拿大的护理工作:破碎,但并非无法修复
Pub Date : 2023-12-27 DOI: 10.25071/2291-5796.159
Michael Villeneuve, Linda Silas
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引用次数: 0
Nurses - Workforce Commodity, or Autonomous Professionals: What Nurses Know about their Value, Working Conditions, Impacts on Patient Care, and Nursing Practice Concerns 护士--劳动力商品,还是自主专业人员:护士对自身价值、工作条件、对患者护理的影响以及护理实践问题的认识
Pub Date : 2023-12-27 DOI: 10.25071/2291-5796.156
Anna Power-Horlick
The current focus on the critical shortage of nurses puts nurses at risk for representation as a health workforce commodity, rather than being recognized as an autonomous, knowledge-based profession without which the health of Canada’s population is in jeopardy. Nurses’ knowledge and professional role includes evaluation of their career, working conditions, and impact on patients and populations of care. The concern that nurses are leaving the profession can be analyzed within a feminist perspective related to autonomy and advocacy. The focus of this reflective commentary is to highlight, at a personal and collective level, that nurses are witnesses to the conditions fueling nursing shortages, the impact on the practice environment and the structural factors influencing these areas. We are therefore compelled to articulate the seriousness of our concerns and assert our knowledge and value as a profession.
目前对护士严重短缺问题的关注,使护士有可能被视为一种卫生劳动力商品,而不是被视为一种自主的、以知识为基础的职业,没有这种职业,加拿大人口的健康就会受到威胁。护士的知识和专业角色包括对其职业生涯、工作条件以及对病人和护理人群的影响进行评估。可以从与自主和倡导有关的女权主义视角来分析对护士离职的担忧。本反思性评论的重点是在个人和集体层面强调,护士是造成护理人员短缺的条件、对实践环境的影响以及影响这些领域的结构性因素的见证人。因此,我们不得不阐明我们所关注问题的严重性,并申明我们作为一个专业的知识和价值。
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引用次数: 0
Policy-related Homelessness Discourses in Canada: Implications for Nursing Research, Practice, and Advocacy 加拿大政策相关的无家可归话语:对护理研究、实践和倡导的影响
Pub Date : 2023-07-31 DOI: 10.25071/2291-5796.145
Arnel Boras, M. Komakech, D. Raphael
Despite Canada’s commitment to several international human rights instruments recognizing the right to housing, homelessness remains widespread nationwide. Informed by critical political economy theory and critical discourse studies, we examined relevant literature focusing on homelessness policy-related documents in the Canadian context. The findings demonstrate interrelated homelessness policy discourses: 1) emergency shelters, 2) housing first, 3) social determinants of health, 4) human rights, and 5) political economy approach. We conclude that a critical political economy approach offers the most helpful way of understanding and responding to the homelessness crisis in Canada. Homelessness is a socioeconomic and political problem requiring nurses and health professionals to take sociopolitical actions. As nurses and health justice advocates, we stand in solidarity with labour movements to protect public health. This study can be adopted in local, national, and global settings.
尽管加拿大对承认住房权的若干国际人权文书作出了承诺,但无家可归现象在全国仍然普遍存在。在批判性政治经济学理论和批判性话语研究的指导下,我们研究了有关加拿大背景下无家可归政策相关文件的相关文献。调查结果显示了相互关联的无家可归政策话语:1)紧急避难所,2)住房优先,3)健康的社会决定因素,4)人权,5)政治经济方法。我们的结论是,批判性的政治经济学方法提供了理解和应对加拿大无家可归危机的最有用的方法。无家可归是一个社会经济和政治问题,需要护士和保健专业人员采取社会政治行动。作为护士和卫生正义倡导者,我们与工人运动团结一致,保护公众健康。这项研究可以在地方、国家和全球范围内采用。
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引用次数: 0
Vers des stratégies de plaidoyer structurel : une étude sur le processus de plaidoyer chez les infirmières en santé communautaire 面向结构性倡导策略:社区卫生护士倡导过程的研究
Pub Date : 2023-07-31 DOI: 10.25071/2291-5796.151
G. McCready, Hélène Laperrière
In order to reduce social inequities in health, nurses need to move from patient advocacy to policy advocacy. Literature reports many barriers when nurses try to address the structural level of policy advocacy. Very little empirical research exists to show how nurses respond to these barriers and the resulting impact on the effectiveness of policy advocacy. This study characterized the types and the process of advocacy practiced by community health nurses. A collaborative ethnography with 21 nurses showed that their policy advocacy was often dismissed, leading to negative consequences such as less policy advocacy attempts, changes in their clinical evaluation with patients and personal experiences of moral distress. We argue that structural change will only occur when collective advocacy will be supported by organizations, therefore reducing inequities that affect both community health and working conditions of nurses. Afin de réduire les iniquités sociales de santé, les infirmières doivent dépasser le plaidoyer axé sur les individus en investissant des stratégies de plaidoyer ciblant les structures et les politiques. Dans cet article, nous soutenons que de ne pas exercer de plaidoyer structurel peut amener des conséquences néfastes pour les infirmières elles-mêmes et les communautés qu’elles desservent. Cette étude caractérise les types et le processus de plaidoyer exercés par les infirmières en santé communautaire. Une ethnographie collaborative avec 21 infirmières montre que leurs tentatives de plaidoyer structurel étaient ignorées, décourageant les tentatives futures, entraînant des changements dans leur évaluation clinique et des expériences de détresse morale. Nous argumentons que le changement structurel surviendra seulement lorsque les stratégies de plaidoyer seront collectivisées et soutenues par les organisations de santé, réduisant ainsi les iniquités affectant à la fois la santé communautaire et les conditions de travail des infirmières.
为了减少卫生方面的社会不平等,护士需要从患者倡导转向政策倡导。文献报道了许多障碍,当护士试图解决政策倡导的结构水平。很少有实证研究表明护士如何应对这些障碍以及由此产生的对政策宣传有效性的影响。本研究对社区卫生护士倡导的类型和过程进行了分析。一项针对21名护士的合作人种志研究表明,她们的政策倡导经常被驳回,导致诸如政策倡导尝试减少、她们对患者的临床评估发生变化以及个人道德痛苦经历等负面后果。我们认为,只有当组织支持集体倡导时,结构变革才会发生,从而减少影响社区健康和护士工作条件的不平等。Afin de reduire les iniquites优势种德桑特莱斯infirmieres doivent depasser le plaidoyer斧苏尔les每个en investissant des策略de plaidoyer ciblant les结构等政治。在第6条中,“不确定的情况是不确定的”,“不确定的情况是不确定的”,“不确定的情况是不确定的”,“不确定的情况是不确定的”,“不确定的情况是不确定的”。这个练习曲caracterise les类型等le突起de plaidoyer exerces par les infirmieres en桑特欧盟法规。一项民族志合作研究包括21项研究:结构上的 结构上的 结构上的 结构上的 结构上的;我们argumentons le换向机构structurel surviendra seulement当莱斯策略de plaidoyer对于毛粹et soutenues莱斯德桑特组织,依照ainsi reduisant les iniquites affectant像次卫生法规et de阵痛des infirmieres les条件。
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引用次数: 0
Breast/chest feeding Support: Critically Analyzing a Canadian Policy Guiding Nursing Practice 母乳/胸部喂养支持:批判性分析加拿大指导护理实践的政策
Pub Date : 2023-07-31 DOI: 10.25071/2291-5796.147
Hermandeep Deo, Emmanuela N Ojukwu, G. Boschma
The World Health Organization has identified the importance of improving the rates of breast/chest feeding for population health. Canadian health organizations have put public health resources toward breast/chest feeding support. Despite statements of purpose describing health promotional interventions to be focused on improving overall population health, many times these methods are based only upon biomedical knowledge and fail to adequately address the needs of diverse populations. Thus, in this paper we critique a Canadian policy providing clinical guidance to care providers through the application of a relational inquiry framework. We draw on the first author’s experience as a Public Health Nurse delivering breast/chest feeding support within the scope of these guidelines to further illustrate the point. The results from published evidence are integrated within this critique to provide an evidence base for policy improvement recommendations to improve the social, cultural, and political components of breast/chest feeding typically overlooked in current standards.
世界卫生组织确定了提高母乳/胸部喂养率对人口健康的重要性。加拿大卫生组织将公共卫生资源用于支持母乳/胸部喂养。尽管目的声明将健康促进干预措施的重点放在改善总体人口健康上,但很多时候,这些方法仅以生物医学知识为基础,未能充分满足不同人口的需求。因此,在本文中,我们批评了加拿大的政策,通过应用关系查询框架为护理提供者提供临床指导。我们利用第一作者作为公共卫生护士在这些指南范围内提供母乳/胸部喂养支持的经验来进一步说明这一点。已发表证据的结果被纳入本评论,为政策改进建议提供证据基础,以改善当前标准中通常被忽视的母乳喂养的社会、文化和政治组成部分。
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引用次数: 0
Racialized-gendered Experiences and Mental Health Vulnerabilities of Young Asian Women in Toronto, Canada 加拿大多伦多亚洲年轻女性的种族性别经历和心理健康脆弱性
Pub Date : 2022-12-16 DOI: 10.25071/2291-5796.125
Krisel Abulencia, Coralee McLaren, M. Vahabi, J. Wong
Discourses of mental health vulnerabilities of women in the Asian diaspora s are often invoked through the concepts of “culture” with little consideration of asymmetric power relations and structural influences. We used a narrative approach to explore the experiences and perspectives on culture, identities, relationships, and mental health among young Asian women living in Toronto, Canada. We engaged 14 participants in focus groups and individual interviews, and identified four overall themes: (1) racialized-gendered bodily abjection, (2) experiences of enacted racism and sexism, (3) perceptions of familial expectations, and (4) their strategies of coping and resilience. Our analysis revealed how Whiteness and structural violence shape the racialized-gendered experiences of young Asian women and perpetuate microaggressions that compromise their mental  health and well-being. Critical  nursing practice must question the idea of “culture” embedded in the dominant discourse of “culturally competent” care. Nurses need to achieve structural competence to dismantle systems of oppression and unequal power relations.  
关于亚洲散居妇女心理健康脆弱性的论述经常通过“文化”概念来引用,很少考虑不对称的权力关系和结构性影响。我们采用叙事的方法来探讨生活在加拿大多伦多的年轻亚洲女性在文化、身份、人际关系和心理健康方面的经历和观点。我们对14名参与者进行了焦点小组和个人访谈,并确定了四个总体主题:(1)种族化的性别身体自卑,(2)制定的种族主义和性别歧视的经历,(3)对家庭期望的看法,以及(4)他们的应对和恢复策略。我们的分析揭示了白人和结构性暴力如何塑造年轻亚洲女性的种族性别经历,并使损害她们心理健康和福祉的微侵犯永恒化。关键护理实践必须质疑“文化”嵌入“文化主管”护理的主导话语的想法。护士需要获得结构性能力,以拆除压迫和不平等权力关系的系统。
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引用次数: 0
Leadership and System Transformation: Advancing the Role of Community Health Nursing 领导力与体制转型:促进社区卫生护理的作用
Pub Date : 2022-12-16 DOI: 10.25071/2291-5796.101
J. Etowa, I. Hyman
It is widely recognized that structural and social determinants of health (SDoH) account for a large proportion of health inequities in Canada. According to the Public Health Agency of Canada (PHAC), many health actors are required to provide leadership and direction in tackling health inequities. In this paper we argue that community health nurses (CHNs) are well situated to play a critical role in health system transformation in Canada. CHNs are known for having a holistic and collaborative approach with competencies beneficial for the reduction of health inequities. However, to become more consistently effective advocates of health equity, CHNs require competencies in the principles of equity and social justice, community engagement, communication, coalition building, and system transformation. Having a critical mass of CHNs with appropriate leadership skills in knowledge generation and mobilization, advocacy, and collaboration is fundamental to effectively addressing health inequities in Canada.
人们普遍认识到,健康的结构性和社会决定因素在加拿大卫生不公平现象中占很大比例。根据加拿大公共卫生署(PHAC)的说法,需要许多卫生行为者在解决卫生不公平问题方面提供领导和指导。在本文中,我们认为,社区卫生护士(CHNs)很好地定位在卫生系统转型在加拿大发挥关键作用。卫生保健中心以具有有利于减少卫生不平等的能力的整体和协作方法而闻名。然而,要成为更加持续有效的卫生公平倡导者,中国儿科医生需要具备公平和社会正义原则、社区参与、沟通、联盟建设和系统转型方面的能力。在知识产生和动员、宣传和协作方面拥有适当领导技能的临界数量的chn是有效解决加拿大卫生不公平问题的基础。
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引用次数: 0
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Witness: The Canadian Journal of Critical Nursing Discourse
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