{"title":"No Imagining too Radical, No Action too Disruptive","authors":"Blythe Bell, Cheryl Van Daalen-Smith","doi":"10.25071/2291-5796.104","DOIUrl":"https://doi.org/10.25071/2291-5796.104","url":null,"abstract":"","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"226 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115481307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence of Intimate Partner Violence (IPV) in Australia is rising. Women experiencing IPV seek assistance through Emergency Departments (ED). Women exhibit help-seeking behaviours to nurses who work in emergency over medical or allied health professionals. Nurses’ capacity to recognise the need to care for women experiencing IPV is essential. The aim of this study was to explore nurses’ capacity to care for women who have experienced IPV through outlining inhibiting factors that limit care and create a discourse that contributes to addressing these factors. Pre (n=10) and post (n=6) focus groups (FGs) were undertaken with nurses who work in ED. In between the FGs an intervention was applied to prompt change to caring practices. The discourse generated from the FGs was subjected to a Foucauldian discourse analysis from a poststructural feminist perspective. Participants’ capacity to care was found to be based on the values they formed on IPV, as shaped by their post-registration training. The formation of boundaries was fundamental in inhibiting the participants’ capacity to care. Challenging boundaries through educational inquiry into nursing values can be effective in shifting perspectives of IPV. The raising of awareness of IPV in our communities serves as a vital tool in eliciting cultural behaviour change within EDs and within nursing culture.
{"title":"Hiding in Plain Sight","authors":"Vijeta Venkataraman, T. Rudge, J. Currie","doi":"10.25071/2291-5796.73","DOIUrl":"https://doi.org/10.25071/2291-5796.73","url":null,"abstract":"The incidence of Intimate Partner Violence (IPV) in Australia is rising. Women experiencing IPV seek assistance through Emergency Departments (ED). Women exhibit help-seeking behaviours to nurses who work in emergency over medical or allied health professionals. Nurses’ capacity to recognise the need to care for women experiencing IPV is essential.\u0000The aim of this study was to explore nurses’ capacity to care for women who have experienced IPV through outlining inhibiting factors that limit care and create a discourse that contributes to addressing these factors. Pre (n=10) and post (n=6) focus groups (FGs) were undertaken with nurses who work in ED. In between the FGs an intervention was applied to prompt change to caring practices. The discourse generated from the FGs was subjected to a Foucauldian discourse analysis from a poststructural feminist perspective. Participants’ capacity to care was found to be based on the values they formed on IPV, as shaped by their post-registration training. The formation of boundaries was fundamental in inhibiting the participants’ capacity to care. Challenging boundaries through educational inquiry into nursing values can be effective in shifting perspectives of IPV. The raising of awareness of IPV in our communities serves as a vital tool in eliciting cultural behaviour change within EDs and within nursing culture.","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123199760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlotte Riordon, Sionnach Hendra, Christine Johnson
Canada’s public health (PH) systems are vulnerable to constant system and structural changes, influenced by political and economic factors. This rapid review examines how PH system restructuring impacts population health outcomes, with special consideration of health equity. Due to a lack of Canadian evidence, international research was examined to produce recommendations for Canadian nurses, researchers, and decision-makers. Evidence indicates that PH spending and PH system organization have important impacts on population health outcomes and suggests PH reform has a negative impact on health equity. Opportunities for advocacy, activism, lobbying and capacity building to achieve health equity are discussed. Nurses, in a unique position between public policy and the lives of those they care for, are presented with the opportunity to effect social change through political action and to work across disciplines to address inequities. We encourage researchers and decision-makers to prioritize looking more deeply at the impact of PH reform.
{"title":"The politics of public health: A rapid review of the impact of public health reform on population health outcomes","authors":"Charlotte Riordon, Sionnach Hendra, Christine Johnson","doi":"10.25071/2291-5796.66","DOIUrl":"https://doi.org/10.25071/2291-5796.66","url":null,"abstract":"Canada’s public health (PH) systems are vulnerable to constant system and structural changes, influenced by political and economic factors. This rapid review examines how PH system restructuring impacts population health outcomes, with special consideration of health equity. Due to a lack of Canadian evidence, international research was examined to produce recommendations for Canadian nurses, researchers, and decision-makers. Evidence indicates that PH spending and PH system organization have important impacts on population health outcomes and suggests PH reform has a negative impact on health equity. Opportunities for advocacy, activism, lobbying and capacity building to achieve health equity are discussed. Nurses, in a unique position between public policy and the lives of those they care for, are presented with the opportunity to effect social change through political action and to work across disciplines to address inequities. We encourage researchers and decision-makers to prioritize looking more deeply at the impact of PH reform.","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131099387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Power, Discourse and Resistance in Mental Health Care","authors":"D. Holmes, A. Perron","doi":"10.25071/2291-5796.85","DOIUrl":"https://doi.org/10.25071/2291-5796.85","url":null,"abstract":"","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127577645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Etowa, Bagnini Kohoun, E. Etowa, Getachew Kiros, I. Mbagwu, Mwali Muray, Charles Dabone, Lovelyn Ubangha, Hilary Nare
Despite the universal healthcare system in Canada, Canadians of African Descent (CAD) still face numerous problems that place them at higher risk to pandemics such as COVID-19. From the struggles of working as frontline workers, to challenges compounded by pre-existing chronic medical conditions such as Diabetes, CAD may face unique issues, further weighing on their existing and potential health outcomes. This situation calls for closer attention to the specific needs of CAD who may be at greater risk of late diagnosis and delayed treatment for COVID-19. Historically, marginalized communities such as CAD must be included in healthcare considerations and planning, so as to avoid further leaving them behind during and after the storm. Past evidence has shown that structural inequities shape who is affected by disease and its economic fallout. Therefore, the unique needs of CAD must be considered in healthcare planning with the ongoing COVID-19 response. Keywords: pandemic, marginalized, healthcare, COVID-19, Canadians of African Descent
{"title":"“Leaving no one behind”: COVID-19 Response in Black Canadian Communities","authors":"J. Etowa, Bagnini Kohoun, E. Etowa, Getachew Kiros, I. Mbagwu, Mwali Muray, Charles Dabone, Lovelyn Ubangha, Hilary Nare","doi":"10.25071/2291-5796.84","DOIUrl":"https://doi.org/10.25071/2291-5796.84","url":null,"abstract":"Despite the universal healthcare system in Canada, Canadians of African Descent (CAD) still face numerous problems that place them at higher risk to pandemics such as COVID-19. From the struggles of working as frontline workers, to challenges compounded by pre-existing chronic medical conditions such as Diabetes, CAD may face unique issues, further weighing on their existing and potential health outcomes. This situation calls for closer attention to the specific needs of CAD who may be at greater risk of late diagnosis and delayed treatment for COVID-19. Historically, marginalized communities such as CAD must be included in healthcare considerations and planning, so as to avoid further leaving them behind during and after the storm. Past evidence has shown that structural inequities shape who is affected by disease and its economic fallout. Therefore, the unique needs of CAD must be considered in healthcare planning with the ongoing COVID-19 response. \u0000Keywords: pandemic, marginalized, healthcare, COVID-19, Canadians of African Descent","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"197 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133782308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tara C. Horrill, J. Lavoie, Donna E. Martin, A. Schultz
Despite advancements in research and medicine, health inequities and disparities among First Nations peoples (FN) in Canada are well documented and continue to grow. Once virtually unheard of, cancer now is a leading cause of death among FN. Many factors contribute to cancer disparities, but FN face unique challenges in accessing healthcare. In this critical review and analysis, we explore potential links between cancer disparities and poor access to cancer care among FN. Research suggests FN experience difficulty accessing cancer services in several ‘places’ of care, including screening, diagnosis, treatment, survivorship and palliative care. Furthermore, there are notable ‘spaces’ or gaps both within and between these ‘places’ of care likely contributing to cancer disparities among First Nations. Gaps in care result from jurisdictional ambiguities, geographical location, unsafe social spaces, and marginalization of FN ways of knowing, and can be linked to colonial and neocolonial policies and ideologies. By drawing attention to these broader structural influences on health, we aim to challenge discourses that attribute growing cancer disparities among FN in Canada solely to increases in ‘risk factors’.
{"title":"Places & Spaces: A Critical Analysis of Cancer Disparities and Access to Cancer Care Among First Nations Peoples in Canada","authors":"Tara C. Horrill, J. Lavoie, Donna E. Martin, A. Schultz","doi":"10.25071/2291-5796.62","DOIUrl":"https://doi.org/10.25071/2291-5796.62","url":null,"abstract":"Despite advancements in research and medicine, health inequities and disparities among First Nations peoples (FN) in Canada are well documented and continue to grow. Once virtually unheard of, cancer now is a leading cause of death among FN. Many factors contribute to cancer disparities, but FN face unique challenges in accessing healthcare. In this critical review and analysis, we explore potential links between cancer disparities and poor access to cancer care among FN. Research suggests FN experience difficulty accessing cancer services in several ‘places’ of care, including screening, diagnosis, treatment, survivorship and palliative care. Furthermore, there are notable ‘spaces’ or gaps both within and between these ‘places’ of care likely contributing to cancer disparities among First Nations. Gaps in care result from jurisdictional ambiguities, geographical location, unsafe social spaces, and marginalization of FN ways of knowing, and can be linked to colonial and neocolonial policies and ideologies. By drawing attention to these broader structural influences on health, we aim to challenge discourses that attribute growing cancer disparities among FN in Canada solely to increases in ‘risk factors’.","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128659924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2018, over 70% of the 69,775 temporary migrant agricultural labourers arriving in Canada participated in the Seasonal Agricultural Workers Program (SAWP). Despite having legal status in Canada, these individuals are often systematically excluded from community life and face barriers when accessing health and social services. SAWP workers’ exclusion from many public spaces and their incomplete access to the benefits of Canadian citizenship or residency provide us a unique opportunity to examine social and political mechanisms that construct (in)eligibility for health and protection in society. As individuals seeking to care for the sick and most marginalized, it is important for nurses to understand how migrant agricultural workers are positioned and imagined in society. We argue that the structural exclusion faced by this population can be uncovered by examining (1) border politics that inscribe inferior status onto migrant agricultural workers (2) nation-state borders that promote racialized surveillance and; (3) everyday normalization of exclusionary public service practices. We discuss how awareness of these contextual factors can be mobilized by nurses to work towards a more equitable health services approach for this population.
{"title":"Borders and boundaries in the lives of migrant agricultural workers: Towards a more equitable health services approach.","authors":"Susana Caxaj, A. Cohen, B. Buffam, Oudshoorne Abe","doi":"10.25071/2291-5796.69","DOIUrl":"https://doi.org/10.25071/2291-5796.69","url":null,"abstract":"In 2018, over 70% of the 69,775 temporary migrant agricultural labourers arriving in Canada participated in the Seasonal Agricultural Workers Program (SAWP). Despite having legal status in Canada, these individuals are often systematically excluded from community life and face barriers when accessing health and social services. SAWP workers’ exclusion from many public spaces and their incomplete access to the benefits of Canadian citizenship or residency provide us a unique opportunity to examine social and political mechanisms that construct (in)eligibility for health and protection in society. As individuals seeking to care for the sick and most marginalized, it is important for nurses to understand how migrant agricultural workers are positioned and imagined in society. We argue that the structural exclusion faced by this population can be uncovered by examining (1) border politics that inscribe inferior status onto migrant agricultural workers (2) nation-state borders that promote racialized surveillance and; (3) everyday normalization of exclusionary public service practices. We discuss how awareness of these contextual factors can be mobilized by nurses to work towards a more equitable health services approach for this population.","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117023121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The advent of “the abortion pill” (Mifegymiso) in 2015 has shaped the contemporary context of access to abortion in Canada. In this paper, we highlight findings of a literature review that uses a gender and intersectional lens and critical discourse analysis to explore contemporary abortion access and implications for nursing. The discursive dynamics influencing nurses’ understandings of abortion, that is, the contexts in which some discourses are privileged over others yet often operate at the unconscious level to influence everyday knowledge and practices, are important to discern to work towards social justice goals. Findings suggest that normative and contradictory features of discourses such as women’s health, motherhood, and abortion access are relevant. Given the relative silence of abortion in nursing literature and prevailing gender normativity in nursing, there are compelling reasons to apply a critical feminist lens to deepen nurses’ understandings and critical reflection about abortion. There are implications for current education, research, and nursing practice.
{"title":"A critical feminist discursive analysis of dynamics shaping abortion in Canada: Implications for nursing.","authors":"M. Lebold, Judith A MacDonnell","doi":"10.25071/2291-5796.76","DOIUrl":"https://doi.org/10.25071/2291-5796.76","url":null,"abstract":"The advent of “the abortion pill” (Mifegymiso) in 2015 has shaped the contemporary context of access to abortion in Canada. In this paper, we highlight findings of a literature review that uses a gender and intersectional lens and critical discourse analysis to explore contemporary abortion access and implications for nursing. The discursive dynamics influencing nurses’ understandings of abortion, that is, the contexts in which some discourses are privileged over others yet often operate at the unconscious level to influence everyday knowledge and practices, are important to discern to work towards social justice goals. Findings suggest that normative and contradictory features of discourses such as women’s health, motherhood, and abortion access are relevant. Given the relative silence of abortion in nursing literature and prevailing gender normativity in nursing, there are compelling reasons to apply a critical feminist lens to deepen nurses’ understandings and critical reflection about abortion. There are implications for current education, research, and nursing practice. ","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130303236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health equity is defined in ways that espouse values of social justice and benevolence and is held up as an ideal state achievable by all. However, there remains a troubling gap in health outcomes between Indigenous Peoples and other Canadians. Public health stakeholders aspire to ‘close the gap’ and ‘level the gradient’ to reduce inequities though the implementation of various health equity focused strategies. The Truth and Reconciliation Commission of Canada echoes this objective and calls for self-determining structural reform to address health inequity for Indigenous Peoples. This paper proposes an IND-equity model as a reconciliation inspired response that upholds Indigenous self-determination and is informed by diverse Indigenous ways of knowing. When adopting this model, the goal is to complete the circle and foster wholistic balance. Further development and implementation of an IND-equity model requires advocacy by all health practitioners. Nurses hold potential to lead and engage in structural reform through an Indigenous health ally role.
{"title":"COMPLETING THE CIRCLE: TOWARDS THE ACHIEVEMENT OF IND-EQUITY- A CULTURALLY RELEVANT HEALTH EQUITY MODEL BY/FOR INDIGENOUS POPULATIONS","authors":"B. Downey","doi":"10.25071/2291-5796.59","DOIUrl":"https://doi.org/10.25071/2291-5796.59","url":null,"abstract":"Health equity is defined in ways that espouse values of social justice and benevolence and is held up as an ideal state achievable by all. However, there remains a troubling gap in health outcomes between Indigenous Peoples and other Canadians. Public health stakeholders aspire to ‘close the gap’ and ‘level the gradient’ to reduce inequities though the implementation of various health equity focused strategies. The Truth and Reconciliation Commission of Canada echoes this objective and calls for self-determining structural reform to address health inequity for Indigenous Peoples. This paper proposes an IND-equity model as a reconciliation inspired response that upholds Indigenous self-determination and is informed by diverse Indigenous ways of knowing. When adopting this model, the goal is to complete the circle and foster wholistic balance. Further development and implementation of an IND-equity model requires advocacy by all health practitioners. Nurses hold potential to lead and engage in structural reform through an Indigenous health ally role.","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128461335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Symenuk, Dawn Tisdale, Danielle H. Bourque Bearskin, T. Munro
The year 2020 marks five years since the Truth and Reconciliation Commission (TRC) of Canada released its Calls to Action, directing nursing to take action on both “truth” and “reconciliation.” The aim of this article is to examine how nurses have responded to the TRC’s call for truth in uncovering nursing’s involvement in past and present colonial harms that continue to negatively impact Indigenous people. A narrative review was used to broadly examine nurses’ responses to uncovering nursing’s complicity in five colonial harms: Indian hospitals, Indian Residential Schools, child apprehension, Missing and Murdered Indigenous Women and Girls (MMIWG), and forced sterilization. The paucity of results during the post-TRC period demonstrates a lack of scholarship in uncovering the truth of nursing’s complicity in these systems. Based on findings, we explore two potential barriers in undertaking this work in nursing, including a challenge to the image of nursing and anti-Indigenous racism.
{"title":"In Search of the Truth: Uncovering Nursing’s Involvement in Colonial Harms and Assimilative Policies Five Years Post Truth and Reconciliation Commission","authors":"P. Symenuk, Dawn Tisdale, Danielle H. Bourque Bearskin, T. Munro","doi":"10.25071/2291-5796.51","DOIUrl":"https://doi.org/10.25071/2291-5796.51","url":null,"abstract":"The year 2020 marks five years since the Truth and Reconciliation Commission (TRC) of Canada released its Calls to Action, directing nursing to take action on both “truth” and “reconciliation.” The aim of this article is to examine how nurses have responded to the TRC’s call for truth in uncovering nursing’s involvement in past and present colonial harms that continue to negatively impact Indigenous people. A narrative review was used to broadly examine nurses’ responses to uncovering nursing’s complicity in five colonial harms: Indian hospitals, Indian Residential Schools, child apprehension, Missing and Murdered Indigenous Women and Girls (MMIWG), and forced sterilization. The paucity of results during the post-TRC period demonstrates a lack of scholarship in uncovering the truth of nursing’s complicity in these systems. Based on findings, we explore two potential barriers in undertaking this work in nursing, including a challenge to the image of nursing and anti-Indigenous racism.","PeriodicalId":354700,"journal":{"name":"Witness: The Canadian Journal of Critical Nursing Discourse","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128279454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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