Nursing Inquiry最新文献

Nursing education holds a history framed in white supremacy and whiteness. Efforts to employ antiracist strategies have been hindered, largely due to an inability for faculty to acknowledge and hold accountability for racialized harms that occur within nursing educational structures. A nurse-midwifery program in the Pacific Northwest United States uncovered harm that impacted students and identified a need to respond and hold accountability. Guided by the framework of Transformative Justice, a truth and reconciliation process was implemented as a first step to better address racism within nursing and nurse-midwifery education. This paper describes the process to support other institutions in their work to address harms within nursing education.

Within the context of neoliberal healthcare, nurses and other health professionals face working conditions that leave them perpetually feeling inadequate, as though they are not enough. They are consistently expected to achieve more with less resources. In such an environment, mere professionalism proves wholly insufficient, enforcing norms of altruism and kindness. Professionals must transcend this disciplinary tool and embody a 'more-than-professional' approach. This study, informed by critical posthumanism, employs three mythical archetypes-the Medusa, the Witch and the Siren-to illuminate potential avenues for resistance against prevailing trends in healthcare. Drawing on the perspectives of Hélène Cixous, Silvia Federici and Jacques Rancière, we introduce a process of resistance for healthcare professionals pushing back against the challenges of crumbling healthcare systems. Cixous' feminist reimagining of Medusa symbolizes intensified embodied sensory experiences, emphasizing the power of irony, laughter and writing in highlighting the daily struggles faced by healthcare workers. Federici's depiction of the Witch exposes clandestine alliances among healthcare workers and patients, akin to a pact with the devil, countering the individualistic, alienating approach to care provision and resisting neoliberal pressures. The Witch archetype embodies resistance grounded in creativity against the commodification of public healthcare. Finally, Rancière's 'politics of the Siren' offers a strategy for disrupting entrenched hierarchies from the underworld. Like Sirens, healthcare workers and patients can subversively transform their silence into songs of resistance, simultaneously operating from beneath the surface of accountability measures. Our intention is to showcase the emergence of posthuman 'professionals' who adapt by forging new modes of social relations in response to neoliberal constraints, straying from conventional, apolitical notions of 'professionalism'. Drawing lessons from mythical figures of resistance offers a fresh understanding of subversion as a catalyst for social and political transformation within the healthcare sector.

In this article, we aimed to evaluate the utility of critical posthumanism for nurses interested in planetary health-a growing area of study that requires a decentering of the human, and environmental justice considerations. We used Chinn and colleagues' method to describe and critically reflect on critical posthumanism, extending the theory analysis method to include a wide range of academic and video sources. We found that critical posthumanism is like a double-edged sword: It provides a lens through which to transcend human-centric approaches to healthcare but is marred by its lack of clarity and inaccessibility. We argue critical posthumanism can be adapted to enhance its potential at the intersection of nursing and planetary health. An analysis of critical posthumanism is followed by a discussion framed by five ways of knowing in nursing, highlighting real-world examples of how critical posthumanism can aid nurses in dealing with planetary health concerns. By exploring the intersections of critical posthumanism with nursing knowledge, we demonstrate how critical posthumanism can enable nurses to comprehend and tackle environmental issues intricately linked to human health.

Many people want to spend the last stages of their lives at home, in familiar surroundings, and possibly with people they know. However, this increasing desire on the part of older, ill, or even dying people also makes support from other people unavoidable, which in many cases involves family members, loved ones, or even friends. These family caregivers care for the person concerned, even though they lack the professional skills of nursing staff, for example, and have usually not been prepared for this task. This article focuses on the ethical significance of the moral identity of family caregivers. While the effects of this care constellation on the caregivers have often been discussed in the scientific literature, ethical considerations regarding moral identity have so far been neglected. In the first step, the question of what is actually meant by the term moral identity is examined. The second step shifts attention to those people who have taken on the care of a loved one. The relevance of this previously discussed identity is emphasized by using study results and work in this context, and placed in relation to family caregivers. The third step shows that (1) moral identity must be understood as a necessary prerequisite for adequate and humane care, (2) this identity can be enhanced through the caregiving relationship, and (3) the activities undertaken by family caregivers reveal their moral identity. These considerations are finally summarized, provided with ethical aspects, and awareness of this important work of family caregivers is raised.

Nursing education, as with professionalization projects, is fraught with epistemicide, false separations, and a focus on expertise over relations and accountability. This is a critical reflection of the first 5 years of a four-semester prelicensure Community Engagement course series. As the course lead, I have consistently initiated adjustments, based on experiences teaching multiple sections and synthesizing comments and feedback from students and faculty, with an eye toward longstanding and pressing concerns in the world around us. Two broad epistemic arrangements emerge from this critical excavation: (1) naturalized hierarchy, false separations, and appraisals of relevance and (2) relationality and reflection as unsettling. There is a need for sustained collective examination and shift in how the nursing education and healthcare industries curate the meanings and practice of "community," "health," and "nursing," peering out from the regulatory oversight of neoliberal forces. How might we situate student progression, program implementation, institutional contracts, and curricular standards within the contexts of nursing programs' responsibilities to local communities in light of unfolding events locally and globally and their historical antecedents? How are we all, as faculty, disrupting siloes, false separations, and the contradictions of professionalism and the biomedical model to intentionally advance health equity? May we continue to illuminate the presence of community as being everywhere, not merely in juxtaposition to acute care. May we unsettle the prevailing theorization and practices of community throughout nursing education and commit to imagining and practicing relational praxis.

Existing challenges to the legitimacy of mental health nursing in the United Kingdom and beyond have stimulated a critical self-reflection and discourse around the mental health nursing role, forcing the profession to question its identity and critically re-evaluate its position within the wider healthcare arena. In this discussion paper, I suggest that the current difficulties in conceptualising mental health nurse identity arise from our role being inherently interwoven with distinctive challenges and unique needs of our service users. Emerging from this idea is that the 'being' (and the 'doing') of mental health nursing is firmly situated within the sphere of intersubjective relations. Drawing upon Hegel's ideas of reciprocal recognitive relations, to support the notion that our profession's role and purpose are better understood when defined in relation to the work that we do with our service users, I argue that it is in the understanding (and even embracing) of intersubjectivity as a core principle of mental health nursing, where we might not just better understand ourselves but also know how to shift asymmetric relations with our service users towards those which are more commensurate and mutually beneficial.

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care.

This scoping review mapped the academic literature focused on the therapeutic itinerary of children who seek care in health services and proposed an explanatory model to expand the concept and classification of these health itineraries. A total of 789 articles were reviewed, of which 28 were eligible for inclusion. In these 28 it was possible to observe that the child's therapeutic itinerary is more than a physical path, but also encompasses all choices within a specific social and cultural environment in which the child is inserted. Our proposal is to expand the concept beyond the therapeutic, classifying the itinerary also according to the objective, the decision-making agent, respect for the presence of company, the health subsystem used, according to the physical continuity of the itinerary, the perception of efficacy of the patient, the nature of the illness, the administration of healthcare, the means of transport used, the person providing information about the itinerary, the planning of the itinerary and its completeness. Knowing the child's itineraries toward healthcare allows the development of innovative discourses and practices for future public policies, through which the principles of comprehensiveness and resoluteness in children's health would be strengthened. There is still a need to deepen knowledge about the meanings and feelings regarding their interpretations of the events suffered in childhood.

There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as 'a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross-cultural situations', may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on 'Mutual collaboration and professional relationships' in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing.

In this manuscript, we explore the connections between Florence Nightingale's Cassandra and Virginia Woolf's A Room of One's Own while taking the authors' personal and social contexts into account. We conduct a detailed textual analysis from a feminist perspective. Cassandra and A Room of One's Own exhibit singular textual commonalities, such as evidence of trauma, the integration of myth and fiction as literary devices aimed at facilitating the author's access to various social spheres, the use of interpellations to impact the audience, and an argument for education as a path by which privileged women can enter the public realm. Both authors' personal wounds and intellectual frustrations influenced their work, thus making their writing very powerful.