As practicing nurses, we see firsthand that our system runs rampant with health inequalities and disparities. With the concept of caring being integral in the nursing profession, it is no wonder that nurses advocate for these vulnerable groups and individuals. This keen awareness of social justice, or lack thereof, is a skill that should be instilled or begun to be instilled early in a student nurse’s academic journey.
Most nursing programs, however, are focused on clinical expertise and standardized test preparedness rather than teaching students to be aware of and to address macro-level problems in our society (Thurman & Pfitzinger-Lippe, 2017). Nurse educators, particularly those in academia, have the power and the obligation to begin to change this narrative. Nurse educators should begin integrating social justice concepts throughout nursing curricula because it can have a significant impact on students’ understanding and application of social justice (Thurman & Pfitzinger-Lippe, 2017). In fact, there is a movement in nursing education causing a shift toward a social justice agenda that moves away from the traditional, individualized models of nursing care (Read et al., 2015). Furthermore, including social justice as an integral, core component of the curricula enforces the message that addressing the structural causes of illness and injury is as much a part of the nursing profession as individual bedside care (Thurman & Pfitzinger-Lippe, 2017). To promote this transition to “upstream” thinking, it is suggested that educators can use the social change model (Read et al., 2015).
The social change model asserts that leadership is a collaborative, service-oriented, values-based process that is about effecting change on behalf of society (Read et al., 2015). The social change model can be broken down into seven values: consciousness of self and others, congruence, commitment, collaboration, common purpose, controversy with civility, and citizenship. The earlier these values are fostered in the curricula, the more time students will have to work with these concepts and apply them throughout their academic journey.
I also think it is important to look within our own profession and apply the concepts of social justice. Historically, the nursing profession has been a largely homogenous workforce, and as a result our profession is still plagued with the echoes of these biases. For example, the article by Thurman & Pfitzinger-Lippe (2017) was written exclusively in a female perspective. For example, the authors state: “A social justice framework would allow a nurse to actively analyze and concern herself with social injustices such as . . .” (Thurman & Pfitzinger-Lippe, 2017). Much of nursing literature is this way, when in fact one in ten nurses are male (Harrison, 2021). Men, however, receive differential treatment when it comes to hiring and promotion, career opportunities, and stigma associated with gender perceptions (Harrison, 2021). Thurman & Pfitzinger spend the introduction of their article championing the contributions of Florence Nightingale to the profession of nursing. Undoubtedly, the profession of nursing owes Nightingale credit, however even Nightingale believed it would not be appropriate for men to be nurses because their hands were “rough” and “not fitted to touch, bathe, and dress wounded limbs,” (Harrison, 2021). This idea persists in our profession to this day, and gender biases are not the only example of injustices in nursing. Read et al. (2015) worked to employ the social change model to develop leadership characteristics and target students who may not self-identify as leaders. This was because Read et al. (2015) noted the disparities in the nursing profession and the need for insightful nurse leaders with diverse backgrounds.
The point is, extreme inequalities exist in our society, particularly in regard to health outcomes. But in order to effectively address these inequalities, we also have to look inward at our own profession to promote inclusivity and diversity. The best way to solve structural barriers to equality in health care is to encourage diversity in the nursing community to broaden the perspective of the profession and give a voice to communities that are underrepresented in nursing, but simultaneously more at risk for suffering from health inequalities.
Nurse educators have a pivotal role in fostering leadership characteristics in their students, particularly if nursing is going to continue to work to reduce disparities in health. Leadership is both the result of inborn and situational variables, and educators can have a profound effect on these situational variables. Leadership can be facilitated by instilling the message to emerging leaders that they have personal control over their development, creating and exposing future leaders to other successful leaders for observation and potential mentorship, providing opportunities for service in leadership positions, and giving developmental feedback and encouragement that builds leadership self-efficacy (Read et al., 2015).
It is by molding the next generation of students into nursing leaders with well-informed, diverse perspectives that nursing educators will influence the next generation and subsequent generations of nurses.
References:
Harrison, T. (2021). Florence Nightingale’s legacy on the role of men in community nursing. British Journal of Community Nursing, 26(6), 302-306.
Read, C. Y., Pino-Betancourt, D. M. & Morrison, C. (2016). Social change: A framework for inclusive leadership development in nursing education. Journal of Nursing Education, 55(3), 164-167.
Thurman, W., & Pftizinger-Lippe, M. (2017). Returning to the profession’s roots: Social justice in nursing education for the 21st century. Advances in Nursing Science, 40(20), 184-193.
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