Literature on racism, anti‐racism, whiteness, nursing education and nurse educators was reviewed and analysed for the development of race consciousness and application of anti‐racist pedagogy. The literature describes an oppressive educational climate for non‐white identifying people, a curriculum that does not attend to the social construction of difference, and a nursing culture that is not consciously situated in a broader sociopolitical context. A particular focus on studies of nurse educators demonstrates a stark need for personal and professional development towards effectively (...) delivering anti‐racist pedagogy and a deconstruction of white normativity and dominance amongst white faculty. The protection and reproduction of white privilege is identified through the scholarship itself through a lack of racial analysis, an externalization of the root of oppression and non‐specific study measures and outcomes. The persistence and pervasiveness of white dominance in nursing and the lack of anti‐racist competence in white educators, particularly, merits a shift in anti‐racist efforts away from short‐term skill acquisition initiatives towards the deconstruction of socialized white supremacy and enactments of white privilege in nurse educators themselves. (shrink)

Neoliberal ideology and exclusionary policies based on racialized identities characterize the current contexts in North America and Western Europe. Nursing knowledge cannot be abstracted from social, political and historical contexts; the task of examining the influence of race and racial ideologies on disciplinary knowledge and inquiry therefore remains an important task. Contemporary analyses of the role and responsibility of the discipline in addressing race‐based health and social inequities as a focus of nursing inquiry remain underdeveloped. In this article, we examine (...) nursing's engagement with ideas about race and racism and explore the ways in which nursing knowledge and inquiry have been influenced by race‐based ideological discourses. Drawing on Henry and Tator's framework ofdemocratic racism, we consider how strategic discursive responses—the discourses of individualism, multiculturalism, colour‐blindness, political correctness and denial—have been deployed within nursing knowledge and inquiry to reinforce the belief in an essentially fair and just society while avoiding the need to acknowledge the persistence of racist discourses and ideologies. Greater theoretical, conceptual and methodological clarity regarding race, racialization and related concepts in nursing inquiry is needed to address health and social inequities. (shrink)

The nursing community in the United States polarized in September 2020 between Dawn Wooten's whistleblowing about forced hysterectomies at an immigration center in Georgia and the American Nurses Association's refusal to endorse a presidential candidate despite the Trump administration's mounting failures to address the public health crisis posed by the COVID‐19 pandemic. This reveals a need for more attention to political aspects of health outcome inequities. As advocates for health equity, nurses can join in recent scholarship and activism concerning the (...) political determinants of health. In this paper, we examine recent work on the political determinants of health with an aim to add two things. First, we seek to build further on the notion of “political” determinants of health by distinguishing policy and governance structures from dynamics of politicization through appeal to critical disabilities studies. Second, we seek to apply this further nuanced approach to challenge rhetorical uses of “vulnerable populations,” where this phrase serves to misrecognize systemic institutionalized forces that actively exploit and marginalize people and groups. By refocusing attention to political systems organized around and perpetuating inequitable health outcomes, nurses and other health care professionals—as well as those whom they serve—can concentrate their effort and power to act on political determinants of health in bringing about more equitable health outcomes. (shrink)

Background: Several studies have investigated the experiences of first-generation immigrant nurses in new workplaces. Yet, little is known about how native nurses and newcomers collaborate in their care for aging residents in European nursing homes. Objective: To gain a deeper understanding of interactions between first-generation immigrant nurses and native nurses in their care for aging residents in a Dutch nursing home. Methods: Ethnography, including 105 h of shadowing immigrant and native nurses, 8 semi-structured interviews with 4 immigrant and 4 established (...) nurses, and 2 focus group discussions with 8 immigrant and 6 established nurses in a Dutch nursing home. Data were analyzed by a post-positivist grounded theory coding approach. Ethical consideration: The Medical Ethical Review Committee of the Leiden University Medical Center approved this study. Results: The interactions between established staff and newcomers were influenced by norms, rules and regulations, policies and protocols. In daily practice and institutional structure, we observed both opportunities and challenges. The strict time schedules and the requisite standards of care were opportunities related to nurses’ expectations. Residents’ needs were sometimes challenging and inhibited newcomers’ active participation. However, sometimes new practices were developed where nurses created common ground, tinkered, and formed an inclusive playing field to enact good care. Conclusion/ discussion: This study shows that despite obstacles, there was room to make small changes in the rules of the game of nursing. These moments of tinkering may be sufficient to establish a stable, inclusive workforce for first-generation immigrants and give room to the evolvement of hybrid professional identities. Implications: The findings of this Dutch study are relevant for nursing ethics related to “good care” and nurses in other cultural contexts on how the integration of immigrant nurses in European countries in general could be facilitated. (shrink)

In this paper, I bring together Jewish and Buddhist philosophical resources to develop a notion of radical responsibility that can confront a complicity within nursing and health care between empathy and (neo)liberal white supremacist hegemony. My inspiration comes from Angela Davis's call for building coalitions to advance struggles for peace and justice. I proceed as follows. First, I note ways phenomenology clarifies empathy's seeming foundational role in nursing care, and how such a formulation can be complicit with assumptions about private (...) individualism. Second, I turn to the Jewish philosophies of Martin Buber and Emmanuel Levinas, and their advocacy for a kind of responsibility that precedes the constitution of individuality as this can provide a resource for action and practice circumventing liberal influenced empathy. I note critical reservations about direct and practical application of Levinasian ethics in nursing care, and turn to engaged Buddhist philosophies of interdependence—such as in Thich Nhat Hanh and the Dalai Lama—as a corrective. Third, I conclude by indicating ways interreligious radical responsibility can reorient us toward housekeeping habits of character and away from exceptional crisis management, noting specific examples and actions in health care, nursing education and nursing scholarship. (shrink)

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. (shrink)

Sharply in focus in the United States right now is the disproportionate COVID‐19 infection, hospitalization, and mortality rates of Black, Indigenous, Hispanic, and Pacific Islanders living in the United States in contrast to White people. These COVID‐19 disparities are but one example of how systemic racism filters into health outcomes for many Black, Indigenous, and other People of Color (BIPOC). With these issues front and center, more attention is being given to the ways that White medical professionals contribute to these (...) disparities, including their socialization to ignore or deny inequities. As such, the present study sought to understand how educating White health‐care pre‐professionals about systemic racism might influence their understanding of and responsibility for disrupting White supremacy. Data were drawn from 49 White‐identified nursing students who participated in a mapping project that uncovered instantiations of systemic racism in the United States. Participant written reflections were analyzed using thematic analysis. Findings revealed that mapping projects can develop White people's knowledge and understanding of systemic racism. We introduce the construct, transformative dissonant encounters, to describe how this project precipitated shifts in world view necessary for White people to confront systemic racism. Implications for nursing educators, psychological researchers, and antiracist activists are discussed. (shrink)

Social justice is put forth as a core professional nursing value, although conceptualizations within foundational documents and among nurse educators remain inconsistent and contradictory. The purpose of this study was to explore how faculty teach social justice in theory courses in Baccalaureate programs. This qualitative study utilized constructivist grounded theory methods to examine processes informing participants' teaching. Participants utilize four overarching approaches: fostering engaging classroom climates, utilizing various naming strategies, framing diversity and culture as social justice, and role modeling a (...) critical stance. They deploy specific strategies, varying largely by race, educational background, and nursing specialty. A background in social sciences supports pedagogy that interrogates health inequities rather than merely raising awareness about disparities. Findings also reveal that faculty of color navigate institutional structures predicated upon colorblind racism and problematic views of culture, which many white faculty teaching non‐Community Health Nursing courses described doing. To enact social justice and be answerable to our communities, concerted anti‐oppression efforts are needed across education, research, practice, and policy. This includes sustained commitment to address colonialism and whiteness in every institution that defines, promotes, and claims to advance nursing so that we can fulfill our responsibility to address unjust systems and structures to serve our communities. (shrink)

Significant global events in recent years have had a substantial impact on the nursing profession. The COVID-19 pandemic, climate change, and systemic racism are a few of the many complex issues that create a landscape of disruption and uncertainty in healthcare. With the aims of protecting both people and the planet, the United Nations’ Sustainable Development Goals offer a road map to combat these global concerns, yet require more widespread consideration as a way forward. Education on the Sustainable Development Goals (...) is recognised as a key aspect for healthcare professionals to take action towards achieving the targets of the goals. For student nurses, the undergraduate curriculum offers an opportunity to enculturate future nurses on the important role they play in the global agenda to transform our world. Brazilian pedagogue Paulo Freire's theoretical approach to education, critical pedagogy, espouses transformation with conscientization, dialogue and liberation, which may create a paradigm shift toward global action. This discussion paper seeks to provide an argument for embedding the Sustainable Development Goals into nursing curricula using the philosophies of Freire's critical pedagogy. It will argue that a critical approach to education is required to create the transformation needed for student nurses to be educated on the Sustainable Development Goals. (shrink)

Language tests for overseas registered nurses (ORN) working outside their home country are essential for patient safety, as communication competency needs to be established in any workforce. We argue that the current employment of existing language tests is structurally and institutionally racist and disadvantages ORNs from non‐European Union (EU) and non‐White countries seeking to work in the United Kingdom. Using Critical Race Theory (CRT), we argue that existing English language tests for ORNs seeking registration in the United Kingdom are discriminatory (...) due to the UK's racist migration policies and a regulatory body for nursing and midwifery that fails to acknowledge and understand its own institutionally racist practices. (shrink)

In this article, I discuss the structural domination of whiteness as it intersects with the potential of individual critique and reflexivity. I reflect on my positioning as a white nurse researcher while researching international nurse migration. I draw on two large qualitative studies and one small focus group study to discuss my reactions as a white researcher to evidence of institutional racism in the British health services and my growing awareness of how racism is reproduced in the British nursing profession.

Although Gramsci's notions of hegemony and subalternity may seem outdated in this 21st century, a critical examination of the literature shows that these concepts apply in this global pandemic and political context. Racialization is a form of structural violence. In this paper, I also explore Gramsci's’ notion of engaged intellectuals to support the idea of social and political activism in nursing. Nurse scholars call for the decolonization of the discipline. Gramsci's philosophical approach to hegemony can be extended to racialization in (...) nursing. Gramsci's notions of civil society and state can help nurses to see the structures that create racism in nursing and society. (shrink)

In the profession of nursing, whiteness continues to be deeply rooted because of the uncritical recognition of the white racial domination evident within the ranks of nursing leadership. White privilege is exerted in its ascendency and policy-making within the nursing discipline and in the Eurocentric agenda that commands nursing pedagogy. While attention to antiracism has recently increased, antiracism pedagogy in nursing education is nascent. Pedagogical approaches in the nursing profession are essential. Because it encompasses the strategies used to transmit the (...) science in how nurses practice and teach, which has predominantly been informed using a Eurocentric lens. This paper presents a literature review on antiracist pedagogy in nursing education, discussing how nurse educators can integrate antiracism pedagogy in nursing education, highlighting examples presented by the authors. Key terms related to antiracism are reviewed. The resultant themes from the literature review include resistance to antiracist pedagogy, managing emotional responses, and supporting transformative learning using an antiracist approach. The primary implementation of Eurocentric pedagogical approaches whiteness pervasive in nursing education must be uprooted. Antiracist and other antioppressive learning approaches must be embraced to understand the insidiousness of racial inequities and its power in sustaining structural oppression in nursing academia. (shrink)