A patient's experience unfolds through a nurse's personal conversation with herself. Conveyed through three voices, the nurse's dialogue highlights her many internal struggles; those with her conscience on what she understands to be best practice, those important to her as a person, those of an ethical nature that profoundly affect one's search for meaning, and those in the personal–professional realm driven in part by institutional culture. These multivoiced knowledges are confronted in ways that foreground language and understanding as performative acts. (...) At the same time, another journey is co‐constructed with the reader, one that weaves in‐between the symbolic and the real, engaging the imaginary in (inter)play. The nurse's response to the inner conversation with her ‘self/selves’ problematizes practice, illuminates the patient's perspective while highlighting the nurse's sense of her marginal position. Insight into reified and hegemonic assumptions, strategies of how control is maintained through organizational surveillance, trust and moral agency help to foreground personal expectations as the nurse begins to grapple with her own feelings of betrayal. Tackling these insights offers opportunities to rethink oppressive practices in the provision of care. It also enables an alternative appreciation of the everyday dilemmas confronting nurses and offers new meaning to practice. (shrink)

While nursing practice embodies certain observable and sometimes habitual actions, much inheres in these actions that is not immediately discernible. Taking on Lyotard's exegesis of the unpresentable, I undertake an analysis of the unpresentable as it occurs in nursing practices. The unpresentable is a place of alterity often excluded from dominant discourses. Yet this very alterity is what practising nurses face day after day. Drawing from two nursing situations, one from a hermeneutic phenomenological study and the other from the literature, (...) I elucidate the unpresentable from a nursing point of view. Evoking Lyotard as well as selected philosophers from the continental philosophical tradition, I also question whether nursing in its present discourse is capable of responding to the unpresentable in nursing situations. Through the philosophical stance of presentation and representation, I delineate the urgent need to bring the otherness of the unpresentable into our nursing discourse. Nurses in practice confront a wide array of human differences and diversities and come to the realization that no framework alone can ever really have primacy over the multiform presentations of human suffering that so strikingly evoke alterity. (shrink)

Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti‐intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti‐intellectualism in nursing education. We use John Henry Newman's view of the (...) purpose of a university education as a heuristic perspective to examine anti‐intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency‐based curricula and business models rooted in neoliberal financial policies reinforce anti‐intellectualism in nursing. Anti‐intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti‐intellectualism. Counteracting anti‐intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti‐intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized. (shrink)

Through its social and political activism goals, postcolonial feminist theoretical approaches not only focus on individual issues that affect health but encompass the examination of the complex interplay between neocolonialism, neoliberalism, and globalization, in mediating the health of non-Western immigrants and refugees. Postcolonial feminism holds the promise to influence nursing research and practice in the 21st century where health remains a goal to achieve and a commitment for humanity. This is especially relevant for nurses, who act as global citizens and (...) as voices for the voiceless. The commitment of nursing to social justice must be further strengthened by relying on postcolonial theories to address issues of health inequities that arise from marginalization and racialization. In using postcolonial feminist theories, nurse researchers locate the inquiry process within a Gramscian philosophy of praxis that represents knowledge in action. (shrink)

The origins of marginalization in nursing and the health sector in Ghana can be traced to colonialism and how a colonial era laid a solid foundation for inequities and entrenched disparities, as well as the subsequent normalization of marginalizing acts, in the health sector, particularly for women. Drawing upon varied literature over a 60‐year period and perspectives from feminist theory, this paper considers the lasting impact of Ghanaian women's historical position during the colonial era and within the patriarchal system that (...) ensued. Through this process, it becomes possible to shed light on the crucial role that colonialism has played in women's experiences, perspectives, and health‐seeking behaviors, and the manner in which it has created a healthcare sector that marginalizes women's health. Although women possess valuable knowledge which should be an asset to consider when providing healthcare services, marginalization of that knowledge has become normalized across society and the healthcare system. There is an urgent need to disrupt and challenge this normalization, and to advocate empowerment and recognition of women's valuable knowledge and experiences, providing women a voice in health decision‐making discourses and in the research processes by which we understand and develop healthcare. Through this, healthcare in Ghana could become more empowering, inclusive, and responsive to the unique experiences and needs of Ghanaian women. By understanding something of the historical origins of women's health marginalization within colonialism, nurses can begin to appreciate women's knowledge and integrate it into healthcare strategies that are more gender‐sensitive and equitable. (shrink)