In this study, we discuss the colonial project as an eliminatory structure of indigenous ways of knowing and doing that is built into Canadian social and health institutions. We elaborate on the role nursing plays in maintaining systemic racism, marginalization and discrimination of Indigenous Peoples. Based on historical practices and present‐day circumstances, we argue that changing language in research and school curriculums turns decolonization into what Tuck and Yang call a ‘metaphor’. Rather, we propose decolonization as a political project where (...) nurses acknowledge their involvement in colonial harms and disrupt the assumptions that continue to shape how nurses interact with Indigenous people, including knowledge systems that perpetuate colonial interests and privilege. Decolonization requires nurses to understand the colonial practices that led to dispossession of land, erasure of knowledge, culture and identity, while upholding indigenous ways of knowing and doing in health, healing and living. As a political manifesto that liberates indigenous life from oppressive structures of colonialism and capitalism, The Red Deal is presented as a visionary platform for decolonization. The aim of this study is to articulate three dimensions of caretaking within The Red Deal as a framework to decolonize nursing knowledge development and practice. Based on the philosophical dimension embedded in The Red Deal that revoke norms and knowledge assumptions of capitalism that destroy indigenous ways of knowing and doing, we underscore an approach toward decolonizing nursing. Our approach rejects the apolitical nature of nursing as well as the unilateral western scientific knowledge approach to knowledge development and recognition. A critical emancipatory approach that addresses the socio‐political and historical context of health care, recognizes dispossession of land and adopts a ‘multilogical’ vision of knowledge that gives space for representation and voice is needed for true decolonization of nursing. (shrink)

This article aims to present the life and work of German thinker Hartmut Rosa as a philosopher of interest for nursing. Although his theoretical framework remains fairly unknown in the nursing domain, its main key concepts open up a philosophical and sociological approach that can contribute to the understanding of a wide range of study phenomena related to nurses, nursing, and healthcare. The concepts of social acceleration, alienation, and resonance are useful to explore healthcare organizations' performance by bringing the time (...) dimension of modernity to the center; to grasp nurses' experiences of caring for patients; and to understand nurses as agents endowed with the capacity to deploy their political agency to create alternative forms of relationship to themselves, to others, and the world, challenging the institutional order of healthcare organizations when it fails to resonate with their professional ethos. In this article, we propose Hartmut Rosa's theoretical framework as a new and inspiring phenomenological and critical lens that should be further explored to advance knowledge concerning phenomena that are found at the crossroads of the nursing domain and other fields of knowledge. (shrink)

Stimulated by our conversations at the 2018 International Philosophy of Nursing Society Conference and our shared interests, the coauthors present an argument for augmenting the broader discussion of “missed care” with our synthesized concept called structural missingness. We take the problem of missed care to be largely grounded on a particular economic construction of the healthcare system within an era of what some are calling the Capitalocene, capturing the pervasive influence of capitalism on nature, humanity and the world order. Our (...) perspective is that of the United States, however, extrapolations can be made to the social and healthcare systems in other countries. We are concerned with the underlying conditions that structurally reify inequality and ultimately undermine nursing practice. To situate the discussion, we briefly review existing literature on the contextualization of missed care. We understand contemporary circumstances of missed care as a function of the neoliberalization of healthcare, including the idea of nursing as a commodity. From this, we discuss the implications of missed care, which forms the basis of our critique. Synthesizing the term “structural missingness, we locate a moral imperative in the professional and disciplinary commitments of nursing to consider who and what have been left out. This moral imperative for the nursing profession, along with other social and health related professions, underscores our obligation to be involved in uncovering inequities and conceptualizing upstream solutions for structural missingness. (shrink)

The idea of agency has long been used in the nursing literature in the study of nurses' roles regarding the patients they take care of, but it has not often been used to study its relationship with nurses themselves and their status in the healthcare system. The purpose of this article is to analyze how the idea of agency is used in nursing research to better understand how we might advance our thinking around nurses' agency to shape nursing and healthcare (...) with an emancipatory intent. Based on the results of a literature review focused on the study of conceptions, treatments, and applications of the concept of agency in nursing, we present a critical discussion to reflect on the need to consistently define the idea of nurses' agency, to guide research concerned with this topic in theoretical frameworks with emancipatory and social change tenets, and to make a call to develop the idea of agency as a central one to rework nurses' relationship with themselves. The idea of agency provides a valuable analytical framework for the study of a wide range of issues around nurses' status in healthcare organizations and in the healthcare system while offering a means for nurses' emancipation. (shrink)

This article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical–economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology (...) for a future context. It is a question about which nursing theories and what nursing knowledge should be developed in order to benefit patients and relatives of the future. We suggest that future knowledge development in nursing be developed in an interchange between theory and practice and guided by philosophy like a kind of pendulum where all three elements are treated as equals. We suggest a framework for the development of nursing knowledge based on a caring‐ethical practice, a theory on life phenomena in suffering and relationship‐based nursing, and thereby, we may be able to help patients to be cured, to recover, to be alleviated or comforted when suffering. (shrink)

This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to (...) define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: ‘A practice pervaded by comprehensive responsibility’, ‘A practice that recognises a patient's unique needs’, ‘A practice based on multifaceted knowledge’ and ‘A practice that mediates between traditional values and changing demands’. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice. (shrink)

The global COVID‐19 pandemic challenged the world—how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person‐centred care (PCC) is the philosophical premise upon which models of (...) health care are developed and implemented. Given the strain that COVID‐19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic. (shrink)

Nurses have their own ways of talking about their experiences of injustice in healthcare organizations. The aim of this article is to describe how nurses talk about their work‐life experiences and discuss the discursive effects that arise from nurses' use of language regarding their political agency. To this end, we present the findings garnered from a study focused on exploring how nurses deploy their political agency to project their idea of social and political justice in public healthcare organizations and how (...) they face the challenges and uncertainties of (re)thinking their institutional order when it does not resonate with their professional ethos. We then discuss the implications that nurses' use of language has in relation to their ability to deploy their political agency to oppose the forms of injustice they face in their daily practice. We conclude by stating that careful attention should be placed on understanding the discursive implications of nurses' use of language on their individual and collective emancipation in healthcare organizations. (shrink)