During the “Decolonizing Nursing: What? Why? How? webinar on September 23rd, there were questions posed for the panelists that could not be addressed due to time constraints. We promised to post responses to these questions on the Nursology.net blog – and here is the first of those responses!
The first question we are addressing is from nursologistRudolf Cymorr Kirby Martinez in the Philippines, and a blog contributor to Nursology.net! The Philippines has provided well educated and competent nurses to fill nursing shortages in the United States for decades. Dr. Martinez posed the following question:
From the perspective of a developing country who supplied nurses for developed countries, colonization of nursing, especially education, is often masked as globalization. In the process of conforming to the requirements for working abroad and in the guise of being “globally competitive”, the local and distinct practice of nursing is set aside. The nursing curriculum of some developing countries are more American than local.
I would like to begin by stating that the idea of developed and developing countries is one of the most colonial ideas. It centers the vision of superiority made by the “developed” nations over the others. These “developed” nations have been characterized for invading and exploiting the resources of other countries. Also, this notion underlies that the “developing” want to be like the “developed,” rather than considering their greatness and contributing to their self and authentic growing.
I agree in that, in many instances, globalization is a masked form of colonization. The “international cooperation” must be a “reparation” made by the colonizer for more than 500 years of historic colonization of other nations, which remains even today. This critical state of oppression, exclusion, and discrimination is a product of an historical political and economical relationship between the invaders and the invaded, in which the dominant nations must be accountable of their acts dating back to before the invasion of Abya Yala (word used by the native tribes of Latin America to refer to their territory as an indivisible macrocontinent from south to north (from Argentina to Canada) and that I will use here instead of “America” as a form of vindication..)
Having this global perspective, the idea that we have been sold (to us, the developing ones, the others) grounded in otherness is that we want to be like them (the dominant and developed). Such an idea has led, in many instances, to lose our own identities and, even nowadays in the north, the very identity of nursing is blurred. Then, the invitation is to reclaim what is ours, what has been denied to us and, in the other hand, to the dominant white elite of the discipline to recognize the epistemologies outside of what they consider the core of the discipline. This will be the first step in a co-construction of a new epistemology of Nursing and in the rescuing of the local identities and practices of Nursing.
I do not believe nursing education in some countries is masked as globalization. I note you are from the Philippines and nursing education is part of the economic development blueprint of your country. As a past member of the National Council of State Boards of Nursing, I can remember vividly and somewhat in shock, a presentation by government officials telling us emphatically that nursing was part of their blueprint for globalization. Even today, physicians who would have a hard time getting credentialed in this country are retrained in your country as nurses who then immigrant to the US. Economists suggest that countries taking part in the global economy are experiencing more economic growth and poverty reduction than those countries which remain in isolation. So, globalization is both good and bad. However, the nursing community can turn this around by also seeing it as an opportunity for increased communication, and cultural exchange. How might beliefs and practices of other countries humanize and change nursing worldwide. How might nurses from other countries help nursing in your country design a more authentic part of your curriculum as well. You can certainly honor and embrace your cultural heritage as is done in the US, Canada, and other parts of the world. As an African American woman, I honor and embrace my ancestry and believe that it makes me unique and powerfully different. Others can do the same.
On September 23, 2021, Nursology.net and the Center for Nursing Philosophy sponsored a powerful panel presentation focused on the topic “Decolonizing Nursing.” Seven nurse scholars of color shared their perspectives and their current work to bring the perspectives of people of color to the center, to empower anti-racist thought and action, and to activate real social justice in nursing and healthcare. The panel was moderated by Miriam Bender, PhD, RN, Director of the Center for Nursing Philosophy at the University of California Irvine. Peggy Chinn and Marlaine Smith from the Nursology.net management team provided technical support for the event. We are delighted to share the recording of the event below!
The Panelists were:
Lisa Bourque Bearskin, RN, PhD, Thompson Rivers University (BC)
Lucinda Canty, RN, PhD, University of St. Joseph (CT)
Barbara Hatcher, PhD, MPH, RN, FAAN, Hatcher-DuBois-Odrick Group, LLC
Lucy Mkandawire-Valhmu, PhD, RN, University of Wisconsin-Milwaukee
Daniel Suárez-Baquero, PhD, MSN, BSN, University of California San Francisco
Bukola Salami, RN, MN, PhD, University of Alberta
Jennifer Woo, PhD, CNM, WHNP, FACNM, Texas Woman’s University
The time ran short for addressing questions posted in the Q&A for the webinar, but we have shared the questions with the panelists, and future blog posts here will feature panelist responses to these questions!
Spontaneous feedback was posted in the “chat” throughout the panel discussion – all expressing deep appreciation to each of the panelists for their riveting presentations. Toward the end of the webinar, additional comments reflect the whole of the experience for those attending:
Such an amazing discussion!
Raising my hands to all of you.
Thank you! Love from the Philippines!
Thank you all so much for such a fruitful presentation.
What a wealth of knowledge and sharing, SO grateful
WOW! I can’t wait to share this with my faculty team
Can we have a part 2? This has been emotional and insightful and empowering. Thank you to each speaker and organizers and hosts
This panel was so energizing and inspiring! Thank you all!!
Thank you to the speakers for opening hearts and minds
Thank you for the eloquence with which you shared!!!!
Thank you for such an inspiring event. I am hopeful for the future of nursing
Now open for submissions – until 11:45 pm EST on November 15, 2021!
The abstracts can be for either a 30-minute “Knowledge Session” or for a virtual poster presentation!
Visit the Nursing Theory Conference website for more details about submitting your abstract! Access to the abstract submission page is also posted in “Due Dates” to the right of each Nursology.net page!
The Society of Rogerian Scholars’ 34th Annual Conference will be held on Zoom beginning the afternoon of October 1st and ending after the morning of October 3rd. There is still time to register and attend. Find out more about the conference at societyofrogerianscholars.org.
First they came for the communists And I did not speak out Because I was not a communist Then they came for the socialists And I did not speak out Because I was not a socialist Then they came for the trade unionists And I did not speak out Because I was not a trade unionist Then they came for the Jews And I did not speak out Because I was not a Jew Then they came for me And there was no one was left To speak out for me.
The recent discovery of multiple unmarked grave sites of children who died in Canadian residential schools is certain to be a shock for many Canadians. Growing up in the Canadian prairies, I learned nothing of the residential school system, still operating during my school years. Indeed, to learn that the last Canadian residential school closed only in 1996, decades after I had graduated from school, was a somber awakening for me.
I grew up as the child of immigrants from Russia, my parents and grandparents among those escaping almost certain starvation in Stalin’s Russia. The Canadian government was generous, offering land to European immigrants who would farm it, land, that had belonged to Indigenous Nations who had been relegated to reservations in more Northern regions of the country. I did not learn of these economic incentives until years after my parents died; I do not know if they and other European immigrants were aware that they were beneficiaries of ruthless, racist colonial policies and the harm they inflicted. If they had been, would they have refused the land or would they have felt entitled as white “Christian” settlers?
As I look back on my formative years, I recognize the blatant racism towards Indigenous people that was so prevalent in the use, for example, of pejorative references to Indigenous individuals, who often sought work as farm labourers. Years later, television further reinforced racist stereotypes, through the Westerns that were a major movie genre.By the late 1990s, I had become more sensitive to such racist messaging, Watching the 1995 Disney movie, “Pocahontas” with my toddler granddaughter, I was horrified at the scene in which sailors of the incoming English ship see the land and its native people and sing “Savages, Savages”. Thankfully, she didn’t understand and asked what they were saying. Determined not to repeat the message, I responded, “Sandwiches, sandwiches – They must be very hungry.”
In my nursing career, I have had the opportunity to work as a public health nurse with Indigenous communities in our County in addressing some of their health priorities. The connections I made during that time afforded me the later opportunity to invite Indigenous Elders to guest in my community health classes to speak to students directly about the health issues faced by Indigenous communities. But the experience that reached my very soul was being invited to visit the Eabametoong First Nations community during my time as President of the Registered Nurses Association of Ontario. During that visit I was invited to a meeting in which an elderly man tearfully spoke about his own experience in a residential school. It was heart-breaking and life changing. Not everyone has these opportunities, and to those who do not, I recommend the 2002 film, The Rabbit-Proof Fence. The film is based in Australia and depicts both the colonizing intention and brutal methods used in the attempt to extinguish Indigenous culture and replace it with a white, European one.
The residential school system began in the latter half of the 19th century, during Florence Nightingale’s lifetime. Lynn McDonald, a sociologist who has catalogued the entire collection of Nightingale’s written works (See https://cwfn.uoguelph.ca/volumes/), notes that despite racism being a social norm at the time, Nightingale was born into a more liberal family that did not share these views. Through her travels, Nightingale had become aware of the colonial residential school systems and the high morbidity and mortality rates of Indigenous residential school children. As was typical of her evidence-based approach, she studied the health of Indigenous students in colonial residential schools and in 1863 generated a report , comparing her findings with the health of white British children. It is not clear to whom the report was sent, presumably the responsible British government official(s). The report includes the statistical evidence of the health disparities of Indigenous children with British white children and includes an overview in which Nightingale identifies probable causes, areas for further research, and suggestions for corrective actions. Some of these suggestions might be expected, such as measures that would reduce the spread of communicable diseases, e.g., avoiding overcrowding and providing adequate ventilation.
Other suggestions relate to Nightingale’s concern with the colonization process. For example, she notes that “no account appears to be taken of the past history of the races on whom it is desired to confer the inestimable blessings of Christian civilization” (p.13). She remarks on the naturally “stronger stamina” of some tribes in their “uncivilized condition” who, when they “are obliged to conform themselves…to the vices and customs of their civilized (!)neighbours, they perish from disease” (p. 15, italics and exclamation point in original). Nightingale notes critically that many of the pioneers of “British civilization are not always the best,…ready for any act of oppression” (p.16) , and ready to take advantage through the introduction of alcohol and indulgence of their own personal vices.
Although Nightingale’s report is critical of the process of colonization, and there is some suggestion that she questioned the purpose of colonization in what seems a sarcastic reference in to bestowing “inestimable blessings of Christian civilization”, the report falls short of criticizing British Imperialistic ambitions and its related colonization policies.
As we, in the 21st century engage in de-colonization efforts, it is important to appreciate Nightingale’s work in raising the issue of the health of Indigenous residential students and providing evidence and recommendations for improvement. We wish that she had gone further and challenged the oppressive and racist nature of colonization as a foreign policy. It has become popular to label her as ‘racist’ and dismiss her on those grounds. But to do so is itself dehumanizing, as it does not consider the complexities of living within a culture while gaining sufficient distance from it to address its inherent flaws.
We must ask ourselves, how many of us know the effects of our countries’ foreign policies on citizens of other countries and have lobbied for changes to those policies? Indeed, how many of us have studied the effects of our governments’ current domestic policies with respect to the health of Indigenous people and joined with them in demanding change?
At this time, in Canada, the discovery of unmarked graves of children at former residential school sites is far from over. We cannot undo the past, but we can support Indigenous people in their grief, and we can join with them in lobbying for meaningful change to confront the systemic racism that still exists and informs current policies. Canadian Senator, Murray Sinclair, Canada’s second Aboriginal judge who led the Truth and Reconciliation Commission in 2015 noted that, “The most important actors in the process of reconciliation are not governments, are not church leaders, they are the people of Canada.”
Nursing involves the health and healing of individuals, groups, and communities, in a culturally sensitive manner. Never has the need for healing been more pressing than now, with the discovery of more and more children’s graves at former residential school sites. Actions to facilitate such healing is consistent with nursing knowledge, particularly caring theories such as Watson/s Theory of Human Caring and Critical Caring. Furthermore, I would suggest that Senator Sinclair’s call for action for the “people of Canada” is actually an ethical imperative for nurses. Taking action to address systemic racism at the policy level is also consistent with theoretical nursing knowledge, evident in nursing theories that include a focus on upstream nursing, e.g., Critical Caring and the Butterfield Upstream Model of Population Health. .
If we, as nurses in the 21st century, reflect with disappointment that Nightingale did not go far enough in 1863, surely it gives us cause to reflect deeply on the activism that we are called to answer to in our own time. We have the opportunity to take Nightingale’s recommendations one step further by actively engaging with Indigenous communities and other communities of color who suffer the injustices of racism. We can advocate for policies free of outdated systemic racism. We can get involved in forming anti-racist policies and actions. The time is now!
Thelma Schorr is among the greatest of nursing journal editors, serving at the American Journal of Nursing (AJN) company for forty years from 1950-1990. She progressed from editorial assistant to editor-in-chief, and then ten years as president and publisher. When she assumed the editorship of AJN, Thelma assured that the journal provided news for & about nursing, often unavailable otherwise, because this content covered labor issues that hospitals would rather suppress.
Thelma was the de-facto “founder” of the International Academy of Nursing Editors (INANE), gathering together a small group of editors in 1982 to form a new kind of network dedicated solely to the improvement of nursing literature (see inaugural photo below). She was instrumental in creating INANE as an independent “non-organization” functioning as an international collaborative – a collective of nursing editors and publishers focused on meeting the practice, research and education needs of the nursing profession, maintaining a tradition of “non-organization” (meaning that there are no formal officers, no elections, no dues!). (see https://nursingeditors.com/about/). Thelma was honored with INANE’s Margaret Comerford Freda Editorial Leadership Award in 2020, recognizing her enduring influence on nursing journal publishing.
Early in her career prior to joining the AJN company, Thelma launched her illustrious career in journalism by engaging the press to address a health crisis of the time. As a staff nursse at Bellevue Hospital in New York City, she was alarmed that the hospital was keeping active TB patients on an open ward. She fought to have them isolated on a separate unit and no one would listen. So she contacted NY CBS reporter Gabe Pressman and he broke the story, forcing NY Health & Hospitals to provide isolation units for active TB patients.
From that early start, Thelma became a life-long mover and a shaker. She led the way to establish the role of the journal editor as an independent, autonomous function not to be driven or manipulated by organizational or commercial interests. With the rise of feminism in the 70s, Thelma’s editorials emphasized that nursing was not to be subsumed under “medicine,” that “healthcare” was the proper umbrella term. Gradually public media followed this lead. She envisioned possibilities for nursing as a significant discipline in its own right (not as assistants to physicians) and shaped all of her actions to reflect and promote nursing’s professional identity.
During her tenure at the AJN company, she directed the publication of multiple nursing journals and pioneered the inclusion of continuing education articles in nursing journals. Along with Anne Zimmerman, she co-edited Making Choices, Taking Chances: Nurse Leaders Tell Their Stories in 1988, and in 1999, co-wrote with Shawn Kennedy, 100 Years of American Nursing.
Thelma is widely known for her dedication to first-time, inexperienced authors to learn to write for publication. She welcomed creative ideas and encouraged nurses to value their own experience and knowledge. She pioneered the practice of making continuing education available in print journals, making it possible for all nurses to pursue life-long learning to improve patient care. For this, AJN received magazine publishing’s highest award – the Ellie (elephant statue) from the American Society of Magazine Editors. She also pioneered programmed instruction, which was a forerunner of computer instruction. These were offered in the 1970s, long before personal computers & Internet.
Thelma’s editorial leadership has left an unmatched mark on nursing, one that all nursing editors seek to emulate.
Seated, L to R: Unidentified, Elinor S. Schrader (Editor AORN), Thelma M. Schorr (editor, AJN), Rozella Schlotfeld, Dean Case Western University & guest speaker), Sue Hegyvary (Associate dean and Assistant V.P., RPSLMC, Chicago & introduced symposium).Standing, L to R: unidentified, Julie Stillman (Little Brown and Co.), Patricia (Tucker) Nornhold, Peggy Chinn (Editor ANS), Leah Curtin (Editor, Supervisor Nurse), Alison Miller (C.V. Mosby Co), Richard H. Lampert (Appleton-Century-Croft), Shirley H. Fondiller (assistant to the dean for special programs and projects, RPSLMC, and Program Coordinator for the first National Journalism Symposium, April 1981)
After registering, you will receive a confirmation email containing information about joining the meeting.
Dr. Smith is co-author of the book MIddle Range Theory for Nursing, now in its 4th Edition. She was also one of the podium presenters at the 2019 Case Western Reserve Nursing theory conference, shown with other presenters, shown below! We hope you can join us!
Contributor: Ellen E. Swanson, MA, RN, BSN, PHN, HNB-BC (Retired)
Recently I had a professional practice story published in the American Holistic Nurses Association journal, “Beginnings”. Several responses to the story motivated me to think about the potential use of professional practice stories in nursing education. I shared with a local nursing professor and the magazine editor the possibility of using professional practice stories to have students identify what nursing theories and ways of knowing they saw in a given story.
This prompted a literature review on the topic of storytelling in nursing. I also recalled that I had a section about storytelling in my graduate position paper of 1998. One of the references for that paper was “To a Dancing God” by Sam Keen (1970; 1990). I reviewed his quote: “A visceral theology majors in the sense of touch rather than the sense of hearing.” (p. 159). I immediately said to myself that if there can be visceral theology, there can be visceral Nursology!
And what would visceral Nursology look like? Definitions of visceral include “proceeding from the instinctive, bodily, or deep abdominal place rather than intellectual motivation.” This brought to mind two concepts: the felt sense and aesthetic knowing.
I first explored the concept of the felt sense in 2007, and continued to read more about it over time. One way I came to understand the felt sense is as an immediate precursor to intuitive insights.
The following statements about ‘felt sense’ are taken from two books which I found quite helpful. The first book is Focusing (1979) by Eugene T. Gendlin. The second book is Waking the Tiger: Healing Trauma (1997) by Peter A. Levine. A more recent book, Your Body Knows the Answer: Using Your Felt Sense to Solve Problems, Effect Change & Liberate Creativity (2014) by David I. Rome teaches how to access the felt sense.
The felt sense is a difficult concept to define with words, as language is a linear process and the felt sense is a non-linear experience. Consequently, dimensions of meaning are lost in the attempt to articulate this experience. (Levine p. 67)
A felt sense is not a mental experience but a physical one. Physical. A bodily awareness of a situation or person or event. An internal aura that encompasses everything you feel and know about the given subject at a given time – encompasses it and communicates it to you all at once rather than detail by detail. (Gendlin p. 32)
Perhaps the best way to describe the felt sense is to say that it is the experience of being in a living body that understands the nuances of its environment by way of its responses to that environment. (Levine p. 69)
In many ways, the felt sense is like a stream moving through an ever-changing landscape…..once the setting has been interpreted and defined by the felt sense, we will blend into whatever conditions we find ourselves. This amazing sense encompasses both the content and climate of our internal and external environments. Like the stream, it shapes itself to fit those environments. (Levine p. 69-70)
The felt sense can be influenced – even changed by our thoughts – yet it’s not a thought, it’s something we feel. (Levine p. 70)
The felt sense is a medium through which we experience the fullness of sensation and knowledge about ourselves. (Levine p. 8)
Nowadays the phrase, “trust your gut” is used commonly. The felt sense is the means through which you can learn to hear this instinctual voice. (Levine p. 72)
The felt sense heightens our enjoyment of sensual experiences and can be a doorway to spiritual states. (Levine p. 72)
One must go to that place where there are not words but only feeling. At first there may be nothing there until a felt sense forms. Then when it forms, it feels pregnant. The felt sense has in it a meaning you can feel, but usually it is not immediately open. Usually you will have to stay with a felt sense for some seconds until it opens. The forming, and then the opening of a felt sense, usually takes about thirty seconds, and it may take you three or four minutes, counting distractions, to give it the thirty seconds of attention it needs. When you look for a felt sense, you look in the place you know without words, in body-sensing. (Gendlin p. 86)
I was so relieved to see how I had practiced nursing for decades put into words. I couldn’t always explain how I knew the effective interventions that seemed to just ‘happen’. I didn’t feel free to explore this in the non-holistic based career roles the first 30 years of my career. My graduate work in the late 1990’s gave me freedom to explore more holistic ways of thinking and practicing, but still doing it all rather privately. Membership in the Minnesota Holistic Nurses Association also gave me colleagues with whom to share more holistically.
The next movement toward being more open about my practice came when I learned about Modeling and Role Modeling Theory in 2012, two years before my retirement! Perhaps if I had been more open to nursing theories earlier, I wouldn’t have felt like I needed to hide how I practiced all those years. Listening, presence, and putting myself in the shoes of the other were always three of my stronger interventions. To see a theory include this latter one was such a relief. And it was in studying Modeling and Role Modeling that I learned there were a variety of ways of knowing, and aesthetic knowing was one of them.
However, I did not understand aesthetic knowing as fully until the more recent Nursology posts. I experience sheer delight with this learning. I can finally acknowledge my way of practicing to my nursing community. Chinn & Kramer (2018 p. 142) define aesthetic knowing as “An intuitive sense that detects all that is going on and calls forth a response, and you act spontaneously to care for the person or family in the moment.” It involves sensations as opposed to intellectuality. Chinn & Kramer (2018) also say “Aesthetic knowing is what makes possible knowing what to do and how to be in the moment, instantly, without conscious deliberation.” In other words, I have to not only let my head get out of the way, but also not let my head talk me out of aesthetic knowing, in both my professional life and personal life.
And so it is for me, that aesthetic knowing is Visceral Nursology. I now have a theory, an organization, and a way of knowing that supports how I practice.
Chinn, P.L. & Kramer, M.K. (2018). Knowledge Development in Nursing: Theory and Process. (10th Ed.). Elsevier. St. Louis, MO.
Erickson, H.L. (Ed). (2006). Modeling and Role-Modeling: A View from the Client’s World. Unicorns Unlimited. Cedar Park, TX.
Gendlin, E. T. (1979). Focusing. (2nd ed.) Bantam Books. NY.
Keen, S. (1970, 1990). To a Dancing God: Notes of a Spiritual Traveler. Harper Collins. San Francisco.
Levine, P.A. with Frederick, A. (1997). Waking the Tiger: Healing Trauma. North Atlantic Books. Berkeley, CA.
Rome, D.I. (2014). Your Body Knows the Answer: Using Your Felt Sense to Solve Problems, Effect Change & Liberate Creativity. Shambhala. Boston & London.
About Ellen Swanson
Ellen E. Swanson is retired from a 46 year nursing career that included ortho-rehab, mental health, OR, care management, consulting, and supervision. She also had a private practice in holistic nursing for 15 years, focusing on health and wellness teaching and counseling. She served on the leadership council for the Minnesota Holistic Nurses Association for ten years. She enjoys writing that incorporates holistic concepts, whether through storytelling or her booklet about Alzheimer’s or her book about healing the hierarchy.
Join us to learn more about our voices reckoning with racism in nursing. Share your voice in a dialogue, discussion, and future direction inspired by first person interviews and shown through the compelling stories of Black, Indigenous, Latinx, and other nurses of color.
Featuring Nurses from the “Overdue Reckoning on Racism in Nursing” project: Lucinda Canty, Sue Hagedorn, Raeann LeBlanc, Frankie Manning, Melissa Mokel, Gayle Robinson and StoryCenter guides and media production team: Jonny Chang, Joe Lambert, Sharon Mosley, and Daniel Weinshenker.
A Seedworks Foundation Supported Event in Collaboration with StoryCenter