In a recent article published by Nursing Philosophy, I make the case for cultivating a radical imagination for nursing. In this blog post, I will explore the connections between this radical imagination and its possibilities for nursing theory. The realities of the COVID19 pandemic have created hardships that we all experience, albeit in different ways. “We,’ critical posthuman philosopher Rosi Braidotti (2020) wrote, “are all in this together, but we are not all the same,” a reminder that, though times seem tough for everyone, they are tougher for some than for others. Rather than sharing a boat, poet Damian Barr (2021) notes that “we are in the same storm. Some of us have super yachts. Some of us just have the one oar.” For folks seeking care, this might mean long waits, ICU admissions far from home, primary care delayed, death at home without treatment, disproportionate exposure due to incarceration, and more, which points to the idea of structural missingness (Hopkins Walsh & Dillard-Wright, 2020). For nurses, the reckoning of the pandemic has thrown some long-standing problems into stark and undeniable relief, the stressors of supply chain and short staffing converging to create crisis.

And these things are deeply entangled, folks seeking care and the folks who provide it. So much so that, to my thinking, we would do well to think about these in tandem, in connection, in concert, in kinship to a far greater degree than we have historically. It is critical for us to remember that, in spite of an ever-present urgency to return to “normal,” the before-times of the pre-pandemic were far from perfect. Not everyone can access care – for innumerable reasons – under the auspices of healthcare in late-stage capitalism. The raging fires of nurse burnout forced by shock doctrine crisis conditions are flames fanned from embers ignited well before COVID19 (Klein, 2007). This is a reminder, of course, that the pandemic can tell us things about our past, about our present, and about what is possible for the future, if we listen carefully. And choose to hear (Roy, 2020).

From here, I’d like to depart from things as they are in order to speak to the urgency of radical imagination for nursing (Dillard-Wright, 2021). It is, of course, imperative that we see the present – its problems and its precursors – clearly, both within nursing and in the broader context in which we nurse. Seeing clearly, understanding, gives rise to the possibility of imagining what else could be. Not because it provides a roadmap, but rather because it illuminates what questions we might ask (Kaba, 2021).  A radical imagination is simply this, imagining what is possible, irrespective of past and present limits (Haiven & Khasnabish, 2014). And so often, in nursing, we foreclose on possibility when we accept the limits of nursing as we know it, healthcare as we know it, the economy as we know it, inequity as we know it, the order of things as we know them. This has implications for us as nurses and for the folks for whom we care, of course. When we forego radical imagination, we choose the current order of things, particularly if we can accept the premise that the system, rather than broken, is functioning exactly as intended (Kaba, 2021). And we know that “this order of thing” doesn’t work for everyone. It maybe even doesn’t work for most of us.

Following cyborg feminist philosopher of science Donna Haraway (2016), who sees human-technological-animal-other connections in all things, “It matters what thoughts think thoughts.” I would like to chase down this idea in the context of nursing theory in order to push the limits of what we might think of as nursing theory. If we can widen our angle on theory, if we consider theory to be, as in the words of Mary Ellen Purkis (2019), “an explanation for what is going on,” perhaps we can make space for the kinds of speculative futurism/fabulation/feminism/fictions that both captivate our collective imagination and makes space for alternate possibilities. I’m not the first to suggest a radical imagination for nursing: the phrase itself appears in a Journal of Advanced Nursing editorial by Parker in 1996 and other work and plenty of other scholarship and activism embraced/embraces this kind of possibility, from the early work of Marie Branch and JoAnn Ashley to CASSANDRA Radical Feminist Nurses Network to the theories of Martha Rogers and Margaret Newman to more recent works focused on critical, feminist, antiracist persepectives that have materialized since the beginning of the 21st century.

This kind of theorizing perhaps diverges from how Nursology often conceptualizes theory, which is often rooted in something a bit more explicitly scientific, empirically-testable. But theory, following bell hooks (hooks, 1991), is — or can be — also liberatory practice. My urging here is to recognize that theory in and for nursing takes many shapes, leads in many directions, and may not be testable. What a radical imagination can do for us as theorists is help us recognize the limits we may not even realize we accept and push ourselves further, to “imagine another world. And ready to fight for it” (Roy, 2020).

References

Barr, D. (2021, March 25). George Takei just shared this thought of mine. Damian Barr. https://www.damianbarr.com/latest/damian-barr-george-takei-we-are-not-all-in-the-same-boat

Braidotti, R. (2020). “We” Are In This Together, But We Are Not One and the Same. Journal of Bioethical Inquiry, 17(4), 465–469. https://doi.org/10.1007/s11673-020-10017-8

Dillard-Wright, J. (2021). A radical imagination for nursing: Generative insurrection, creative resistance. Nursing Philosophy, n/a(n/a), e12371. https://doi.org/10.1111/nup.12371

Haiven, M., & Khasnabish, A. (2014). The Radical Imagination. Fernwood Publishing.

Haraway, D. J. (2016). Staying with the Trouble: Making Kin in the Chthulucene. Duke University Press.

hooks, bell. (1991). Theory as Liberatory Practice. Yale Journal of Law and Feminism, 4, 1

Hopkins Walsh, J., & Dillard-Wright, J. (2020). The case for “structural missingness:” A critical discourse of missed care. Nursing Philosophy, 21(1), 1–12. https://doi.org/10.1111/nup.12279

Kaba, M. (2021). We Do This Till We Free Us: Abolitionist Organizing and Transforming Justice. Haymarket Books

Klein, N. (2007). The Shock Doctrine: The Rise of Disaster Capitalism. Macmillan.

Parker J. M. (1996). Space, time and radical imagination: nursing in the here and now. Journal of advanced nursing, 24(6), 1103–1104. https://doi.org/10.1046/j.1365-2648.1996.00999.x

Petrovskaya, O., Purkis, M. E., & Bjornsdottir, K. (2019). Revisiting “Intelligent Nursing”: Olga Petrovskaya in conversation with Mary Ellen Purkis and Kristin Bjornsdottir. Nursing Philosophy, 20(3), e12259. https://doi.org/10.1111/nup.12259

Roy, A. (2020, April 3). The Pandemic is a Portal. https://www.ft.com/content/10d8f5e8-74eb-11ea-95fe-fcd274e920ca