THE BURDEN OF THE MORAL COURAGE NEEDED TO ACT IS LESS THAN THE TRAUMA OF REPEATEDLY WITNESSING INJUSTICE
Editor's Note: The following guest editorial is by Robin Narruhn, PhD, MN, RN, Assistant Professor at Seattle University. This editorial is presented as part of her participation in the 2021-22 ANS Editor Immersion Program. - Peggy Chinn, Editor
As a nation, we are grieving the tragic mass shootings in Buffalo, New York, and Uvalde, Texas, and now Tulsa, Oklahoma, happening days apart and taking the lives of the innocent. Our grief and confusion are palpable. We seem to be paralyzed by inaction, frozen, and seemingly lacking agency, by the overwhelming structural policies that allow gun violence to flourish in our nation. We are bewildered by the lack of police response and legislative barriers. A critical conscientization will assist us in recognizing the deep images of racism wherein Black people were slaughtered by a White supremacist in a grocery store. Just days later, a mass shooting where Brown children were not deemed worthy of protection by the police were killed. Workers and patients at a medical center in Tulsa, Oklahoma, were wounded a bit more than a week after the Uvalde tragedy. Gun violence and mass shootings are a stark, racist, common, and unjust occurrence in our nation.
Gun violence is only one of the areas of injustice and health inequity in our nation. We are experiencing inequities in police brutality, mass incarceration rates, educational opportunity, wealth generation, and COVID-19 rates. Crimes against people who are LGBTQ, Islamaphobia, and anti-Semitism are prevalent in our nation. Racism, poverty, decreased life opportunities, homelessness, ableism, and more are all part of our national landscape.
Social justice is a foundational value in the Nursing Code of Ethics (American Nurses Association, 2015), specifically in provision 9, and implied throughout all the provisions. Nurses must work on health policy (provision 7) and protect human rights (provision 8) as per the Nursing Code of Ethics (American Nurses Association, 2015). Nurses are called upon to advocate for justice. We need to work on just health care policy. There are calls to embed social justice throughout the nursing curriculum; however, we are cautioned to remain apolitical, yet somehow advocate for the individuals, communities, and populations in our care. Too often, we are told nurses should not be political despite the clear need for nurses to contribute to health policy and advocacy.
There are many ways nurses can mitigate social injustice and health inequities, namely, by serving on relevant committees, working in the community, voting, and policy making are all steps nurses can take to contribute to social justice. There is a body of literature addressing social justice as it pertains to our work as nurses. Reading articles in Advances in Nursing Science, or perusing blogs such as Nursology or Overdue Reckoning on Racism, can increase our theoretical knowledge.
Nursing pedagogy must include an explicit framework addressing the structural conditions and power dynamics and use a systemic critical analysis (Garneau et al., 2018) that abolishes gun violence and other health inequities. We are rarely taught to address social justice. Instead, the empirical, technical, and biomedical aspects of nursing take precedence despite the reality that other skills are needed to mitigate social injustice as it applies to health. Too often, we attribute health inequities to individual behaviors or "lifestyle choices," cultural practices, or genetics and neglect the crucial step of effective analysis.
Critical consciousness, contextualization, historical perspective, structural competency, reflection, and moral courage are all components of a pedagogy addressing social justice. As evidenced by the national events in Buffalo, Uvalde, and Tulsa, a lack of social justice and advocacy can be just as fatal as any other disease. Social justice can no longer be considered an optional soft skill and should be recognized and taught by nursing faculty who have the expertise to help all faculty integrate it into the nursing curriculum. Next, a willingness to do the heavy lifting of applying theories of social justice to practice is necessary. In other words, we must attend to the need to develop a praxis of social justice in nursing. Nursing is the nation's largest health care profession, with more than 3.8 million registered nurses nationwide. We are missing an opportunity. The burden of the moral courage needed to act is less than the trauma of repeatedly witnessing these injustices. As nurses, we must act.
-Robin A. Narruhn, PhD, MN, RN
Assistant Editor
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