Here at the NurseManifest project, we have tended to emphasize grass roots, “on the street” kinds of activism to bring our deepest nursing values into everyday experience. But manifesting nursing values needs to happen everywhere, and one of the spheres where this is vitally important is in the Board Rooms, large and small. Lisa Sundean, who is one of our NurseManifest bloggers, is embarking on her dissertation project to explore nurses on Boards, and in the interest of sharing her work wide and far, she has established website and blog – SundeanRN.org! Her first blog post is now available, explaining why this is vitally important! I highly recommend that you read her post: What do Boards Have to do with Nursing? And if you have never considered serving in this capacity, think about it now! We need to be manifesting nursing everywhere – at the bedside, the chairside, the curbside, and yes, the board side!
I recently participated in a live Twitter Chat called Where are the Nurses? I think I saw it promoted on Twitter, but I can’t even remember for sure. Regardless, it piqued my interest and I joined in. The discussion was about nurses in leadership and in social media.
I’m a nurse and certified diabetes educator, and I’ve been engaged in social media since about 2008. That is when I joined Facebook to connect with friends – not at all related to my professional work. Then in 2011 I started a website with a blog because I was about to publish a book and was told I needed to have a blog. I soon became involved in what is called the Diabetes Online Community (DOC), which is made up of blogs, social networks, websites, and more – for, by, and about people with diabetes.
Shortly after that I created a “business page” on Facebook, where I started sharing diabetes-related items & information that I thought people would enjoy. Then I joined LinkedIn and Twitter. Yikes! But for a long time I did not interact much with the “Twitter Universe/Twitterverse” or LinkedIn. I wasn’t even sure what the point was. What I’ve learned about LinkedIn is that it’s about professional networking. It’s a great place to look for positions and to find people to fill positions. I’ve had someone find me on LinkedIn and ask me to write a chapter in a book and another person ask me to be on an advisory board.
My kids are into Instagram and Snapchat. I think of those two social media platforms as being strictly for social interactions. I think of Facebook as being either/both personal or professional. And I think of LinkedIn as being more professional. Twitter can also be used for either/both. I use Twitter for professional interactions: I “tweet” my weekly blog post – to get it out there – and I participate in occasional twitter chats.
Until two weeks ago I had only participated in diabetes-related Twitter Chats (also, it turns out, referred to as “tweetchats”). The one I saw promoted in a tweet was called “Healthcare Leadership” with the hashtag #hcldr (a hashtag is a label for a specific topic – you can search for topics by entering hashtags into Twitter or you can follow/participate in certain discussions by including the hashtag in your tweets). Healthcare Leadership is a “weekly, educational tweetchat Tuesdays at 8:30 pm Eastern (North America).” What was so ironic about my experience participating in this nursing tweetchat, was that several of the people involved were directly related to the DOC and regularly participate in diabetes tweetchats! It truly is a small Twitterverse (despite millions of users).
One of the questions asked in the #hcldr chat was why aren’t more nurses involved in social media? Some obvious answers might be lack of time or interest, but other suggestions included concerns about privacy, liability and “enmeshment.” Here is an abridged transcript of that Twitter-based conversation.
Many nurses (including those who are reading this post) are involved in social media, while several others have not gotten there (yet). Some nurses may be using social media for personal reasons, but haven’t joined the professional side of it. It’s completely your choice about how you use social media. I acknowledge that it can take a lot of time. Time management skills are critical in nursing in general, let alone when using social media. But if you are looking for connections, or a new position, or simply want to reach out to discuss ideas, social media is a fabulous option.
Hiking uphill along a strenuous stretch of mountain trail in Vermont, I happened along an older woman hiking downhill. I estimated her to be in her early 80s. My first thought was, “Oh my goodness. I need to help this woman. This is far too strenuous for her. She might fall, get lost or dehydrated.” But I quickly realized she was moving perfectly fine, steady and balanced with 2 hiking sticks, sturdy shoes, a backpack (perhaps with water, a snack, and a phone), a hat, and sunscreen visible on her nose. I didn’t have hiking sticks, a snack or a hat. She had a smile on her face. She greeted me with cheer and moved along with the gait of a nimble mountain goat. And that’s when it hit me.
Why did I assume she needed my help? Why did I assume she lacked the ability and fortitude for the hike? Why did I immediately see myself as her protector? In fact, I am always inspired by older people who are active, agile, and adventurous. I want to be that person in my later years. And yet, I imagined her as feeble, incapable, in need of my help and protection. I based my assessment on the assumption that she was weak. And in that assumption, I never considered her strengths.
As nurses, are we programmed to see problems or opportunities? Do we assume weakness in our patients, our colleagues, our students? Does caring mean we place ourselves in a privileged position over others? If so, what is lost by this weakness-based approach? Better put, what could be gained by a strengths-based approach? Consider approaching patients, colleagues, students with the assumption that they bring strengths to every situation. Instead of uncovering problems to solve, we can assess circumstances, identify strengths, and collaboratively define opportunities to optimize those strengths rather than focus on weaknesses. Rather than feeling disabled, dis-empowered or disrespected, our patients, our colleagues, our students, even we, feel strengthened, empowered, energized, and respected. This is not a call to ignore problems and certainly not a call to ignore emergency situations that need immediate intervention. It is a difference in approach between “What is the problem and how can we fix it?” to “What is this circumstance, what is going well, and how can we do more of it to restore balance?”
Perhaps this is a trivial nuance in thinking but plenty of positive psychology and brain science literature point to the power of positivity and strengths-based approaches to situations. It so occurred that I began drafting this blog post just as Adeline Falk-Rafael’s post, Peace as a Prerequisite for Health, appeared on the NurseManifest blog site. I cannot help but draw connections to the deep reflections in her bittersweet post. While reflecting on recent outbreaks of violence and civil unrest, she calls attention to courage and peace, social justice and equity as positive antidotes to violence and antecedents for health. Her photo choice: Lesha Evans, a Black female nurse confronting law enforcement in poised courage beautifully illustrates the power of positivity in creating peace and health. She chose to emphasize a strengths-based approach.
I am inspired by Lesha Evans. I am inspired by the vitality of the woman I passed along the trail. I admire their strength, their passion, and their commitment to living fully in peace and positive strength. I have to admit, even as I recognized the strength of the woman on the trail, I made a mental note to keep an eye out for her on my way back down…just in case… Once again, she showed me that strength and courage win. I never saw her again…she was well along her way to greener pastures by the time I completed my descent. I owe a debt of gratitude to this woman on the trail for giving me the opportunity to engage in critical reflection and to find professional inspiration in an unlikely place. I really do want to be that woman hiking the trail like a nimble mountain goat when I am in my 80s and I hope the younger whippersnapper who passes me thinks, “Wow! I want to be like her one day!”
A special note of gratitude goes to Peggy Chinn for her words of wisdom and encouragement in the development of this post.
[Edited 8/6/16] At a time when many are celebrating the official nomination of Hillary Rodham Clinton I am also acutely aware that many are not. While there are many valid concerns that have been raised, what troubles me most is to hear the contempt and disbelief that anyone could support Trump. It concerns me because it reflects a de-humanizing and de-valuing of many in the white working class.
We expect that our students and coworkers will be sensitive to the values and personal goals our patients and their families. We expect nurses to be non-judgemental towards patients who are living in poverty, suffering from addictions, or making decisions that do not seem based in upper-middle class norms and values. Can we also expect nurses to develop an understanding of how to be respectful and understand what is important to people with different political views.
Sociopolitical Knowing is a core strength of professional nursing. Conceptualized by Jill White in 1995, sociopolitical knowing occurs on two levels:
1) the sociopolitical context of the persons (nurse and patient), and 2) the sociopolitical context of nursing as a practice profession, including both society’s understanding of nursing and nursing’s understanding of society and its politics. [emphasis added]
To start the dialogue, I am circling back to the Spiral Dynamics model that was used to organize the sociopolitical context of nursing in the published Results from the Nurse Manifest 2003 Study: Nurses’ Perspectives on Nursing.
Basics principles of leadership and motivation according to Spiral Dynamics:
- identify the specific needs and capacities of individuals and groups, and
- calibrate the precise developmental messages that fit each unique situation.
Sociopolitical knowing requires an understanding of how to connect with and motivate people where they are. It means developing an understanding of what messages will be most effective in “pushing someone’s buttons” or eliciting a strong emotional response. The table below highlights the most prevalent value memes in modern society – defined through worldview, core values, and value-based reasons for violence and war.
How Trump connects: From sexual innuendos and vulgar speech to stoking conspiracy theories and racist viewpoints, Trump often makes his connection with people’s minds, guts, and testicles. He has effectively tapped into pent-up frustrations and fears, justifying aggression and intolerance to make America “great again” (red and orange) and “safe again” (blue and green).
How Clinton connects: From It Takes a Village to Hard Choices, Clinton has a long history of speaking to people’s hearts, minds, and ovaries. She has effectively tapped into national pride and hope, focusing on accomplishments that make America “great right now” (red and orange) and safer through unity and tolerance (blue and green).
Both campaigns employ messaging that is strategically targeted at different audiences. The point of this blog entry was not to start a political debate — this is not the place for that. Rather, I am hoping to start a conversation about understanding how we might apply sociopolitical knowing to strengthen our ability to communicate with others. I hope that through application of sociopolitical knowing we can better connect with different communities about the work of nursing, and issues that impact the patient populations and communities we serve.
Please help build the dialogue around sociopolitical knowing, through comments here, and conversations with your coworkers, family, and friends.
References for further reading:
Charen, M. What Hillbilly Elegy Reveals About Trump and America: A harrowing portrait of the plight of the white working class. National Review, July 28, 2016.
Harryman, W. Is Hillary Clinton the First Integral Politician? Integral Options Cafe, November 6, 2005.
Jarrín, O. F. Results from the Nurse Manifest 2003 Study: Nurses’ Perspectives on Nursing. Advances in Nursing Science, 29(2), E74-E85.
Pew Research Center. Few Clinton, Trump Supporters Have Close Friends on the Other Side. August 3, 2016.
Schwartzbach, S. M. Drowned: Nurses Under Water. The Nurse Sonja. July 27, 2016.
Vance, J. D. Hillbilly Elegy: A Memoir of a Family and Culture in Crisis. 2016; HarperCollins: New York, NY.
White, J. Patterns of knowing: review, critique, and update. ANS Adv Nurs Sci. 1995 Jun;17(4):73-86.
My thanks to Peggy Chinn for reviewing this post and making such helpful suggestions.
I’ve been reminded this week on a very personal level of how precious life is. All life, although I acknowledge that to some that may seem disrespectful. It is not meant to be. Black Lives Matter is an important movement that arose in response to the disproportionate number of Black men killed by police. I applaud it for that. Slogans play an important role in raising public awareness but sometimes it is easy to forget their intent and use them for one’s own purposes. I have some concerns that, like any meme, it can and has been misconstrued and used to justify violence against others.
Recently, Toronto’s pride parade was stopped by a Black Lives Matter group because they insisted a police float in the parade be removed. I am concerned that recent shootings of police officers in Dallas and Baton Rouge may be a violent aberration of the intent of the movement. Others seem to share that concern. Some Black Lives Matter leaders have called for peace and an end to violence. I have seen no more poignant call for peace than by the mother of Alton Sterling’s son this past week. And I have seen no more courageous action to demonstrate peaceful resistance than that by a nurse, Lesha Evans, captured in what has quickly become an iconic photograph epitomizing peace in action (Downloaded from http://www.amateurphotographer.co.uk/latest/photo-news/black-lives-matter-protest-photo-goes-viral-86659).
This year marks the 30th anniversary of the first International Conference on Health Promotion. The Ottawa Charter that resulted from that meeting identified a number of prerequisites to health. Although there is no indication that they are listed in order of any importance, the first among them is peace. The last are social justice and equity. The list was a precursor for what have since been described and researched as social determinants of health. Many of the others listed, such as food, income, education, and shelter many of us are privileged to take for granted; yet many cannot and they experience the increased morbidity and mortality that results when the prerequisites are absent. Lesha Evans wwalked the walk of promoting peace at great risk to herself and it applaud her actions as a Black person, a woman, and a nurse.
But I think of others who haven’t formed such a visible movement as Black Lives Matter but who are disenfranchised and often systematically treated poorly and unjustly – I think of Aboriginal people, homeless people, refugees, those with mental illness, those who we make “the other” whether because of race, color, gender, religion, sexual orientation or who find themselves at a place where two or more of these factors intersect. There could be a long list of “______ lives matter.” In thinking of them, I would like to say Black lives matter AND all lives matter.