A few weeks ago (I know, don’t tell me it feels like months!), when the 45’s “Muslim Ban” was in full swing, Pamela Cipriano, the current President of the American Nurses Association, issued a statement that reads as follows:
“Nursing is committed to both the welfare of the sick, injured, and vulnerable in society and to social justice. The ANA Code of Ethics for Nurses with Interpretive Statements establishes the ethical standard for the profession in its fervent call for all nurses and nursing organizations to advocate for the protection of human rights and social justice.Therefore, ANA opposes any action that erodes the human rights of people, and strives to protect and preserve the rights of vulnerable groups such as the poor, homeless, elderly, mentally ill, prisoners, refugees, women, children, and socially stigmatized groups.This underlying principle must be considered in light of the current Administration’s efforts to halt refugee admissions for 120 days and block citizens of seven Muslim-majority countries from entering the United States for 90 days.Any actions taken that are intended to increase the safety of our country must be clearly defined and not jeopardize human rights nor unfairly target religious groups.” (http://nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2017-NR/ANAPresidentResponds-ImmigrationEO.html).
Social Media Reaction
I happened to read this on facebook, so of course I was very excited to see a nursing leader take a public stand. As I moved onto the comments section, I was concerned by what I saw, as it seems about 50% of the nurses commenting were concerned about the political nature of Dr. Cipriano’s statement, and comments were made that nurses should not be making political statements, that ANA should not be taking political stances, and that there is no room for politics in nursing.
We still have a lot of work to do in educating nurses, both in the academic and professional settings. We need to ensure that nurses understand their ethical obligation to act as advocates for populations; and that this obligation extends beyond the bedside and workplace setting and out into the wider arena of politics.
Ethics and Political Action, Advocacy, and Activism
The Code of Ethics for Nurses With Interpretive Statements (American Nurses Association, 2015: http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html) guides us in our nursing practice. In particular, nurses should be aware of the implications around the following provisions (emphasis added with italics):
- Provision 7: The nurse in all roles and settings advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.
- Provision 8: The nurse collaborates with other health professional and the public to protect human rights, promote health diplomacy, and reduce health disparities.
- Provision 9: The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.
All nurses can access this document for free online at the above link, and I would recommend particular attention be paid to provision 9.3 (integrating social justice, p. 53) and 9.4 (social justice in nursing and health policy, pg. 53-54).
I particular like how the ANA code provides a context for nurses to realize that our work does not stop at the bedside; we care for and advocate for those who do not have a strong voice, those who need support in attaining the best pathways toward good health and healing, and we care for and advocate for populations and the planet.
In this sense, when we made aware of political issues like the possible repeal of the Affordable Care Act, it becomes clear that we are ethically obligated to take action to ensure that vulnerable populations do not lose access to their healthcare, and that we be part of the conversation as new processes and policies emerge via federal and/or state mandates regarding healthcare insurance. This area may seem obvious, but we are also ethically obligated to take action when we see the health of specific populations and the health of the planet at risk.
One example of this might be the “extreme vetting process”, which is targeting refugees from specific war torn areas such as Syria. The atrocity of human destruction in Syria and the need for refugee re-settlement is one that nurses should be concerned about; the damage that is done to human life and the degradation of the environment and the planet in Syria is a global concern, and a nursing concern. Nurses should therefore be fulfilling our ethical obligation by questioning the new extreme vetting process and supporting a call to assist Syrian refugees. A war torn vulnerable human population requires social justice action.
I am sure there will be more examples that require nurses to fulfill our ethical obligations in the forthcoming days and weeks as we look at this administration’s stances around the environment, healthcare, and even education (yes, our children are a vulnerable population away, one that needs a strong voice in support of the best educational practices).
So what can we as individual nurses do?
Make an action plan around a singular or perhaps a few areas of political concern. Keep in mind, your actions do not need to be huge or time consuming; calling, emailing, or writing your representative on a regular basis can take just a few minutes of your time, and it can be of great impact. Don’t forget to mention you are a nurse, and always strive to share personal stories around your topic of choice. Align yourself with other like-minded nurses, and take steps to balance your work-family-advocacy-self-care efforts. Rejuvenate yourself, and find communities that you align with.
The reason why we became nurses may vary to some degree, but most of us felt a calling toward healing, toward caring, toward supporting people and populations in maximizing their health. And the world needs nurses right now to fulfill their ethical obligations in the political arena.
16 thoughts on “The Ethics of Nurses Being “Political””
Reblogged this on Sasharose31's Blog.
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Quote from Pastor Martin Niemoller after WWII: First 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 left to speak out for me. Yes, we are nurses and we MUST speak out. Thankyou for your work, Dr. Clark.
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Thank you for this very important and informative post, Carey!
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What a clear response to our times and our roles as nurses. Thank you for this post!
I am completely in support of this position. Thank you so much for your clear articulation. There are so many ways that the rights and therefore the health of individuals, families and communities are being trampled. We as nurses much be advocates!
Professor, University of MIssouri-Kansas City
Editor, Public Health Nursing
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Fantastic piece! Reminds us of the importance of being on the right side of history. Nurses are healers, but protectors as well.
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Reblogged this on Busy Nurse Research.
Thank you so much for this….as nursing remains “the most trusted profession” in multiple polls, it is imperative that we speak up with integrity to advocate for health care for all, social justice and respect. It is incumbent on us, individually and as a group, to speak up an support our words with actions. Thank you again, Dr. Clark
I don’t agree…I firmly oppose nurses taking a stand on political issues. Political opinions alienate others, nurses are diverse and as such have a diversity of ideas. This has to be respected, one cannot talk in the name of millions……
Jelly, of course it is fine if you disagree, but the code of ethics does call for us to be advocates and protect patient populations, and that requires being politically active. It does not mean that there won’t be a variety of opinions amongst nurses.
But, Jelly, yours is also an expressed political opinion. You are taking a stand on the political issue of nurses being publicly morally courageous, which is your right to do.
I suggest that just about everything in health care is political – your department’s budget, a facility’s dress code, whether people have insurance, how much your patients have to spend for their medications and insurance, whether patients have access to care and which medications they can be prescribed, what procedures patients are allowed to have, which doctors and/or advanced practice nurses insurance and facilities recognize, and on and on. A more interesting discussion might be – “The ethics of nurses NOT being political.”
Pamela, this is a great point; we can’t support patient autonomy of social justice if we are not being politically active.
Nurses who are concerned that ANA President Cipriano’s support of human rights is somehow “political” is worrisome. Nursing practice is based on ethical principals such as beneficence and non-maleficence, not on political constructs such as “Republican” or “Democrat”. Nurses ensure that humans are treated fairly, with dignity and justice. If this means that nurses need to support a patient who’s rights are infringed against common and popular ideology, it’s still ethics, not politics.
Reblogged this on NurSerial and commented:
Nursing care is based on ethical principals such as “doing good”, “doing no harm” and justice. Nurses support for human rights isn’t political, it’s ethical.
Thank you for sharing. I agree that nurses should take a more active political stance. You are correct in your citation of the Code of Ethics and how it relates to politics. Situations can be both political and ethical. (ANA member)