The Personal is Political


As difficult as it is for me to believe, I only became aware of this slogan early in the 1990s, when I was already in my late 40s! At that time graduate work led me to the exploration of oppressed group theories and specifically feminist theories under that broader umbrella. At that time, and for some time afterward, I associated the “Personal is Political”, correctly or not, with the feminist movement and most specifically with women’s reproductive rights. It was then and certainly is now true on a much broader basis.

 

“Political” seems to have such a negative connotation for so many people who immediately associate it with partisanship, which in itself implies having to “choose sides” or offending friends and should therefore be avoided at all costs. I so often have heard the disclaimer, “I’m not political” when discussing an issue; I’ve seen Facebook friends offer an apology for posting something that others might construe as political (and making excuses that it is worth reading in spite of seeming political) and for announcing they are blocking political posts. And yet, politics can simply refer to relationships within a group and/or activities to gain advantage and/or power within that group, e.g., office politics . Students in my leadership class were challenged to embrace political activism as necessary to the pursuit of social justice. When they protested that they were “not political” I reminded them that if they had ever negotiated for extensions or marks on assignments, they were being political!!!

 

But in its larger sense, i.e, activities related to governance of a specific political entity, such as a town, city, state, country, etc., the personal most certainly must be political; democracy requires it. The freedoms we so easily take for granted – to speak out, to meet, to worship as we choose, etc. have been enshrined in constitutions and charters but are threatened by complacency and/or ignorance. Timothy Snyder, a Yale professor argues that Americans have a year or less to defend American democracy. In a lengthy interview, but one well worth the read, he draws comparisons between Europe in the 1930s and the current time in the U.S. and urges that we learn from history. He makes the point that regardless of the differences between the personalities that may be involved, the conditions and even more importantly the warning signs were there then as they are now -that a change in regime was the intent of those seeking power. And by change of regime, he means a change from democracy to an authoritarian state.

 

For the last number of years, I have travelled to Europe at least once a year, usually on a tour. I love the educational nature of the tours and through them have learned much about European history . Speaking with people who have lived through the Nazi and/or Communist regimes or both, I’ve come to appreciate more fully the cost at which their current freedom has come. Their personal certainly was political. My own parents escaped the Soviet Union a year after Stalin came to power. Many of us have similar stories and for me, it would be a dishonor to the sacrifices they made to dissociate from the political because it has become distasteful!

 

Last year, the tour I took was to England. It was in September, a few months before the American presidential election and a few months after the Brexit vote. I was very aware of being the only Canadian on the tour and wondered if the upcoming election would become a topic of conversation, which, of course, it did! I tried to simply listen but at one point a fellow passenger asked me what I thought. I replied that my fear was that if a certain candidate were elected, it would be the last American election. I was quickly reassured that was not possible because the Constitution and institutions put in place by the Founding Fathers were in essence a guarantee of continued democracy. I hope she’s right; yet recent assaults on the press and judiciary suggest otherwise.

 

The interview with Dr. Snyder referred to above was in response to his Facebook post on “20 Lessons from the 20th Century”). Those lessons contain many political actions that are not visible to others, such as not obeying in advance, believing in truth, and investigating. Others, like “standing out” are more visible, may be more uncomfortable, but are equally important to protecting our freedoms and democracy. He warns that even worse than taking freedom for granted is learning to take unfreedom for granted without realizing that it is our choice and our actions which can make the difference.

Peace as a Prerequisite for Health


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.

Nursing Students or Student Nurses: What’s in a Name


Recently, Jane Dickinson drew attention to the power of the language we use in her blogs examining language and health and in her argument to replace words that shame. It reminded me of another instance of language use that I believe to be inherently harmful – referring to nursing students as student nurses. This practice has been so widely used for so long that I can imagine many gasps and reactions, such as, “Well, that’s what they are; what else should we call them?” Why not nursing students? Is there a difference? I would argue there is a great difference.

I cannot think of one other group of students, health or otherwise, that is referred to with a similar moniker. We do not speak of student doctors, student lawyers, student engineers, for example. They are medical students, law students, engineering students. The lack of parallelism is the first indication that we should examine this practice.

When I “trained” to be a Registered Nurse in a hospital in the early 1960s, student nurses made up a large proportion of the hospital’s workforce. Student nurses were identified by their caps, first having none in the first 6 months, then after the capping ceremony, a white cap. Second year students were identified with a light blue ribbon on their caps, third year meant a dark blue ribbon, until finally Registered Nurses wore the coveted black ribbon. The uniforms likewise differentiated students from Registered Nurses, with graduate nurses wearing all white and students being required to wear a blue dress, with highly starched white bib and apron – all exactly 14” from the floor, regardless of the student’s height (so in class pictures the skirts were exactly at the same length) – along with plastic collar and cuffs. Although I describe the practice of one particular hospital, similar practice were common elsewhere. Student nurses were a category of hospital worker and were, as such, as easily identifiable as housekeeping staff, candy stripers, or Registered Nurses.

I say all of this to make the point that not only did the label “student nurse” make her (with very few males at that time) identifiable, but also indicated something about her place in the organization and the expectations that organization had of her. (I will continue to refer to “her” because, although our class was unusual in that we had 2 males in our class, their uniform was white, like male Registered Nurses wore. It did not change throughout the 3-year program, and neither male students nor male Registered Nurses wore a cap or any other ranking symbol.)

The term student nurse comes from a time when nursing students were expected to be not only subservient (if a physican entered the nursing office, a student nurse who was sitting and charting, for example, was expected to rise and give the physician her seat), but also loyal, innocent and pure. The Florence Nightingale pledge, recited at graduation by the graduating classes of the time, included the promise to “pass my life in purity.”  In the first year after my graduation, I was employed as a Registered Nurse  at a secular  hospital (I ‘trained’ in a Catholic hospital) in a different Canadian province.) Yet the Director of Nursing forbade the graduating class that year from taking the pledge because she didn’t believe they had lived their lives in purity. She enjoyed the power to be able to do that!

This combination of an aura of innocence/ purity with the expectation that student nurses provided intimate care to males made “student nurses” highly desirable as dates.  Even during my student nurse years, engineering students from the local university would come to hospital schools of nursing to find dates for their dances.  Unfortunately, this also applied to nurses generally – the saying “if you can’t get a date, get a nurse” was common for years after I graduated in 1964. The frequent representation of nurses as sex objects, well documented by such authors as Kalisch and Kalisch extended to student nurses as well.

Despite the fact that nursing education has changed dramatically in the last 50 years, the term “student nurse,” with all its connotations, persists.  When I was teaching, I challenged students to refer to themselves as nursing students instead.  In class discussions on the topic, despite students’ general agreement that the connotation of “student nurse” was very different from that of nursing student, very few took up that challenge and subsequently submitted assignments in which they referred to themselves as student nurses. Some told me they were required to designate their status as S.N. when signing their charting.

I was interested in whether or not a Google images search for nursing student yielded any different result than search for student nurse images. The screen shots of the first screen that came up with each search are below.  Without a careful analysis, some differences are immediately apparent.  The top one is the screenshot of student nurse images; the second a screenshot of nursing student images.  

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While both screenshots include some images that appear unrelated, in the top one they are images of children. There are no images of nurses practicing, and the screenshot includes images of the back of a nurse’s capped head, and the nurse as a romantic figure (Cherry Ames). The somewhat self-deprecating text message reads “ Student Nurse Diagnosis: Stress R/T: knowledge deficit, impaired memory, sleep deprivation, unbalanced nutrition, interrupted family process, lack of social interaction, disturbed energy field.”

Note the general increase in diversity and portrayal of adult nurses providing care in the second picture. The unrelated shots appear to depict Go-Kart racing. The text image, giving the same stress diagnosis, makes its point without self-degradation: “Diagnosis: Just a tad stressed r/t complete academic overload, depleted resources, little or no life.

It seems to me that the collages support the argument that the term student nurse has a different connotation than nursing student and its removal from our lexicon is long overdue. Some time ago I wrote a blog about nurses soaring like eagles. It is a parable about an eagle that finds itself in a chicken yard and starts to act like a chicken, rather than fulfilling its destiny and potential as an eagle.  I believe that by referring to nursing students as student nurses we are unwittingly reinforcing the many messages that the term connotes and are hindering their ability to soar like eagles.

                       

Courageous Conscience: Engaging in Politics with a Capital “P”


When I began thinking about a topic for this blog last fall, Canada was in the middle of a federal election and the upcoming U.S. presidential election was already making the news daily. I thought about the changes that have occurred in both our countries and globally since neoliberal ideas privileged “the market” over elected governments in the 1980s. Increasingly, policies reflect the interest of big business and the dictates of “the markets” rather than the electorate. And although both countries are arguably now plutocracies/oligarchies, both maintain a semblance of democracy through democratic structures and processes, such as elections. So what does this have to do with nurses and nursing?

The Nursing Manifesto itself answers that question. It is a call to action and one avenue for that action is engagement with political processes. I am reminded of an address Patricia Moccia gave at a conference in the late 1990s in which she used the term “citizen nurse” to remind us of the importance of bringing a nursing voice to the political table. With the percentage of eligible voters who actually vote near record lows – 54.87% in the 2012 presidential election and 61.1% in the 2011 Canadian federal election – one group could significantly shift results. In fact, in the recent 2015 Canadian federal election, the Liberal party made a concerted effort to get out the “youth vote.” The result was not only a change in governments, from Conservative to Liberal, but an increase in voter turnout to 68.3%. Imagine the possibilities if nurses mobilized to vote!

I’m not suggesting that all nurses will vote alike, any more than “the youth” in Canada did! But I am suggesting that increasing the number of nurses who vote has the potential to influence the outcome of an election. What we have in common is commitment to care for people, for promoting health, for social justice. Our work, then, as citizen nurses is to discover which party or candidate most closely aligns with our own values and become as involved as is right for each of us in supporting that party or candidate. It may involve running for office, contributing money, volunteering to work for a particular candidate, or simply but equally importantly, making an informed vote.

Voters, to my mind, are followers in the democratic process. Robert E. Kelley, who has studied followership for more than 30 years, initially characterized followers on 2 dimensions: active engagement and critical thinking. His 5 categories of followers included sheep and yes-people, neither of whom are critically engaged. As voters, sheep would wait for direction on how to vote, perhaps relying on family or community tradition (my family has always voted this way). A yes-person might be more actively involved with a candidate or party but simply accepts the “party-line” without question. Alienated followers, Kelley asserted, think critically but bring much negative energy with them. Voters in this category might spend that energy criticizing the candidates, parties, the system and either spoiling their ballot or loudly proclaiming their refusal to vote. Pragmatics, Kelley’s 4th category, align themselves with whoever is winning. As voters, they might watch the polls and vote with whoever is leading.

Kelley’s final category is that of effective or “star” followers who are actively engaged critical thinkers with a “courageous conscience” to stand up against illegality and injustice. I think this category of followership exemplifies what being a citizen nurse is about.