Caring in the learning process; insights from a worldly PhD student in Canada


As a nursing student in the largest French-language faculty of nursing in the world, I have the privilege to rub shoulders with budding scholars from all over the world. Today, I’d like to publish a text written by my friend and colleague, Houssem Eddine Ben Ahmed. It is a timely piece that helps remind nurses of our social contract, a concept that can help anchor us in these politically charged times. He is a PhD student in nursing, passionate about the application of Caring. He believes Caring, embodied in a educated and competent nursing workforce, is a question for public health as well as nursing. Here is his piece on Caring and learning processes:

It’s with great pleasure that I send you my brief description about my own experience of professional caring in nursing education. I’m currently a PhD student in Canada, but I was born and raised in Tunisia, where I also entered the academic world. Nursing education is quite different there, and graduate programs are not yet available for nurses. Consequently, I did my Master’s degree in Public Health, where I was able to bridge my nursing knowledge to broader issues. This is what led me to pursue doctoral studies where I could explore the relationship between nursing students and their educators.

 I have learnt from my personal and professional experience how caring is important in many aspects of our lives. There is a professional type of caring that can be developed between two persons (nurse-patient or educator-student). This relationship needs time and can be nurtured and reinforced to promote the development of a caring towards others, outside the initial professional relationship. In the personal realm, there is also one’s innate behavior of caring. I want to distinguish between these two categories of caring because many nurses and educators think it’s impossible to change one’s attitude in our modern (and often cold and uncaring) society. By this distinction, I want to clarify that we, as a nurse scholars who are interested in caring, should work to integrate the professional caring in our science. As a PhD student interested in professional caring in nursing, I’m exploring the professional caring relationship between nursing students and their educators because I strongly believe that for caring to be expressed in all the different domains of nursing (practice, theory, research and policy), we must improve our reflection on, and attention to, the idea of caring in the learning process.

In the course of my first year in my PhD program, I developed a deeper understanding about the difference between a caring and non-caring educator and how this can affect learning processes. I realized how it’s important to function within a safe environment of teaching-learning and how professional caring can have a positive influence on me as a student and on my learning and professional processes. Through my doctoral project, I hope to develop pedagogical knowledge that will help all nurses with a teaching role (educators, directors, nursing scholars)  understand that caring is also taught through the relationship we develop with our students. We need to focus more on developing professional caring in our profession to prepare the next generation of nurses to fulfill their social mandate. Patients and families need caring and competent nurses, and our students need educators that embody this concept to learn the scope depth of what caring is all about.

 

Houssem Eddine Ben Ahmed

Ph.D. student in Nursing Science

Université de Montréal

houssemeddinebenahmed@hotmail.fr

Do our actions make a difference?


#NursesResist
#ProtectHealth

This morning I heard from a nurse in Seattle asking this question in response to our advocacy alert inviting comments on the proposed rules weakening the Affordable Care Act –  “How can I be sure that my writing, calling and speaking up against these changes to ACA don’t actually encourage them to cut more? They seem to take our protests as success on their parts.” This is a terrific question, and it is one that plagues all of us from time to time!  Here is my response – and I invite everyone to add your comments to this post – to help all of us focus on our determination to resist!

It is true that we really cannot know, at least not right away, whether or not anything we do will make a difference. But it is also true that a common initial reaction, by anyone, to opposition is to dig in further and make a “show” of being emboldened – and for the politicians, this is exactly what they will do for the first few signs of opposition.  What they cannot withstand is a continued, large-scale show of opposition because at that point, it threatens their security.  Those who are elected officials begin to realize they cannot survive with large scale opposition.  Those who are appointed officials are also threatened, because our opposition threatens the elected administration that has put them in place.  It may be true that they will ignore our opposition to all actions that threaten the health of the American people, but we will be on record for standing on the side of the people, and as our opposition persists, and grows, if anything will make a difference, this will.

There is another piece to this – there are things that people do that indeed do help them – which is to keep repeating what they say, even if we say “don’t” – when we say “don’t take away our healthcare” we are actually calling forth the image of what we want them not to do – to take it away. When we repeat their tweets and their promises to repeal, we are actually emboldening them.  And so it is important to focus on what they do, not what they say. We will be posting suggestions for positive action regularly on the NurseManifest website, and also sending advocacy alerts like this one!  (note: we are sending email advocacy alerts to all who signed the Declaration of Solidarity and Resistance and included your email)

This question also inspired me to re-visit my post earlier this month – Guidelines for Resistance – guidelines that we are using as we offer suggestions for action.  Here again is the list of guidelines  (tweaked a bit) – to help sort out, as best we can, what actions can be effective.

1. Don’t use the name of the new President, and do not repeat his tweets, even in protest or in the negative (see the example below).
2. Remember this is a regime – he’s not acting alone; he has put in place many who have no interest in serving the needs of people for health and safety.
3. Do not argue with those who support the new administration –it doesn’t work;
4. Focus on his/their policies and actions, not his orange-ness, mental state, or wealth;
5. Keep your message positive; they want the country to be angry and fearful because this is the soil from which their darkest policies will grow.
6. No more helpless/hopeless talk
7. Support artists and the arts – pay attention to the comedians especially
8. Be careful not to spread fake news. Think like a scientist. Check it.
9. Take care of yourselves; and
10. Resist!
One shining example of why #1 on this list is so important.  A few days ago DJT tweeted that the media is the enemy of the people – and in response, some in the media started the hashtag #NotTheEnemy.”  This hashtag simply brings to mind the image of the media as the enemy, and reinforces the damaging image in the initial tweet.  George Lakoff (the originator of the list above) called the media out on this and encouraged everyone to stop using the “enemy” hashtag and imagery – to use instead #ProtectTheTruth.  Even these very little things are vastly important!  So share your ideas and inspirations here – let’s keep the resistance going – and grow it!

Our history is political, so is our future.


     These past couple weeks, I got a chance to connect with extraordinary colleagues across the US and Canada to discuss what it means for a nurse to be political and why. I’m honored today to join the impressive list of nurses writing for this blog. I’m a nurse in Canada and I’ve always been political, but this is not common in nursing today. Nurses and nursing organization often seem to shrink away from discussing socio-political issues in an effort to appear ‘neutral’, yet nurses hold vital knowledge and experience which we could contribute to these important debates.
     Being political doesn’t mean being partisan. This is what I wish to put forward with my first blog on Nurse Manifest. Nurses see on a daily basis the impact of health inequalities, racism, sexism, unemployment and all forms of discrimination on the health of the people we care for. We understand the importance of early childhood education, food security and affordable housing. We see what it costs us as a society to neglect these fundamental issues. We understand why the travel ban that was recently imposed in the US will not protect anyone, rather it will endanger men, women and children left stranded the world over and tear families apart.
     Defunding Planned Parenthood is another threat to the health of millions of Americans. The case of Texas, which has the highest rate of maternal deaths in the industrial world, tragically illustrates what happens when access to reproductive care is restricted. As nurses, we must fight for policies that improve the health of the population, from demanding reasonable nurse patient ratios to enforcing the Geneva Convention rules on refugees. We have a responsibility, because of our knowledge and training, to protect the health of all humans, regardless of race, gender, immigration status, sexual orientation or religion.  
     Being political means being focussed on what is right and healthy for the future of humanity. This means we will let neither fear of censorship or reprisals deter us from speaking out, nor will we be coaxed or lured into silence by demagogy. We will hold decision makers accountable, from heads of state, to mayor’s offices, to hospital administrators.
     Let us not forget our political history as nurses. Many nurses know the political history of Florence Nightingale, but there are countless others. Civil war hero Harriet Tubman was a nurse, as was Sojourner Truth. Irena Sandler, the second world war hero who saved thousands of children from the Warsaw ghetto was a nurse.
     Let us honor their spirits by emulating their fearlessness and dedication to justice and truth. I believe being political is not a choice, but a duty for nurses. The care we provide must extend beyond the walls of the hospital to influence policy. We can make the world healthier.

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.

The Call for Community, Art, and Artists in the Resistance Movement


This week, members of the Nurse Manifest Team gathered together by the warmth of our computer screens for engaging video conference. We took the time to welcome some new members and talk about the future of the movement. I have to say for me, being with like minded #NurseResisters was so energizing (even though I have been suffering through a bout of the flu this week!) and also very comforting.

It’s important for #NurseResisters to remember we are not alone and to gather those around us during these challenging times: when change seems to be happening at a rapid pace, when social media pages are filled with what resisters might find to be concerning or bad governmental news, when there are 10 things you would like to take action on, but you can’t be on the phone all day….it can become easy to become discouraged, overwhelmed, or burned out. This is where truly being with a like minded community can lift your spirits and buoy your endurance.

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And endurance is what we will need. I know right now it sometimes feel like a sprint…get out there and get things done now, get to this march, make your signs, write your emails and postcards, get on the phone….because the administration has been creating changes at a rapid pace, the media and social media have been bumping up our energy, and we feel drawn to create change now.

The thing is, this is not a sprint and it’s not a solo race…it’s more like a team based marathon or ultra-marathon, and it is going to take teams of like minded community members to both participate in and complete the race.

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Individual Sprint

Versus

Team Marathon

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We need to carry lights, march together through the dark night with our nightingale lamps, and strive toward unity. There is no clear finish line, and no medals for winners, second, and third place. There is a beautiful planet and population of people that need caring for and this endurance test is in part about not giving up that vision of a caring, compassionate, kind, peaceful, unified, and spirit filled world.

I suggest other #NurseResisters start gathering with your communities in real life or as we did last week, in real time via video or phone conferencing. Set aside thoughtful, meaningful time to be together, to discuss future actions, and also to just support one another, to laugh together, to share your stories. Communities can rejuvenate and recharge us, and they are a must for folks who plan to run the long race.

I also did want to share that part of our discussion last week focused on the use of humor, satire, parody, art, and music to support and gather people together. Saturday Night live is becoming a great example of the power of humor, parody, and satire to help us lighten our load, to help us rejuvenate, to connect us across time and space.

 

 

While there are many older political songs we can use (Carol King just re-released One Small Voice with free download!: https://soundcloud.com/user-844282824/one-small-voice), it remains imperative that we also create new art and new music that reflects our current siutation here, now in 2017. Until then, let’s be strong together:

“One small voice speaking out in honesty
Silenced, but not for long
One small voice speaking with the values
we were taught as children
Tell the truth
You can change the world
But you’d better be strong”

(Carole King/ copyright Rockingdale Records).