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.

A License to Hide?


When I graduated with my BSN many years ago, I was filled with pride; pride for having completed a rigorous course of study and pride for having passed the most anxiety-producing exam I had ever taken – the NCLEX. I remember my professors saying that myRN professional signature should always include my licensed title and degree; RN, BSN. RN – the holy grail of credentials for those who take the challenge of nursing education and dare to confront the NCLEX. They said all other denominations of nursing come after the RN. So, I became Lisa J. Sundean, RN, BSN and now I am Lisa J. Sundean, RN, MSN, MHA and soon-to-be Lisa J. Sundean, RN, PhD. Aside from my name, what is the constant in this lineage of credentialing ancestry? You got it – RN. Registered Nurse. Hello, I am Lisa and I am a Registered Nurse. In that you can trust according to annual public polls. RN is the only designation that allows me to practice as a nurse. No other credential allows me to practice legally except the RN license.

According to the American Nurses Credentialing Center (ANCC), the proper way to display licensure and credentials is by highest degree earned followed by licensure, state designations, awards/honors, and others (ANCC, 2013). So apparently, I need to tweak the order of my signature. I will consider it. But note, RN is still clearly in the signature. Some would argue that APRN can substitute for RN, but not according to ANCC. I’m not going to argue that point. I will leave that for the APRNs. What matters is that RN is displayed somewhere in the alphabet soup of acronyms.

Several years ago, I was volunteering for a local hospital fundraising organization. While recruiting sponsors for the flagship fundraising event as co-president of the organization, I was signing letters directed toward potential sponsors and donors. Of course, my signature was Lisa J. Sundean, RN, BSN (I didn’t have the MSN, MHA yet). The hired event planner took issue with my credentials saying it would be confusing for sponsors and donors. Naturally, I argued with him and I kept the signature intact. I argued that if people knew a nurse was asking for support they would feel more confident about giving. Revenue for that event increased by more than 100% over the prior year (yes, you read correctly!). Okay, maybe my signature was not the only reason, but nurses do have credibility. For sponsors and donors, knowing a nurse was leading the fundraising effort probably helped.

Not so many years ago, I was finishing my Master’s degree program. The capstone project had me combing through hospital websites and board directories looking for RNs serving on hospital boards. I’d heard of certain hospitals that had RNs on their boards but I was challenged to locate them in the board directories. I was perplexed that very few hospitals listed nurses on boards with their RN titles. The reasons for this are complicated, but in talking about it with a particular hospital CEO and RN, I was told that as nurses move up the career ladder to more senior level executive positions, they sometime drop the RN title because it can become an impediment to further career advancement. Pause. Think about that for a moment. The very licensing credentialing that allows nurses to practice, to deliver educated care to people in need, to advocate as educated and licensed professionals becomes an impediment to personal/professional development…(sigh).

Recently I have noticed that some nurses from academia and other work settings have retired the RN title in favor of using state designations and certifications. It may be obvious to those of us who are familiar with the constellation of initials that these people are, in fact, RNs with superlative credentials. However, the general population, who apparently trust nurses inherently, have no idea how to decode these initials. They wonder, “Is this person a nurse, a professional bill collector, a doctor of neuroscience, a professional health director, or a certified entrepreneur of noetic perspectives?” In all of the high level credentialing that nurses accumulate, the only letters that really stand out to the general population are RN – Registered Nurse.

At a time when nursing is entering its “golden age” as Donna Shalala declared so emphatically in 2010 at the release of the Institute of Medicine report, The Future of Nursing; Leading Change, Advancing Health (Robert Wood Johnson Foundation, 2015), some nurses choose to hide their licensing credential. At a time when we need nurse representation and participation at so many levels for healthcare transformation, some choose to stow the RN away. It is concerning that some feel the need to hide their professional identity to advance and have influence in leadership positions.

Now is the time to display the RN prominently along with other credentials. How else can we take credit for nurses’ roles in health, healthcare, and social justice? The public trusts us. Do we trust in the power of the RN? Let’s commit to leadership influence using the licensing credential that we worked so hard for; the licensing credential that we must hold to advance our nursing education, to provide bedside care, to be recognized as nurse leaders. The RN is not a license to hide. The RN credential is one to display proudly and be empowered by. If career advancement is at risk by our credentials, perhaps the alternative approach is to advocate for all that the RN stands for.

2016 is just days away. Now is nursing’s time. Be an RN. Happy New Year to all my colleagues.

 

References

American Nurses Credentialing Center. (2013). How to display your credentials. Retrieved from http://www.nursecredentialing.org/DisplayCredentials-Brochure.pdf

Robert Wood Johnson Foundation. (2015). Campaign for Action Five-Year Celebration Video. Retrieved from https://www.youtube.com/watch?v=SLM5zC7zmF4&feature=youtu.be

Spiritual consciousness and healing


This is my first time posting a blog and the experience has been both exciting and a little uncomfortable. I am moving out of my comfort zone, writing from my heart and soul. I’m thankful for the experience and hope to get better with time.  Here it goes!

As a young child, growing up in a rural village in the Pines region of Mississippi, and spending time with my mother’s side of the family in my beloved Louisiana, I was in love with the beauty of the infinite universe. I was very connected to the earth that I loved to play in and smell, the flowers I loved to smell and pick, the tomatoes, okra, onion, squash, peas and butterbeans that I loved to eat and that I helped my grandfather nurture and pick when they were ripe, the love and care of my father and mother and older brother, my ancestors, grandparents – both maternal and paternal – and great grandparents, great aunts and uncles and cousins and the infinite universe of goodness, simplicity, love, and beauty. The freedom and love of being a child of the infinite universe allowed me to sense into the universal rhythms of light and dark, activity and rest, stability and change, being and becoming, even though I didn’t have an advanced vocabulary for these things at that time. All of these experiences represented a universe where healing, love, and nurturing occurred. In the past few years, I have come to see these experiences as reflecting spiritual consciousness. I cherish being in touch with spiritual consciousness, and, thus, carefully tend to it patiently as a potentiality for nursing’s healing mission. Can the nurse working within spiritual consciousnes help other human beings experience healing and their own spiritual consciousness in order to transcend suffering of psychic, physical, social, existential, and emotional pain? I believe so.

Within the nursing context, I view spiritual consciousness as the unfolding of loving energy and various modalities of integrating nature and meaning whereby nurses facilitate healing. The nurse’s spiritual consciousness soothes worries and brings healing to others when they are in fear, pain, or suffering. Spiritual consciousness illuminates the universal need for humanization in nursing situations whereby dehumanizing circumstances deny or strip human beings of their dignity and humanity. Spiritual consciousness is the loving consciousness and healing energy that human beings tap into to restore harmony in times of disharmony.

Spiritual consciousness is evolved consciousness for nursing. It can be cultivated by nurses worldwide to facilitate healing. The nurse, in spiritual consciousness, being loving toward another during moments of the other’s suffering, brings healing energy to the situation. Spiritual consciousness is characterized by spaciousness and lightness. It provides a glimpse into the goodness and beauty of the universe, and the freedom not to get bogged down or trapped in mere physical and limiting aspects of being. I believe it is central to nursing’s healing mission. Thus, the notion of spiritual consciousness challenges each of us in nursing to experience this loving energy and to discuss it for better understanding the usefulness and limits of spiritual consciousness for facilitating healing. images

The human mind’s binding capacity can be warded off by shifting into spiritual consciousness. Spiritual consciousness does not include limited and bounded views such as hatred, sense of division, greed and power over others, malice, or separation between us, other human beings, earth, plants, animals, rocks, trees, rivers, stars, and the moon. In spiritual consciousness, we are all universal one.

As nurses gain experience sensing into their own spiritual consciousness, nursing will be better poised to meet its social mandate. Working from within spiritual consciousness, nurses are provided with multiple pathways for healings to occur. As nursing and society evolve, ideas related to spiritual consciousness and healing need further development.

How to Nurse


Are you looking for the perfect gift for a nurse on your holiday list?  Or, are you looking for a book that is entirely consistent with the vision of the NurseManifest values and ideals?  Are you still struggling to clearly answer the nagging question: what is nursing? Or do you just need inspiration? Cover How to nurse Look no further this book is the perfect choice – How to Nurse: Relational Inquiry with Individuals and Families in Shifting Contexts.  I reviewed this book for this blog back in January, but I continue to be inspired and encouraged by this book and decided that now is a perfect time to once again bring this book to the attention of NurseManifestors!  Right at the outset, the authors Gwenneth Hartwick Doane and Colleen Varcoe explain what they mean by the term “relational,” and in so doing reveal the close connection with NurseManifest values:

When we use the word “relational” and speak of a relational inquiry approach to nursing practice, many people think we are merely emphasizing the touchy-feely, emotional side of nursing and particularly “nurse–patient” relationships. However, relational inquiry is far more encompassing than that. Although relationships between people are certainly part of relational inquiry, in this book, the term “relational” refers to the complex interplay of human life, the world, and nursing practice. Specifically, relational inquiry involves highly reasoned, skilled action. Relational inquiry  requires (a) a thorough and sound knowledge base; (b) sophisticated inquiry and observational and analytical skills; (c) strong clinical skills including clinical judgment, decision-making skills, and clinical competencies; and knowledge and skills. Rather, a relational consciousness highlights the interplay of a number of factors affecting the point-of-care . . . . This heightened awareness enables more informed decisions and more effective action.

Overall, a relational consciousness

• Sensitizes us to the relational complexities that affect what happens at the point-of-care
• Directs attention toward the “relational transactions” that are occurring within and among people and contexts
• Enables us to be very intentional and consciously choose how to act in response to these complexities and transactions

Specifically, relational consciousness is the action of being mindfully
aware of the relational complexities that are at play in a situation and
intentionally and skillfully working in response to those relational complexities.

(Doane, Gweneth Hartrick; Varcoe, Colleen (2013-12-30). How to Nurse (Page 3-5). LWW. Kindle Edition.)

I cannot recommend this book highly enough!  In addition to this kind of explanation of the principles on which nursing is based, the book is loaded with examples and real-life activities that emphasize what this means in very practical terms.

Let’s start a lively discussion here about the insights that this book offers, and add more insights related to the connections between the perspectives this book offers and our own NurseManifest vision!

 

 

Nurses and Global Peace


This blog posting will be a bit different from others I have written, but I believe the NurseManifest page is a place where we can open our hearts and souls to the essence of nursing, which is healing, caring, love, and compassion. In a world seemingly torn asunder from fear, violence, and anger, nurses are called forth to support healing on a local and global level. The call comes from something beyond ourselves, and if you stop and listen closely, I believe you will hear that calling. You are a nurse and there is a reason you were drawn to nursing: to support healing through loving kindness and caring.

A few nights before the recent violence spread around the world, from Beruit to Paris, I lay in bed cuddling my 7 year old daughter close. Every night I am blessed to be able to spend some time reading to my daughters and cuddling as they drift off to dreamland. For a few moments that evening, I found myself floating in a space where I felt like the mother of the universe was whispering to me, not in words, but through a deep felt intuitive process. I knew the goodness, the light, and the powerful strength of peace as they came through clearly to me, carrying with them the message that the mother of all, the earth as a complex system, will heal itself. After the moment of certainty passed, I was left with the usual feelings of uncertainty: how will the good and the light prevail in these times of darkness? Who will help make this happen? What is my role in this process?

Then tragedy struck, and violence and war continue to grow. The feelings of uncertainty have not dissipated, so I sit with those, but I also do remain strongly rooted in the belief that as nurses, we can support global peace and healing through our own efforts of creating local peace and healing. And that local peace starts at the place closest to us all, right from our hearts.

As we practice our own healing, creating our own peace and loving-healing processes, we can begin to spread that healing, peace, and love to others. A practice I try and do daily is called loving kindness meditation. I feel on many levels this practice is about my own healing and self-care so that I can be a better nurse, wife, and mother… and it is also about bringing that healing into the world.

I start with focusing on myself, in my heart space, and intending for myself healing through the following words:

May I know peace, joy, love, and ease. May my heart be full. May I be safe, healthy, and happy.

I than send this intention to the loved ones in my life, wishing them all love, peace, ease, happiness, health, and safety: family, friends, pets, students, and colleagues. As the circle of intention spreads outward, I send the intention and feelings of love and peace out to my “enemies” and challengers, and I end with the whole planet, with every being being sent the intention of peace, love, and healing.  The process takes  5-10 minutes.

As nurses supporting healing, we can think and act both locally and globally. Imagine if every nurse sent out an intention, a prayer, a positive thought for healing and peace for the entire mother earth and all of the beings living here. Consciousness studies show that our thoughts and intentions impact our environment and reality.  I think of Jean Watson’s call for us to practice loving kindness and  Martha Rogers’ concept of Unitary Beings. We can reflect the patterns before us, we can create shifts in consciousness to support healing.

Despite the medical system’s over-emphasis on technology-cure-illness management, I still believe that nurses are truly called toward the healing that all beings are capable of experiencing. If you have been called to be a nurse, can you return to that calling, can you spare a few moments to consider the global situation, and what you can do as a nurse to support healing from the truly local level (yourself) and on to the global level?

I would love to hear from nurses and how they are supporting peace and healing around the globe. The call has been made, how will you answer?

 

peace-signs-clip-art-peace-signs-clip-art-10h call has been made… how will you respond?