To Challenge and to Cooperate

Most readers of this blog are already aware of the IOM/Robert Wood Johnson report on the Future of Nursing that was issued in October of 2010.  You may recall my post about the report last June – in fact, there were 16 replies to that post – a record for this fledgling blog!  The replies were thoughtful and brought to the fore exactly what is most badly   needed in nursing – challenges about not only the report, but the assumptions underlying it.  So I would like for us to focus once again on this initiative, not simply because of the terrific discussion it raised on this blog, but because it is generating a substantial degree of action.  Part of the action component is built into the funding plan that accompanied the original report, which actually strengthen the possibility that something will come of it!  But of course the action components need to be watched closely.  The challenge for me, and I suspect for many others who entered the discussion in June, has to do with a fundamental question: “Who benefits?”

During the August conference of INANE (International Academy of Nursing Journal Editors) in San Francisco, the 130+ nursing journal editors and publishers heard a presentation by Susan Hassmiller, the Senior Advisor for Nursing for the Center to Champion Nursing in America.  In response to her presentation, the group decided to initiate a coordinated effort across as many nursing journals as possible, to further the possibilities for the achievement of the report’s recommendations.  So far, the INANE web site has a listing of editorials and resources that have appeared in various nursing journals over the past year or so; in the spring of 2012, many of the journals will carry focused messages about the report, articles, and other content that provides evidence and resources for their readers in moving forward.  I would encourage folks to browse this list … it is impressive, and many of the editorials are well worth looking up and reading.  Also, if you want to see Susan Hassmiller’s presentation from the INANE conference, you can find it here (scroll down to the Friday 8:00 session).

So my question for readers of the Nurse Manifest blog: can we both challenge and cooperate?  I fully agree with many of the challenges that came forward in our discussion in June, including skepticism about the source of the report, and the fact that the report’s recommendations are in fact what we might call “lame.”  However, the cold hard truth is that the recommendations of the report, which of course should already be reality, are far from real.  If we were to achieve the report recommendations as reality, do we not have a better outlook for achieving not only the fundamental goal of better health care and better nursing care, but also the ideal of seeing nursing at the center of health care policy-making.  If we simply sit on the sidelines and challenge the report, then we isolate ourselves from the places where mainstream change might be possible.  If we simply cooperate with the report without questioning some of the assumptions and directions, then we ourselves may all too easily be drawn into an abyss of the status quo.  So bottom line, to me, there is no simple way forward.  But I favor moving forward, challenging ideas and actions where possible to be heard, and with as much cooperation as possible with those who follow a more mainstream path than many of us follow!

Breaking Down Barriers: Advocacy for Integral Health and Human Caring

As we participate in our personal and professional environments how do we break down barriers by advocating for shared power to promote integral health and human caring?

The Peace and Power process breaks down barriers by challenging ideological beliefs and behaviors that alienate and divide us from one another (Chinn, 2008). This process begins with an honest personal inventory and evaluation of sociocultural mores and conditioning that inform our beliefs. It is from this starting point that we can begin to see the power of our thoughts and feelings. How we act and react creates experiences of nurturance and shared power; or of conflict and derision. “Power is the energy from which action arises” (Chinn, p.17). There are many kinds of power, but Chinn’s definition here spurs the notion of advocacy for the use of power as energy. Energy to free, to heal, to care, to make a better, more loving, understanding, healthy, kind and just world.

What are you thinking and feeling right now about what power means to you and your current (personal and professional) life experiences?

Consider the French philosopher Michel Foucault’s (b.1926- d.1984) ideas of power: Foucault (1982) said “Power is everywhere and in everything.”  He believed the effects of power are linked with knowledge, competence and qualification; and that power is a socialized and embodied phenomenon. He also believed that power is discursive rather than (but can be) coercive. Discursive means “running to and from” and involves the use of language (discourse). Indeed, power is communicated in language (verbal and nonverbal).

We often think power means “power over” and attach negative meaning to it, but for Foucault power takes on a socialized, knowledge based meaning; and helps us to see what Peggy means by “power as energy for action.” For a further explanation of Foucault’s beliefs and influences please follow the link below:

As we critically examine the concept of power, we can look at the socialized and embodied beliefs, behaviors and practices that divide and join us.

Watson (2012) suggests we ask “who is this spirit filled person before me?” As we interact with our environment, and those in it, we can ask this question, and go deeper and wider to ask: what are the sociocultural, internal, external, subjective, even global and historical influences and experiences that inform this person and her or his views of self, other and world?  What are the influences of power upon and within this person?

Breaking down barriers to personal and professional advocacy for integral health and human caring can begin with examining power in all its many manifestations.


Chinn, P. L. (2008). Peace and Power: Creative leadership for building community. Jones and Bartlett. Sudbury, Ma.

Foucault, M. (1982). The subject and power. Critical Inquiry, 8(4), 777-795.

Watson, J. (2012). Human caring science: A theory of Nursing. Jones and Bartlett. Sudbury, Ma.