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The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social‐ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work. [ABSTRACT FROM AUTHOR]

It is accepted that research should be systematically examined to judge its trustworthiness and value in a particular context. No such appraisal is required of reports published by organizations that have possibly even greater influence on policy that affects the public. This paper explores a philosophical framework for appraising reports. It gives the reasons why informed engagement is important, drawing on Popper's concept of the open society, and it suggests a method for appraisal. Gadamer's concept of the two horizons and Jauss's reception theory offer a methodological framework to enable the individual citizen, whether professional or lay, to engage in debate about policy that affects him or her. By way of a worked example, the framework is applied to two international reports on nursing. Conclusions suggest that nursing policy should be subjected to robust interrogatory appraisal by both profession and public for a democratic debate and creative discourse. Although this analysis is related to international nursing policy, it has a wider relevance and application beyond nursing. [ABSTRACT FROM AUTHOR]

In recent years, there has been increased interest in the role of religion in the reform of nursing during the mid-nineteenth century. However, less is known about how ‘party’ disputes between evangelicals and followers of the ‘Oxford Movement’ may have affected nursing. This study examines a proposal to create a nursing association for the Diocese of Lichfield in 1864, which leads to a public dispute concerning the ‘ecclesiastical’ nature of the organisation. Leading evangelicals in Derby campaigned against the idea of nurses belonging to a ‘sisterhood’. This resulted in two rival organisations being created in 1865. This paper reports upon the nature and origins of the dispute within the diocese, unsuccessful attempts to draw Florence Nightingale into the dispute and the relative success of the two institutions. The results of this research indicate that the importance of context and of place must be recognised when studying the history of nursing. This research is based mainly, upon newspaper reports, correspondence and miscellaneous sources, including biographies as there are few surviving records from the two organisations under scrutiny. [ABSTRACT FROM AUTHOR]

This paper is based on research in progress focusing on the histories of mission hospitals in the rural communities of KwaZulu Natal, while also building on earlier research into the pluralism of medical systems within the South African Cape. Sources have been drawn from a range of historical documents, including medical and nursing journals, the archives of a number of medical missionary societies and of the Overseas Nursing Association, but the research has also been informed by oral histories of a broad cross-section of health professionals who practised in South Africa. A large literature search included a number of biographies and institutional histories. The paper will be divided into three parts--the first provides a brief background to colonialism and the early nursing history of South Africa; the second looks in more detail at the role played by missionary nurses in establishing nursing as a profession and providing training opportunities for African nurses. The final part contrasts missionary nursing with the supply of, and work done by nurses from the Overseas Nursing Association operating within their quite specific, colonial remit. This will show how the two contrasting professional spheres--one reflecting a fairly short-term commitment, the other, a much broader, 'vocational' involvement--may be seen to represent quite different colonial attitudes, and ultimately quite diverse outcomes. [ABSTRACT FROM AUTHOR]

REUTTER L and KUSHNER KE. Nursing Inquiry 2010; 17: 269–280 ‘Health equity through action on the social determinants of health’: taking up the challenge in nursing Reducing health inequities is a priority issue in Canada and worldwide. In this paper, we argue that nursing has a clear mandate to ensure access to health and health-care by providing sensitive empowering care to those experiencing inequities and working to change underlying social conditions that result in and perpetuate health inequities. We identify key dimensions of the concept of health (in)equities and identify recommendations to reduce inequities advanced in key global and Canadian documents. Using these documents as context, we advocate a ‘critical caring approach’ that will assist nurses to understand the social, political, economic and historical context of health inequities and to tackle these inequities through policy advocacy. Numerous societal barriers as well as constraints within the nursing profession must be acknowledged and addressed. We offer recommendations related to nursing practice, education and research to move forward the agenda of reducing health inequities through action on the social determinants of health. [ABSTRACT FROM AUTHOR]

When Adolf Hitler (1889-1945) came to power in 1933, the new Nazi government focused the German health system on their priorities such as the creation of a racially homogeneous society and the preparation of war. One of the measures to bring nursing under their control was the foundation of a new sisterhood. In 1934, Erich Hilgenfeldt (1897-1945), the ambitious head of the National Socialist People's Welfare Association (Nationalsozialistische Volkswohlfahrt), founded the National Socialist (NS) Sisterhood (Nationalsozialistische Schwesternschaft) to create an elite group that would work for the goals of the National Socialist German Workers' Party (Nationalsozialistische Deutsche Arbeiterpartei, NSDAP). Hilgenfeldt proclaimed community nursing as a priority for NS Sisterhood nurses. Catholic and Protestant sisters, who were traditionally dedicated to community nursing, were to be gradually replaced. However, other competing priorities, such as hospital service for the training of junior nurses and work in conquered regions, as well as the lack of NS nursing personnel, hampered the expansion of community nursing. The paper also addresses areas for future research: everyday activities of NS nurses, the service of NS Sisterhood nurses for NSDAP organisations such as the elite racist paramilitary force SS (Schutzstaffel, Protective Squadron), and involvement in their crimes have hardly been investigated as yet. [ABSTRACT FROM AUTHOR]

Nursing is possible owing to a series of intricate systemic relations. Building on an established tradition of sociological research, we critically analysed the nursing profession in Chile, with an emphasis on its education system, in the light of social systems theory. The paper's aim was to explore basic characteristics of nursing education as a system, so as to outline its current evolution. Drawing on recent developments in nursing, we applied an empirical framework to identify and discuss functionally differentiated systems that are relevant to nursing and observe communications between them. We found that the dynamics of nursing as a whole develop from communications with closely related systems, including the nursing profession and the education system more broadly. While the discipline (as a system of representations) strives to control the profession (as an applied occupational field), the necessities of practicing nurses imply other forces mediating the making of the profession, a process framed by market dynamics in education and health. [ABSTRACT FROM AUTHOR]

Histories of nursing that disregard their linkage to broader historical movements often lead to historically detached versions of nursing identity that omit the perspective of their sources and the ideas of their time. Drawing on materials retrieved through a multilayered research strategy comprising internal and external sources, this article examines the development of a nursing identity in Chile during the period starting in the 1950s through the early 2000s. We analysed the sociopolitical contexts in which the nursing profession grew, the changing direction of its role and how the nursing identity transformed itself. Through the use of historical sources and oral testimonies, we aim to give a nuanced account of how the history of public health and that of the country more broadly changed the object of identification of nurses, creating only relatively recently a sense of nursing community. Processes of identification, fragmentation and integration are highlighted, which challenge usual notions of history as a linear process. [ABSTRACT FROM AUTHOR]

Two nurses diagnosed with opioid addiction launched legal action after being found guilty of unprofessional conduct due to addiction‐related behaviors. When covered by the media, their cases sparked both public and legal controversies. We are curious about the broader discursive framings that led to these strong reactions, and analyze the underlying structures of knowledge and power that shape the issue of opioid addiction in the profession of nursing through a critical discourse analysis of popular media, legal blogs and hearing tribunals. We argue that addiction in nursing is framed as personal choice, as a failure in the moral character of the nurses, as decontextualized from addiction as disease arguments, and as an individualized issue devoid of contextual factors leading to addiction. Our investigation offers a critical case study of a nursing regulatory body that upheld popular assumptions of addiction as an autonomous, rational choice replete with individual‐based consequences – a framing that is inconsistent with evidence‐based practice in health‐care. We put forth this critical interrogation to open up possibilities for counterdiscourses that may promote more nuanced and effective responses to the issue of addiction in nursing. [ABSTRACT FROM AUTHOR]

This article explores risk in professional nursing practice. Professional risk refers to the threat of professional discipline if it is found that a registered nurse has violated professional nursing practice standards. We argue professional risk is socially constructed and understood differently by nurse regulatory bodies, unions, professional associations and frontline nurses. Regulatory bodies emphasize professional accountability of nurses; professional associations focus on system problems in health-care; unions undertake protecting nurses' right to health and safety; and frontline nurses experience fear and uncertainty in their attempt to interpret practice standards to avoid professional discipline. Perspectives of professional risk are investigated by analyzing three professional nursing bodies' views of professional codes governing the right of nurses to refuse unsafe work assignments. The workplace dynamics surrounding work refusal experienced by frontline nurses are illustrated primarily through the lens of the 2003 SARS influenza outbreak in Ontario, Canada. We conclude that frontline nurses in Ontario are required to manage risk by following professional protocols prioritizing patient care and professional accountability which disregard the systemic, unpredictable and hazardous circumstances in their everyday practice. Moreover, we argue professional protocols cannot anticipate every eventuality in clinical practice creating the fear of professional discipline for nurses. [ABSTRACT FROM AUTHOR]