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In this study, we discuss the colonial project as an eliminatory structure of indigenous ways of knowing and doing that is built into Canadian social and health institutions. We elaborate on the role nursing plays in maintaining systemic racism, marginalization and discrimination of Indigenous Peoples. Based on historical practices and present‐day circumstances, we argue that changing language in research and school curriculums turns decolonization into what Tuck and Yang call a 'metaphor'. Rather, we propose decolonization as a political project where nurses acknowledge their involvement in colonial harms and disrupt the assumptions that continue to shape how nurses interact with Indigenous people, including knowledge systems that perpetuate colonial interests and privilege. Decolonization requires nurses to understand the colonial practices that led to dispossession of land, erasure of knowledge, culture and identity, while upholding indigenous ways of knowing and doing in health, healing and living. As a political manifesto that liberates indigenous life from oppressive structures of colonialism and capitalism, The Red Deal is presented as a visionary platform for decolonization. The aim of this study is to articulate three dimensions of caretaking within The Red Deal as a framework to decolonize nursing knowledge development and practice. Based on the philosophical dimension embedded in The Red Deal that revoke norms and knowledge assumptions of capitalism that destroy indigenous ways of knowing and doing, we underscore an approach toward decolonizing nursing. Our approach rejects the apolitical nature of nursing as well as the unilateral western scientific knowledge approach to knowledge development and recognition. A critical emancipatory approach that addresses the socio‐political and historical context of health care, recognizes dispossession of land and adopts a 'multilogical' vision of knowledge that gives space for representation and voice is needed for true decolonization of nursing. [ABSTRACT FROM AUTHOR]

Dr. Marilyn A. Ray, nurse scholar and retired United States Air Force (USAF) veteran and former flight nurse, began her nursing scholarship in Canada. She was influenced by the experiences and interprofessional scholarly ideas that she encountered along her career trajectory. Her early love of the air and space led her to the United States Air Force Nurse Corps, where she served as a flight nurse during the Vietnam war era, followed by leadership positions in nursing education, administration, practice, and research. Dr. Ray's contributions to nursing knowledge includes two nursing theories and a caring inquiry methodology. Dr. Ray is helping to create a new caring science certificate program at Florida Atlantic University, Christine E. Lynn College of Nursing. In this column, Dr. Ray shares the story of her scholarly influences and how they helped her care for her husband and gain insight into her contributions to nursing knowledge development. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the use of Indigenous philosophies and ways of knowing as a means to critique, understand and improve the care of Indigenous infants and families in the neonatal intensive care unit (NICU). Background: The ability of health professionals to provide culturally safe and equitable care to Indigenous infants and their families can affect infant development and long‐term health outcomes. Research suggests that family involvement in care benefits both the infant and their family, but there is limited research that addresses the experience of Indigenous families in the NICU and advances understanding of how nurses involve Indigenous families in their infants' care. Design: A discursive, critical review will be presented to outline the assumptions of Indigenous philosophies and to explore how the consideration and implementation of Indigenous ways of knowing can improve the nursing care of Indigenous infants and their families in the NICU. Method: First, our subjective positioning as Indigenous nurses and as health researchers is described. Second, our understanding of Indigenous philosophical frameworks and how these approaches fit in the context of the philosophy of science is defined. Third, the key elements of an Indigenous philosophical paradigm are described. Fourth, an application of Indigenous paradigms to supporting the care of Indigenous infants and families in the NICU context is made. Conclusions: An Indigenous philosophical approach to nursing is ideal for understanding and improving the experiences of Indigenous infants and families in the NICU. This approach allows nurses to critically analyse the history and legacy of colonialism and its impact on the health and wellbeing of Indigenous peoples. By prioritising the voices and concerns of Indigenous families in the clinical setting and in nursing research, nurses can better understand the experiences of these families in the NICU and use strengths‐based approaches to facilitate family involvement in care. Relevance to clinical practice: The application of Indigenous philosophies in the nursing context can be used to inform the care of Indigenous infants and families in the NICU. Potential benefits include improved therapeutic relationships between nurses and Indigenous families, and increased uptake of parent‐led interventions in nursing practice, which may lead to improved health outcomes for Indigenous infants in the NICU and throughout their subsequent development. [ABSTRACT FROM AUTHOR]

Aims: This manuscript aims to describe one acute care hospital's ICU journey during the COVID‐19 pandemic and how fundamental care was central to the implementation of team‐based models of care. Background: Over the course of the COVID‐19 pandemic, team‐based and alternative models of care are being employed to manage and address global shortages and surge capacity. Employing these alternate models of care required attention to ensure fundamental care needs of patients were being met. Design/Method: The following paper describes an ICU's journey of focusing on the delivery of the fundamentals of care through the implementation of team‐based models of care to address the surge in patient care demands experienced in response to our global pandemic. Conclusions: The implementation of an evidence‐informed approach to optimizing models of care and staffing in the ICU amid the evolving COVID‐19 waves in one acute‐care hospital is provided. This local approach focused on meeting patients' fundamental care needs throughout the necessary introduction of team‐based care models and staffing changes and drew from evolving evidence, the ILC Fundamentals of Care Framework, and regulatory guidance. [ABSTRACT FROM AUTHOR]

Recent Canadian and international events have sparked dialogue and action to address racism within the nursing discipline. While the urgency to seek and implement antiracist solutions demands the attention of nurses, we contend that a contemporary analysis of the mechanisms that continue to perpetuate racism within nursing's theoretical foundation is required first. This study reconsiders the perceived functions of racism within the current state of nursing concepts and theories. In particular, we expose the role that covert racism plays by inadvertently sustaining racism through nursing's theoretical foundation, and how this process strengthens white supremacy. We argue that, in the absence of exposing these covert mechanisms, the development of solutions will be futile in dismantling racism. By making visible the covert mechanisms of racism within nursing's theoretical foundation, we attempt to establish an opportunity for the nursing discipline to dismantle its racist foundation and engage in sustained antiracist action. Lastly, this study demonstrates the need to equip the discipline with a moral commitment to antiracism in an effort to emancipate nursing from its racist legacies. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) in Canada have the potential to significantly benefit the health and academic outcomes of school age children with its impact lasting into adulthood. Unfortunately, cuts in government funding over the years have diminished the presence of PHNs in schools and their ability to practice to their full scope. In the midst of a pandemic, having a strong nursing presence in schools may facilitate public health efforts and reduce the burden on teachers and administration. This discussion paper will explore the current role of nurses in Canadian schools in relation to school nurses in other parts of the world. An overview of the literature looking at the impact of the school nurse on school health (i.e., student health and academic outcomes) will be presented to provide evidence in support of rebuilding nursing capacity in Canadian schools. Finally, the Framework for 21st Century School Nursing Practice will be introduced as a viable nursing theory to facilitate rebuilding PHN capacity in schools. [ABSTRACT FROM AUTHOR]

Serious mental illness (SMI) has long posed a dilemma to society. The use of community treatment orders (CTOs), a legal means by which to deliver mandated psychiatric treatment to individuals while they live in the community, is a contemporary technique for managing SMI. CTOs (or a similar legal mechanism) are used in every province in Canada and in many jurisdictions around the world in the care and management of clients with severe and persistent mental illness (most frequently schizophrenia) who have a history of treatment non‐compliance and subsequent relapse. Although there is ongoing controversy around CTOs, their use continues to be on the rise. René Girard's mimetic theory, in which he posits the social utility of the scapegoat mechanism, may shed some light on how established cultural patterns contribute to contemporary responses to SMI: how culture depends on the reproduction of certain narratives, and how these act to shape the identity of those involved. The CTO specifically can be seen to act as a scapegoating mechanism, wherein, by singling out and controlling individuals who appear to threaten social order, social order is restored. This paper reviews Girard's theory, looks at how it has been applied to SMI, and then considers how it may illuminate the social role of the CTO. This examination may provide mental health nurses with insight into the constructed identities of their patients, as well as the role of mental health care within broader cultural narratives. [ABSTRACT FROM AUTHOR]

Background: A streamlined academic approach for career advancement is needed that allows practical or enrolled nurses to obtain a Bachelor of Nursing (BN) degree. One strategy in this approach is offering college-prepared Practical Nurses (PNs) the opportunity to transition into a baccalaureate program through a bridging course. Bridging initiatives serve as professional development opportunities for learners with personal growth and financial advantages on degree completion and enhance health and human resources for health care systems within national and international landscapes. Objective and methods: A curricular model and strategies on how such a bridging course can be constructed are discussed in this article. The model integrates teaching and learning strategies as well as course sequencing, structure, and assessment strategies. Results and conclusion: This innovative bridging curriculum offers Canadian and international nurse educators a programmatic guideline to create educational pathways for practical or enrolled nurses to obtain a baccalaureate degree. Completion of the bridging curriculum and BN program allow graduates to assume the RN role following a successful pass on the National Council Licensure Examination (NCLEX). [ABSTRACT FROM AUTHOR]

The work of Jacques Derrida has received relatively little attention within nursing philosophy. Perhaps this is because Derrida is known best for deconstructing philosophy itself, a task he performed by making language unintelligible to make a point. This in itself makes his work daunting for nurses who do applied philosophy. Despite these difficulties, Derrida's focus on holding open a space for ideas, particularly those ideas that are invisible or unpopular, holds potential for enhancing the diversity of ideas within nursing. His work, liberally scattered with religious references, and focused on deconstructing language that served the profits of a few, earned him the characterization of a prophet without religion. This idea was further supported in the way his deconstruction attempted to keep spaces open for the un-representable and its generativity in opening new possibilities in life. A deconstruction for generative purposes is particularly helpful within palliative care where language quickly takes on dogma in the face of mystery and where new possibilities support life amidst the irrevocable nature of death. In this article, I discuss Derrida's deconstructive approach of differance and then apply that approach to language common in palliative care. [ABSTRACT FROM AUTHOR]

Drawing on a comprehensive, pan-national analysis of the corporatization of Canadian universities, as well as the notions of 'parrhesiastic' mentorship and practice, the authors examine the effects of the corporatized university, its implications for graduate nursing education and nursing's relative silence on the subject. With the preponderance of business interests, the increasing dependence of universities on industry funding, cults of efficiency, research intensivity, and the pursuit of profit so prevalent in today's corporatized university, we argue that philosophical presuppositions so crucial to critical teaching, research, and reflection on nursing as a discipline are troublingly losing ground. We lament the erosion and fragmentation of philosophy, politics, and ethics as foundations for graduate education, which are increasingly perceived as less valuable, problematic, and in some cases, even burdensome. The effect of corporatization is the suppression of the critical engagement required of faculty in the everyday workings of institutions. We argue that, when the ideals of intellectual freedom, academic responsibility, duty, and obligation, as supported by philosophical thought, are smothered by the normalizing power of corporatized research agendas, philosophical approaches to inquiry and knowledge development become marginalized as scholars find themselves floundering in the face of a seeming 'philosophy lost'. [ABSTRACT FROM AUTHOR]

Aim A discussion of how nurses can contribute to and lead improvement science activities in health care. Background Quality failures in health care have led to the urgent need for healthcare quality improvement. However, commonly quality improvement interventions proceed to practice implementation without rigorous methods or sufficient empirical evidence. This lack of evidence for quality improvement has led to the development of improvement science, which embodies quality improvement research and quality improvement practice. This paper discusses how the discipline of nursing and the nursing profession possesses many strengths that enable nurses to lead and to play an integral role in improvement science activities. However, we also discuss that there are insufficiencies in nursing education that require attention for nurses to truly contribute to and lead improvement science in health care. Design Discussion paper. Data sources This paper builds on a collection of our previous work, a 12-month scoping review (March 2013-March 2014), baseline study on a quality improvement management system (Lean), interviews with nurses on quality improvement implementation and supporting literature. Implications for nursing This paper highlights how nurses have the philosophical, theoretical, political and ethical positioning to contribute to and lead improvement science activities. However up to now, the potential for nurses to lead improvement science activities has not been fully used. Conclusion We suggest that one starting point is to include improvement science in nursing education curricula. Specifically, there needs to be increased focus on the nursing roles and skills needed to contribute to and lead healthcare improvement science activities. [ABSTRACT FROM AUTHOR]

Sister (Sr.) Marie Simone Roach, of the Sisters of St. Martha of Antigonish, Nova Scotia, died at the Motherhouse on 2 July 2016 at the age of 93, leaving behind a rich legacy of theoretical and practical work in the areas of care, caring and nursing ethics. She was a humble soul whose deep and scholarly thinking thrust her onto the global nursing stage where she will forever be tied to a central concept in nursing, caring, through her Six Cs of Caring model. In Canada, she was the lead architect of the Canadian Nurses Association's first code of ethics, and her influence on revisions to it is still profound more than 35 years later. In this paper, four global scholars in nursing and ethics are invited to reflect on Sr. Simone's contribution to nursing and health‐care, and we link her work to nursing and health‐care going forward. [ABSTRACT FROM AUTHOR]

Background: Learner-oriented strategies focusing on learning processes are needed to prepare nursing students for complex practice situations. An arts-based learning approach uses art to nurture cognitive and emotional learning. Knowles'theory of andragogy aims to develop the skill of learning and can inform the process of implementing arts-based learning. This article explores the use and evaluation of andragogy-informed arts-based learning for teaching nursing theory at the undergraduate level. Method: Arts-based learning activities were implemented and then evaluated by students and instructors using anonymous questionnaires. Results: Most students reported that the activities promoted learning. All instructors indicated an interest in integrating arts-based learning into the curricula. Facilitators and barriers to mainstreaming arts-based learning were highlighted. Findings stimulate implications for prospective research and education. Conclusion: Findings suggest that arts-based learning approaches enhance learning by supporting deep inquiry and different learning styles. Further exploration of andragogy-informed arts-based learning in nursing and other disciplines is warranted. [ABSTRACT FROM AUTHOR]

Aim A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Background Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Design Discussion paper. Data sources A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. Discussion The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. Implications for nursing A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Conclusion Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. [ABSTRACT FROM AUTHOR]

Drawing upon selected literature from the United Kingdom, Denmark, and Canada we examine how Foucault's concepts of 'episteme', 'rupture' 'parrhesia' 'care of the self', and 'problemitization' have been applied to particular contexts of leadership development, pedagogy, nursing knowledge, and the relationship between caring and politics. Our aims are threefold: to give examples of how selected Foucauldian concepts have been taken up in practice; to clarify how we are positioned today as nurses; and to invite more nurses to engage critically with historical inquiry and to engage in deep philosophical reflection about their relationship with nursing. We begin by examining the conditions and circumstances of Foucault's life, and conclude by posing the question in our subtitle to stimulate debate about the philosophical relevance of Foucauldian scholarship to nursing. [ABSTRACT FROM AUTHOR]

While nurses can and do behave as intentional political agents, claims that nurses collectively do (empiric), should (normative) or must (regulatory) act to advance political objectives lack credibility. This paper challenges the coherence and legitimacy of political demands placed upon nurses. It is not suggested that nurses ought not to contribute to political discourse and activity. That would be foolish. However, the idea that nursing can own or exhibit a general political will is discarded. It is suggested that to protect and advance political discussion, to aid explanatory adequacy and clarity, the form in which nursing associates itself with political claims merits critical appraisal. Thus significant numbers of nurses probably reject or disagree with many of the political claims that attach to them - claims often made on their behalf. More specifically, the individual beliefs and goals of nurses can be in conflict with the political pronouncements of nursing scholars and organizations (group agents). It is proposed that nurses need not share substantive normative beliefs/goals and, if this proposal holds, group descriptors such as 'nurses' and 'nursing' cannot meaningfully or easily attach to political claims. Shared value theory is linked to the fallacy of composition and the concept of collective ascription error is introduced to explore the implausibility of using group descriptors such as 'nurses' and 'nursing' to refer to the beliefs/goals of all nurses. [ABSTRACT FROM AUTHOR]

Our analysis in this paper unfolds on two levels: a critique of the 'realities' of graduate nursing education and an argument to sustain its 'ideals'. We open for discussion an aspect of graduate nursing education dominated by instrumental reason, namely the research industry, using an internal critique approach developed by Max Horkheimer and Theodor Adorno of the Early Frankfurt School. As we explain, internal critique arises out of, and relies on, the mismatch between goals, or 'ideals', and existing realities. Thinking about 'ideals' of the academy, we draw on Hans-Georg Gadamer's view of the university as a place to think freely, creatively, and critically. The contemporary realities of the university, on the other hand, that emphasize the market values of the research industry forcefully shape nursing academic scholarship in a particular direction. In our attempt to recognize and disrupt the forces of the research industry with its instrumental reason, we consider Judith Butler's writings on how norms operate in society. We show that our growing involvement in the research industry makes it very difficult to disentangle ourselves from that situation. The values of the research industry actually suppress the very ideals of education and scholarship that we would like to uphold. As a contra-force, the internal critique of the 'existing realities' in the graduate nursing education unmasks the tyranny of the research industry and makes visible the importance of sustaining the higher goals and ideals in nursing scholarship. [ABSTRACT FROM AUTHOR]

Over the past several decades, nurses have been increasingly theorizing about the relationships between culture, health, and nursing practice. This culture theorizing has changed over time and has recently been subject to much critical examination. The purpose of this paper is to identify the challenges impeding nurses' ability to build theory about the relationships between culture and health. Through a historical overview, I argue that continued support for the essentialist view of culture can maintain a limited view of complex race relations. I also argue that attempts to apply culture theory, without knowledge of important historical, political, and economic factors, has often resulted in oversimplified versions of what was originally intended. Furthermore, I argue that individual-level interventions alone will be insufficient to address health inequities related to culture. Despite new critical conceptualizations of culture and the uptake of cultural safety, nursing scholars must better address the broader organizational, population, and political interventions needed to address inequities in health. I conclude with suggestions for how nurses might proceed with culture theorizing given these challenges. [ABSTRACT FROM AUTHOR]

An editorial is presented on the experience of the author with people of different colors and race while working in the nursing field of the healthcare industry. It talks about the author's childhood life being sheltered from people of other colors by his parents and his school. It tells about the author settling down in Canada which is known for it's multicultural society.

In this paper, we explore the concept of bearing witness in nursing practice. We examine the description of bearing witness in the nursing literature, particularly that offered by William Cody who suggests that bearing witness results in the limited moral obligation of "true presence." We then turn to Lorraine Code's work on testimony, drawing parallels between the concepts of testimony and bearing witness. Code suggests that receiving testimony results in a responsibility to respond, and that this is an ethico‐political obligation. We discuss these ideas in relation to a Canadian exemplar of witnessing the Truth and Reconciliation Commission of Canada's work to understand and address the historical injustices done to Indigenous peoples in Canada. Here, we focus on the Commission's definition of witnessing and highlight the experience of Shelagh Rogers who served as an honorary witness. As an outcome of our analysis, we suggest that bearing witness in nursing practice is most usefully conceptualized as both a moral and a political obligation. Implications for nursing practice are suggested, including first, the need to critically examine our own understandings of power and privilege in order to authentically bear witness and avoid being complicit in injustice, and second, the concomitant responsibility to take action to challenge injustice once we have borne witness to it. [ABSTRACT FROM AUTHOR]

In 1974, the Liberal government of Pierre Trudeau released a "green paper" known as the Lalonde Report, after the health minister at that time. The report formulated perspectives on health and the main concepts and ideas developed in it, particularly the concept of "lifestyle," which became the foundation of public health policies in many different European countries and the United States. The concept of "lifestyle" connected personal behaviour and habits to the individual health condition; people were not dying due to a lack of access to medical care but because they lived a life prone to personal risk taking. Furthermore, what is seldom discussed is that this report not only propagated the (neo)liberal view of citizens as autonomous rational actors (homo oeconomicus), with personal responsibility for their health, but it was a first step in the transformation of Medicare and went far beyond the question of health promotion. Health was no longer something that happened to a person but was created through personal choice and, therefore, one had to assume responsibility for one's behaviour. Using Foucault's definition of government as the "conduct of conduct," we will demonstrate that the Lalonde report must be understood as a specific "technology of government" and contributed to a neoliberal transformation of health care despite the fact that the Canadian system of Medicare was based on the idea of universality, meaning citizens had equal access to health care independent of their socio‐economic situation. As we will demonstrate, the Lalonde report undermined this foundation and initiated a profound reorientation, not only of the healthcare system, but even more importantly, it radically changed the way we think about our behaviour around health‐related issues. We will also discuss how the making of the report contributed to the redefinition of politics and demonstrated a lack of concern with liberal‐democratic decision‐making processes. [ABSTRACT FROM AUTHOR]