ppn 101

what is nursing

profession focused on promoting health, preventing illness, providing care, relieving suffering, and supporting people throughout the lifespan.

roles: caregiver, advocate, educator, leader

grounded in knowledge, skills, ethics, and compassion

criteria of a profession, professional behaviour, nursing and academic link

nursing professionalism

behaving in a way that demonstrates the values, knowledge, skills, ethics, and responsibilities expected of a nurse.

commitment to high standards of practice

integrity responsibility and ethical behaviour

compassion and respect for patient dignity

collab w other health professionals

nursing as a profession

1. Practice Discipline: Nursing is a practice discipline, meaning the profession is centred around the actual care and practical actions performed with and for people.

2. Self-Regulation: Nursing is a self-regulated profession. This means that nurses, through specific regulatory bodies, set the expectations, standards, and rules for their own practice.

what does it mean that nursing is a practice discipline

nursing combines theory/knowledge with clinical application. nurses use what they learn in school in real patient care scenarios

what guides nursing practice

evidence informed decision making practice - use the best available evidence/research, along with their nursing knowledge and the patients situation to decide what to do

why is research important in nursing

it helps nurses use the best available evidence to provide safe and effective care

what does accountability mean in nursing

being responsible for your actions, decisions and the care you provide

what is nursing competency

having the knowledge, skills, judgement and abilities needed to provide safe and effective nursing care

what types of rules and guidance help ensure safe nursing care

codes of ethics, practice standards, best practice guidelines, laws, and regulations

competency vs accountability

accountability - being responsible for the care you provide

competency - being capable of providing safe care

what are practice standards

standards that describe what nurses are expected to do to provide safe competent care

what organizations help guide nursing practice in canada

the CNA and provincial regulatory bodies

who are nurses accountable to

the public, patients, nursing profession

what does it mean to be a self regulated profession

nurses have the responsibility and authority to regulate their own profession under government trust and oversight

what 3 things does a nurse use to make clinical decisions

research, critical thinking, professional judgement

what does the CNO do

regulatory body responsible for overseeing the profession. The CNO performs several critical functions:

* Approval of Programs: Evaluating and approving nursing education programs

* Registration and Licensure: Managing the process by which individuals become legally allowed to practice.

* Regulation of Practice: Ensuring that nurses meet the required standards to protect the public

what does the CNA do

The Canadian Nurses Association (CNA) provides a code of ethics that applies across the entire country

* Provincial/Territorial Codes: Each province and territory maintains its own specific regulatory documents and codes of ethic

• Play a vital role in documenting nursing history to encourage critical thinking about past systemic inequities

key attributes of nursing (8)

• Knowledge: The theoretical and practical foundation required for competent practice.

• Accountability: Being answerable for one's own actions and decisions.

• Autonomy and Self-regulation: The ability to make independent professional judgments and the capacity for the profession to govern its own standards.

• Inquiry: The necessity for nurses to constantly ask questions about their work to improve outcomes

• Research: Utilizing evidence-based research to drive the profession forward

• Collegiality and Collaboration: The requirement to work within a team to provide comprehensive care; nursing cannot be practiced in isolation

• Innovation: Developing new ways to improve care and processes.

• Ethics and Values: Adhering to moral principles and professional standards in all interactions.

florence nightingale

• she implemented changes focused on nutrition and cleanliness → before her interventions, soldiers were dying in large numbers from infections and other preventable issues rather than their actual battle wounds

• during the crimean war in eastern europe she organized a group of nurses to serve at an army hospital in scutari.

• advocate - spoke up for patients health

• scholary & theorist - highly educated, contributed theories and writings that shaped modern nursing

• innovater - introduced new standards of care, emphasizing hygiene, environment and patient dignity

• considered the first nurse researcher & epidemiologist bc she used concrete evidence and stats to demonstrate the effectiveness of her changes

• established a nursing school in Britain using an apprenticeship training model which served as a blueprint for nursing programs worldwide

florence nightingale critiques

lack of diversity - NS limited to white upperclass woman

colonialism - “daughter of the british empire” supporting colonial practices

mary seacole

A Black Jamaican nurse who independently established a "British Hotel" to care for soldiers during the Crimean War after being rejected by Nightingale's team

indigenous nursing and colonialism

• indigenous people used local plants as medicine and provided essential midwifery and community health support

• colonial impact: Canadian government sought to assimilate indigenous people which led to the suppression of traditional healing knowledge and the establishment of indigenous hospitals run by colonial staff

• indigenous women were barred from entering NS until the 30’s

charlotte edith anderson montour

• FIRST INDIGENOUS nurse in Canada

• barred from NS in ontario but was accepted in NY, became an RN in 1914 and served with the American army in World War I before returning to the Six Nations Reserve as a nurse and midwife

• Advocated for better health care access and opportunities for indigenous ppl

harriet tubman, mary eliza mahoney, lillian holland harvey

• barrier breakers - challenged cultural and racial discrimination to care for their communities and advance nursing

• advocates - championed equality, human rights and dignity 4 all ppl

• role models - demonstrated grit, professionalism, perseverance

• expanded opportunities for black nurses, strengthened nursing as a profession of equality

harriet tubman

american abolitionist, the underground railroad

nurse in the civil war, used natural remedies for dysentery and smallpox infections

continued nursing post war, started home for the elderly

mary elizabeth mahoney

1st licensed black nurse

1 of 4 to graduate her program at one of the first US nursing schools

worked as a private nurse, advocated for black healthcare and rights

lillian holland harvey

became the dean at the tuskegee school of nurses

used her position as dean to create ww2 opportunities for black nurses in army corps

bernice redmond

• denied entry to canadian nursing schools so she studied in the US graduating w a nursing diploma in 1945 then she returned to canada and worked in public health nursing in nova scotia

• became the first black nurse to join the Victorian order of nurses in Nova Scotia

• her achievments increased pressure on canadian nursing schools to admit black women helping break racial barriers in nursing education

colleen campbell, marianne overton, ruth bailey, gwen barton

became among the first black woman to graduate from a nursing program in Canada 1948

the angel of mercy

stemming from the era of Florence Nightingale through World War I this emphasizes the nurse as a noble, religious, self-sacrificing, virtuous individual

the ‘mother’

following World War II, as women returned to domestic roles, the image of the nurse, as a maternal nurturing figure became more prominent

the sex symbol

late 1960’s

sexy nurse- sensual, romantic, promiscuous, low-intelligence archetype emerged in media and popular culture and persists in modern-day caricature and costumes

the careerist

current aimed image

intelligent, logical, progressive, empathetic, sophisticated, and assertive

less gender roles, more inclusive

Challenges to Address in nursing image

History Repeating – “Angel” label reinforces outdated religious origins of nursing.

Gender Stereotypes – Media portrays nursing as predominantly women’s work.

Political Pawns – Nurses framed as heroes/angels to serve political agendas.

Forgotten Heroes – Public respect can diminish; nurses sometimes villainized.

social factors that affect the image of nursing

• Gender expectations

• Cultural beliefs

• Media portrayals

• Stereotypes

• Diversity within nursing

• Changing expectations about gender roles

Historically, nursing was heavily associated with women and caregiving.

This contributed to stereotypes that nursing was “women’s work.”

economic factors affecting nursing image

COVID showed how essential nurse are in providing direct patient care, managing health crises and supporting healthcare system

Healthcare funding and working conditions influence how nursing is perceived.

Examples:

• Nursing shortages

• Staffing levels

• Wages

• Workload

• Healthcare funding

• Job opportunities

• Working conditions

Economic pressures can contribute to burnout and affect public perceptions of the profession.

• Recognizing nurses’ impact on patient outcomes can lead to greater recognition and higher status

political Factors affecting nursing images

• Legislation affects scope of practice and authority (e.g., NP prescribing)

• Advocacy promotes understanding of nurses’ roles in health promotion and safety

Government policies influence nursing through:

• Healthcare funding

• Staffing policies

• Scope of practice

• Nursing education

• Regulation

• Public healthcare policy

• Immigration policies

• Labour legislation

what is a patient advocate

a healthcare professional who speaks up for and protects patients needs rights preferences and safety

what 2 ways can influence how society views nursing

advocacy and public education

why is the “virtue script” problematic

• character over skill - emphasizes the calling of inherent kindness of the person rather than the technical, scientific expertise required

• “hero” - promotes a culture of self sacrifice- can be used to justify in advocate resources, like insufficient, PPE or poor pay under the assumption that heroes will endure any hardship

• it creates a paradox where nurses who advocate for better working conditions or safety may be viewed as bad nurses because they are not embodying the self sacrificing hero, ideal

strategies for positive, inclusive image

emphasize science - highlight nursing as a highly technical scientific career - attracts ppl interested in science

showcase diversity - ensure recruitment materials reflect diverse genders, ages and ethnicities - foster inclusivity and ensure nurses reflect the population they serve

highlight flexibility - promote various settings - attract those seeking career longevity

move beyond virtue - focus on transferable skills growth opportunities- rebrand nursing as viable high skill career rather than a calling

what is phenomenology

a philisophical and theoretical approach that studies how people experience the world and the meaning they give to their lived experiences. In nursing it helps us understand what illness, healing and care mean to each client.

what is critical social theory

A theoretical framework that examines and challenges how power, inequality, oppression and social structures influence people’s lives and health. focus: exposing hidden social relationships that influence health

how does phenomenology relate to nursing

helps nurses provide holistic, patient centered care by listening empathizing and understanding the unique meaning a client gives to their illness or care

how does cst relate to nursing

helps nurses identify and challenge barriers to health, unequal access to care, discrimination and power imbalances while advocating for health equity

how do phenomenology and cst complement each other

pheno helps nurses understand what an experience feels like for a person

cst helps nurses understand and challenge the systems that may be causing or worsening that experience

How might a nurse use phenomenology when a client is labelled 'non-compliant'?

The nurse explores the client's perspective instead of judging them. For example: 'Can you tell me what taking this medication has been like for you?' The client may find it frightening, burdensome, or disruptive.

What kinds of questions are typical of phenomenology?

Open-ended, non-judgmental questions about feelings, meaning, perspective, and personal experience, such as: 'What has this experience been like for you?'

What is a limitation of phenomenology?

If used alone, it may overlook the larger structural or systemic issues affecting a person's health.

What does CST aim to uncover about human freedom?

Constraints and barriers that limit people's choices, opportunities, and ability to control their lives.

What does CST mean by challenging power imbalances?

Questioning who has power, who benefits, who is disadvantaged, and how systems or institutions may marginalize vulnerable groups.

what is status quo

The existing way things are done or accepted in society. CST questions whether the current norms, policies, and practices are fair.

What is meant by 'taken-for-granted assumptions'?

Beliefs or practices people accept as normal or natural without questioning them, even when they may reinforce inequality.

What does CST aim to do beyond analyzing problems?

Disrupt the status quo, empower people, challenge oppression, promote justice, and create positive structural change.

nursing example of CST

A nurse notices that low-income patients cannot access diabetes education and follow-up care. The nurse organizes free workshops and works with clinics to improve access.

what is a limit of cst

If used alone, it may overlook personal, subjective experiences and the unique meaning an individual gives to their health situation.

social norms

Shared expectations about how people should behave and what is considered normal or acceptable.

Example: Gender roles or expectations about how a nurse should act.

social control

Ways society influences or regulates people's behaviour, choices, and beliefs.

Example: Pressure to behave according to accepted social expectations.

overt social control

Direct, visible rules, laws, or policies that influence behaviour.

Example: A policy restricting access to certain healthcare services.

covert social control

Hidden or indirect pressures that influence behaviour.

Example: A workplace culture discouraging nurses from speaking up about unsafe care.

Inadvertent social control

Unintended effects that reinforce stereotypes or inequality.

Example: Health education materials unintentionally portraying only one type of family.

social discourse

The ways language, media, and culture shape what society considers true, normal, right, or wrong.

Example: Calling nurses 'angels' instead of recognizing their professional expertise.

why does cst question social norms

Because norms may appear natural or acceptable but can limit freedom, reinforce stereotypes, marginalize groups, or maintain unequal power relationships. CST asks who benefits from the norm and who is harmed

What is the relationship between social discourse and CST?

Social discourse shapes how people understand reality. CST examines how dominant language, media, and cultural narratives can maintain power imbalances and works to challenge those narratives

Why can calling nurses "angels" be problematic according to CST

Although it sounds positive, it may reinforce gendered stereotypes and undervalue nursing as a skilled, professional discipline requiring knowledge, judgment, and expertise.

what is social justice

Fairness, equity, and dignity for all people, including equitable access to opportunities, rights, resources and healthcare.

how does cst relate to social justice

CST provides a lens for analyzing and challenging the root causes of injustice. Social justice is the value and goal: fairness, equity, dignity, and positive change.

What does it mean to challenge oppression in nursing?

Questioning policies, practices, or norms that disadvantage patients or groups, and advocating for changes that reduce inequity.

What is health equity?

Fair opportunity for everyone to achieve their best possible health by addressing barriers and providing support according to people's needs

What is the difference between equality and equity?

Equality means giving everyone the same thing. Equity means addressing different needs and barriers so people have a fair opportunity to achieve similar outcomes.

How can nurses promote social justice?

Advocate for equitable access to care, address social determinants of health, support policy change, provide culturally safe care, and challenge discrimination and bias.

What are social determinants of health?

The social and economic conditions in which people are born, grow, live, work, and age that influence their health, such as income, housing, education, and social support.

How does CST support culturally safe care?

It helps nurses recognize and challenge systemic racism, discrimination, and power imbalances, while respecting diverse cultures and patient perspectives.

what is an example of CST and social justice in practice?

A nurse advocates for transportation assistance or sliding-scale fees so patients who cannot afford frequent appointments can access healthcare.

what is oppression

Oppression is the control of one group by people or groups with greater power or status. It is a system of forces that reduces freedom, limits opportunities, and keeps certain groups subordinate to another group.

What does systemic oppression mean?

Systemic oppression occurs when inequality is built into society's institutions, policies, laws, traditions, or cultural norms.

Example: A healthcare policy that makes it harder for low-income patients to access necessary treatment.

What are the 3 key features of oppression?

• Power imbalance: One group has greater authority or influence.

• Systemic: Inequality is reinforced by policies, laws, traditions, or social norms.

• Subordination: The oppressed group experiences reduced autonomy, rights, or opportunities.

What does subordination mean?

Subordination means being placed in a lower or less powerful position than another group.

Example: A group of nurses is repeatedly denied leadership opportunities because of discriminatory beliefs.

What are examples of oppression in healthcare?

• Minority patients receiving lower-quality care because of stereotypes.

• Women or minority nurses being overlooked for promotions.

• Policies that make healthcare harder to access for low-income patients.

• Healthcare systems that disadvantage certain cultural or racial groups.

How can oppression affect patients?

Oppression can limit patients' access to healthcare, reduce their autonomy, worsen health outcomes, and make them feel powerless or unheard.

Example: A patient facing discrimination may avoid seeking care because they do not trust the healthcare system.

What is the nurse's role in addressing oppression?

Nurses can:

• Identify patterns of unequal treatment.

• Advocate for fair policies.

• Challenge discrimination and harmful assumptions.

• Empower marginalized patients.

• Promote social justice and equitable healthcare access.

Which ways of knowing help nurses address oppression?

Emancipatory knowing and Critical Social Theory (CST).

• Emancipatory knowing helps nurses recognize injustice and work toward change.

• CST helps nurses examine power structures, policies, and social inequalities.

marginalization

Marginalization is the process of pushing people or groups to the edges of society, away from the dominant or "main circle."

It often involves limited access to resources, opportunities, decision-making, and representation.

What does disempowerment mean?

having less power, control, or influence over decisions that affect your own life.

Example: A patient is excluded from care planning because healthcare providers assume they cannot make decisions for themselves.

How do stereotypes contribute to marginalization?

Stereotypes create false assumptions about people. These assumptions can lead to exclusion, unfair treatment, and fewer opportunities.

Example: Assuming a homeless patient is irresponsible may cause healthcare workers to dismiss their concerns.

What is the nursing response to both oppression and marginalization?

Nurses should identify inequities, provide culturally safe care, advocate for access and representation, challenge discrimination, and promote social justice.

Why are nurses uniquely positioned to promote social justice?

Nurses interact closely with patients and communities. They can recognize barriers to care, understand patients' needs, identify unequal treatment, and advocate for changes in healthcare systems.

What are 4 ways nurses promote social justice?

• Advocate for policies addressing social determinants of health.

• Provide culturally competent and culturally safe care.

• Engage in community outreach for underserved groups.

• Educate patients and communities about rights and available resources.

What does culturally safe care mean?

Care that respects patients' cultural identities, recognizes power imbalances, and works to prevent discrimination and harm. The patient should feel respected and safe.

Example: A nurse asks about a patient's cultural preferences instead of making assumptions.

A nurse notices that patients in a low-income neighbourhood have limited access to diabetes education. What action promotes social justice?

The nurse organizes free community workshops and collaborates with local clinics to improve follow-up care.

Why? This addresses a systemic barrier and promotes equitable access to healthcare.

A patient cannot afford transportation to appointments. What could a nurse do?

Advocate for transportation assistance, connect the patient with community resources, and help identify accessible follow-up options.

How can Malala's story be understood using all 3 frameworks?

• Phenomenology: Understands her personal experiences of fear, oppression, and resilience.

• CST: Examines the systems and power structures restricting girls' education.

• Social justice: Advocates for educational rights, fairness, and equal opportunities.

What were Carper's original four ways of knowing?

Empirical, ethical, personal, and aesthetic knowing.

What is the fifth way of knowing?

Emancipatory knowing, which focuses on social, political, and economic contexts, social justice, advocacy, and systemic inequities.

Why are there five ways of knowing instead of only one?

Nursing is complex. Scientific evidence alone cannot address every patient situation. Nurses also need ethical reasoning, self-awareness, genuine relationships, holistic understanding, and social justice awareness.

What is the overall purpose of the five ways of knowing?

To help nurses understand patients, make safe and effective decisions, reflect on practice, and provide ethical, person-centred, and socially responsible care.

How do all five ways of knowing work together?

Empirical provides scientific evidence; ethical guides right and wrong; personal builds relationships; aesthetic supports holistic understanding and creative responses; emancipatory identifies and challenges injustice.

What is empirical knowing?

A way of knowing based on observation and evidence. It assumes knowledge can be accessed through the five senses and verified by others. It forms the scientific foundation of nursing practice. It provides scientific knowledge and research evidence that help nurses choose safe and effective interventions.

example: administering meds according to dose, using lab results to monitor health; following evidence based protocols

What are the three key features of empirical knowing?

1. Observable, measurable, and testable knowledge.

2. Focus on facts, data, and research evidence.

3. Supports safe, reliable, evidence-based practice.