'This Is Not a Patient, This Is Property of the State': Nursing, ethics, and the immigrant detention apparatus

Disrupting the epistemic arrangements of nursing education canon: Reflections about a prelicensure Community Engagement series

Nursing education, as with professionalization projects, is fraught with epistemicide, false separations, and a focus on expertise over relations and accountability. This is a critical reflection of the first 5 years of a four-semester prelicensure Community Engagement course series. As the course lead, I have consistently initiated adjustments, based on experiences teaching multiple sections and synthesizing comments and feedback from students and faculty, with an eye toward longstanding and pressing concerns in the world around us. Two broad epistemic arrangements emerge from this critical excavation: (1) naturalized hierarchy, false separations, and appraisals of relevance and (2) relationality and reflection as unsettling. There is a need for sustained collective examination and shift in how the nursing education and healthcare industries curate the meanings and practice of "community," "health," and "nursing," peering out from the regulatory oversight of neoliberal forces. How might we situate student progression, program implementation, institutional contracts, and curricular standards within the contexts of nursing programs' responsibilities to local communities in light of unfolding events locally and globally and their historical antecedents? How are we all, as faculty, disrupting siloes, false separations, and the contradictions of professionalism and the biomedical model to intentionally advance health equity? May we continue to illuminate the presence of community as being everywhere, not merely in juxtaposition to acute care. May we unsettle the prevailing theorization and practices of community throughout nursing education and commit to imagining and practicing relational praxis.

Poststructuralism and the construction of subjectivities in forensic mental health: Opportunities for resistance

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system.

Nursing in deathworlds: Necropolitics of the life, dying and death of an unhoused person in the United States healthcare industrial complex

This paper begins with the lived accounts of emergency and critical care medical interventions in which an unhoused person is brought to the emergency department in cardiac arrest. The case is a dramatised representation of the extent to which biopolitical forces via reduction to bare life through biopolitical and necropolitical operations are prominent influences in nursing and medical care. This paper draws on the scholarship of Michel Foucault, Giorgio Agamben, and Achille Mbembe to offer a theoretical analysis of the power dynamics that influence the health care and death care of patients who are caught in the auspices of a neoliberal capitalist healthcare apparatus. This paper offers analysis of the overt displays of biopower over those individuals cast aside as generally unworthy of access to healthcare in a postcolonial capitalist system, in addition to the ways in which humans are reduced to 'bare life' in their dying days. We analyse this case study through Agamben's description of thanatopolitics, a 'regime of death', and the technologies that accompany the dying process, particularly in that of the homo sacer. Additionally, this paper illustrates the ways in which necropolitics and biopower are integral to understanding how the most advanced and expensive medical interventions make visible the political values of the healthcare system and how nurses and healthcare functions in these deathworlds. The purpose of this paper is to develop a greater understanding of biopolitical and necropolitical operations in acute and critical care environments, and to offer guidance to nurses in these spaces as they work to uphold ethical duties in a system that increasingly dehumanises.

"So There. I Won.": The Struggle for Power Between Caring and Carceral Institutions

OBJECTIVE

The objectives of this study were to give voice to the lived experiences of nurses and law enforcement officers (LEOs) who interact with one another in acute hospital settings and to interpret and understand their unique perspectives and experiences.

METHODS

This qualitative study employed interpretative phenomenological analysis in the interviews of registered nurses and LEOs. The analysis and discussion was underpinned by biopolitical theories of power and control, including Georgio Agamben, Michel Foucault, and Erving Goffman.

RESULTS

There is a paucity of literature on nurse and law enforcement interactions in the hospital setting. Nurses and law enforcement exerted power and authority through several means. Overwhelmingly, participants described a contentious dynamic between nurses and LEOs in the hospital, wrought with argument, stress, and a feeling of coming from "different worlds."

CONCLUSION

The results provide alarming examples of deformed caring practices and assert the necessity for continued unearthing and discussion of how nurses can, and should, navigate law enforcement interaction. The tangible interference of care is of particular importance and consideration for nurses. Inequity in care and unfavorable outcomes for already marginalized and vulnerable populations are of grave concern. Additional research is needed on the specific ways this struggle for power between institutions and their political actors impairs caring practices and the emotional and psychological sequelae of these interactions.

Nurses as Disciplinary Agents of the State: Ethical Practice and Mandatory Reporting in the United States

This article reviews legislative initiatives that mandate nurses to report patients, families, and clinicians to law enforcement. Most recently, these laws target transgender and gender diverse (TGD) youth and people seeking abortion. In this article, we examine the ethics of such laws through professional ethical codes. Furthermore, through a biopolitical lens, we critically analyze examples of nurses' participation in complying with laws that harm patients. Finally, we discuss the damage these laws have on the nursing profession and assert the necessity of a resituating of professional ethics that considers the complexity of nursing care amidst increasingly blatant state-sanctioned violence.

Gender Influences in the Intersection of Acute Care Registered Nurses and Law Enforcement: The Collision of Caring and Carceral Institutions

To give voice to the lived experiences of nurses and law enforcement officers who interact with one another in an acute care hospital setting, while gaining an understanding of individual perspectives and unique experiences, as well as how they interpret these experiences. This qualitative study used interpretative phenomenological analysis (IPA) to strive to meet the study objectives. There is a paucity of literature on the topic of nurse and law enforcement interaction in the hospital setting. Overwhelmingly, participants described a contentious dynamic between nurses and law enforcement officers in the hospital, wrought with argument, stress, and a feeling of coming from "different worlds." The influence of gender was apparent to the female-identified participants, and gender constructs and therefore gender role conflict were critical points of contention. In exploring how nurses and law enforcement officers think about and describe their experiences, nurses and hospital systems may develop a deeper understanding and appreciation of barriers to care for incarcerated patients and of the challenging experiences nurses face in caring for these patients. The nurses' expressed feelings of intimidation, stress, and impaired self-efficacy in this dynamic underscore the need for institutional support and prioritization of caring practices, and identification of the ways in which carceral practices impair care, as well as nurses' safety.