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Younas A, Monari EN, Ali P. Applying intersectionality to address inequalities in nursing education. Nurse Educ Pract 2024; 77:103982. [PMID: 38669734 DOI: 10.1016/j.nepr.2024.103982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/29/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
AIM The aim of this paper is to discuss the significance of the intersectionality framework for addressing prejudices, racism and inequalities in nursing education and clinical learning environments. BACKGROUND Discrimination and racism against nursing students and educators based on their gender, ethnicity, race and social identities is well-documented in the nursing literature. Despite documented discrimination and incivility based on intersectional factors, it is reported that often nurse educators show limited interest in the culture, diverse experiences and values of nursing students with culturally and linguistically diverse backgrounds. DESIGN Discussion paper METHODS: The discussion was based on contemporary literature about intersectionality, discrimination and racism in nursing. We completed a cursory search of literature in nursing education journal and selected nursing and health science databases. This was not a formal literature review. Using a fictional example, the application of intersectionality to address inequalities in educational settings is illustrated. RESULTS Intersectionality is an invaluable tool for examining interwoven power relations and power struggles arising from racial, gender, ethnic, religious and sexuality and disability-related differences. Nurse educators, students and leaders should be more cognizant of their preconceived views, sociocultural stereotypes and varied forms of sociocultural oppression affecting their interactions with each other in clinical learning environments. CONCLUSIONS Incorporating intersectionality can address prejudices, racism and inequalities arising due to sociocultural, ethnic, power-related and intergenerational issues among educators, students and other personnel involved in creating clinical learning environments.
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Affiliation(s)
- Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, Canada.
| | - Esther N Monari
- Faculty of Nursing, Memorial University of Newfoundland, Canada
| | - Parveen Ali
- University of Sheffield & Doncaster and Bassetlaw Teaching Hospitals, UK
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Prendergast N, Boakye P, Bailey A, Igwenagu H, Burnett-Ffrench T. Anti-Black racism: Gaining insight into the experiences of Black nurses in Canada. Nurs Inq 2024; 31:e12604. [PMID: 37805821 DOI: 10.1111/nin.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/09/2023]
Abstract
The call to address anti-Black racism in workplaces resonates across several organizations and institutions in Canada. But specifically, the coronavirus disease 2019 pandemic shed further light on how health inequities negatively impact the Black community. After conducting a literature review of the experiences of Black nurses in Canada, a deeper understanding of their plight was gained. In healthcare, the findings from the Black Nurses' Task Force report conclude that anti-Black racist practices are pervasive in nursing, and there remains a paucity of research in this area. This study builds off the report by exploring how Black nurses experience anti-Black racism while working in Canada's healthcare system. Inspired by critical race theory and Black feminist thought, an exploratory qualitative research study was conducted, using semistructured interviews to gather data. The study concludes that Black nurses experience anti-Black racism within the workplace, and it manifests itself through some of the attitudes of colleagues, patients, and nurses in leadership roles. Despite policies and statements that were in place to protect them, anti-Black racism continues to occur systematically. The findings point to the need for change in the overall workplace culture, which includes a fair representation of Black nurses in leadership roles, further research to identify best practices for tackling anti-Black racism within Canada's healthcare system, and mandatory training on anti-Black racism for healthcare leaders, educators, and service providers.
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Affiliation(s)
- Nadia Prendergast
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Priscilla Boakye
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Annette Bailey
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Honour Igwenagu
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tahja Burnett-Ffrench
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
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Luhanga F, Maposa S, Puplampu V, Abudu E. "Let's Call a Spade a Spade. My Barrier is Being a Black Student": Challenges for Black Undergraduate Nursing Students in a Western Canadian Province. Can J Nurs Res 2023; 55:457-471. [PMID: 37661642 PMCID: PMC10619184 DOI: 10.1177/08445621231198632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND We need more understanding of experiences that hinder or promote equity, diversity, and inclusion of Black students in undergraduate nursing programs to better inform their retention and success. PURPOSE To explore documented experiences of Black undergraduate nursing students, review barriers affecting their retention and success, and suggest evidence-based strategies to mitigate barriers that influence their well-being. METHODS We used a focused qualitative ethnography for recruiting Black former and current students (N = 18) in a Western Canadian province's undergraduate nursing programs via purposive and snowball sampling. Most participants were female, 34 years or younger, with over 50% currently in a nursing program. Five participants later attended a focus group to further validate the findings from the individual interviews. Descriptive statistics were used to describe participant characteristics; we applied a collaborative constant comparison and thematic analysis approach to their narratives. RESULTS Challenges influencing Black students' retention and success fell into four main interrelated subthemes: disengaging and hostile learning environments, systemic institutional and program barriers, navigation of personal struggles in disempowering learning environments, and recommendations to improve the delivery of nursing programs. Participants also recommended ways to improve diversity and mitigate these barriers, such as nursing programs offering anti-oppression courses, platforms for safe/healthy dialogue, and more culturally sensitive learning-centered programs and responsive supports. CONCLUSIONS The study findings underscore the need for research to better define nursing program conditions that nurture safe, learning-centred environments for Black students. A rethink of non-discriminatory, healthy learning-teaching engagements of Black students and the mitigation of anti-Black racism can best position institutions to promote equity, diversity, and inclusion of Black students.
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Affiliation(s)
- Florence Luhanga
- Faculty of Nursing, University of Regina, Regina, Saskatchewan, Canada
| | - Sithokozile Maposa
- College of Nursing, University of Saskatchewan, Prince Albert, Saskatchewan, Canada
| | - Vivian Puplampu
- Faculty of Nursing, University of Regina, Regina, Saskatchewan, Canada
| | - Eunice Abudu
- Faculty of Nursing, University of Regina, Regina, Saskatchewan, Canada
- Saskatchewan Polytechnic & University of Regina, Regina, Saskatchewan, Canada
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Cubelo F. Linguistic racism towards internationally educated nurses in Finland: Critical reflective analysis. Public Health Nurs 2023; 40:813-816. [PMID: 37495551 DOI: 10.1111/phn.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND The shortage of nurses in Finland has prompted the recruitment of Internationally Educated Nurses (IENs) from developing countries mostly with fragile health systems. However, linguistic racism has emerged as a growing threat to the safety and well-being of IENs in the country. AIM To discuss the consequences of linguistic racism directed towards IENs and to propose solutions to address this issue. METHOD This discussion employed self-reflection as a means of engaging in critically reflective analysis. DISCUSSION The discussion highlighted the factors contributing to linguistic racism, including poor language proficiency, misrepresentation of the nursing profession due to skin color, and political tensions. The phenomenon of linguistic racism affects IENs' communication with patients and colleagues and has a detrimental impact on the mental health and overall health of IENs. CONCLUSION To address the issue of linguistic racism, this discussion proposed a comprehensive strategy that includes anti-racism training for healthcare personnel, the establishment of a conducive workplace culture that fosters diversity and inclusivity, and the provision of adequate assistance and support for IENs.
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Affiliation(s)
- Floro Cubelo
- School of Health and Social Care, Oulu University of Applied Sciences, Oulu, Finland
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- International and Management Affairs, The Filipino Nurses Association in the Nordic Region, Finland
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COVID-19 pandemic in long-term care: An international perspective for policy considerations. Int J Nurs Sci 2023; 10:158-166. [PMID: 37095850 PMCID: PMC10063321 DOI: 10.1016/j.ijnss.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
This paper identifies key factors rooted in the systemic failings of the long-term care sector amongst four high income countries during the COVID-19 pandemic. The goal is to offer practice and policy solutions to prevent future tragedies. Based on data from Australia, Canada, Spain and the United States, the findings support evidence-based recommendations at macro, meso and micro levels of practice and policy intervention. Key macro recommendations include improving funding, transparency, accountability and health system integration; and promoting not-for-profit and government-run long-term care facilities. The meso recommendation involves moving from warehouses to “green houses.” The micro recommendations emphasize mandating recommended staffing levels and skill mix; providing infection prevention and control training; establishing well-being and mental health supports for residents and staff; building evidence-based practice cultures; ensuring ongoing education for staff and nursing students; and fully integrating care partners, such as families or friends, into the healthcare team. Enacting these recommendations will improve residents' safety and quality of life; families’ peace of mind; and staff retention and work satisfaction.
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Naegle MA, Kelly LA, Embree JL, Valentine N, Sharp D, Grinspun D, Hines-Martin VP, Crawford CL, Rosa WE. American Academy of Nursing consensus recommendations to advance system level change for nurse well-being. Nurs Outlook 2023; 71:101917. [PMID: 36736029 PMCID: PMC9889942 DOI: 10.1016/j.outlook.2023.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/08/2022] [Accepted: 12/31/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has required close examination of workforce-related stressors that over decades have contributed to widespread burnout, negative health outcomes, including mental health outcomes, and the loss of the well-educated professionals who are the future of the nursing profession. In the United States and globally, evidence points to factors known to diminish well-being, including inequities, issues of minority status, persistent discrimination, and demanding work environments. The American Academy of Nursing (AAN), dedicated to organizational excellence, nursing leadership and evidence-based policy, develops statements reflecting its mission and those of its nursing affiliates and corporate member, The American Nurses Association. Within nursing, despite the efforts of its members toward advancement, professional fulfillment is often constrained by the systems in which nurses practice and workplace factors over which they have little control. Action by key organizations to initiate changes at systems levels in workplace safety, to increase professional mobility, and propel policies that increase access to health care resources could improve nurse well-being. This paper proposes recommendations from the AAN Expert Panels on Building Health Care System Excellence, Psychiatric Mental Health and Substance Use, and Global Health Expert Panels for the American Academy of Nursing to leverage related policy in the arenas of government and professional/healthcare organizations. Transforming health care work environments and advancing nurse well-being and equity can be accomplished through key, innovative policy changes. These will be achieved through collaboration among associations, organizations, nonprofit groups, and with the public and the media.
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Affiliation(s)
- Madeline A Naegle
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY.
| | - Lesly A Kelly
- Building Health Care Systems Excellence Expert Panel
| | | | | | - Daryl Sharp
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY
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Odzakovic E, Huus K, Ahlberg BM, Bradby H, Hamed S, Thaper-Björkert S, Björk M. Discussing racism in healthcare: A qualitative study of reflections by graduate nursing students. Nurs Open 2023; 10:3677-3686. [PMID: 36692244 PMCID: PMC10170953 DOI: 10.1002/nop2.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/02/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
AIM The aim is to illustrate and analyse reflections from graduate nursing students over their experience of discussing racism in healthcare in an educational intervention. DESIGN A qualitative, descriptive design was adopted. METHODS Data were collected through written reflections and analysed through content analysis. In total, 81 students participated in the intervention; 39 paediatric and 42 public health care nursing students. Of those, 27 participants gave consent to have their written reflections included in the study. RESULTS Three main categories were developed in the content analysis of student reflections: (a) the implicit embeddedness of racism in healthcare organization; (b) the effect of racism on interactions with patients; and (c) a growing awareness of one's own understanding of racism. This study indicates that student nurses discussed racism as relevant to understanding good clinical practice for the benefit of patients and work-based wellbeing of staff. This recognition of the organizational nature of racism warrants nursing leaders and managers to include racism as a social determinant of health in the undergraduate and graduate curricula to educate the next generation of nursing about racism.
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Affiliation(s)
- Elzana Odzakovic
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Karina Huus
- CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Beth Maina Ahlberg
- Department of Sociology, Uppsala University, Uppsala, Sweden.,Skaraborg Institute for Research and Development, Skövde, Sweden
| | - Hannah Bradby
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | - Sarah Hamed
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | | | - Maria Björk
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Luhanga F, Maposa S, Puplampu V, Abudu E, Chigbogu I. "You have to strive very hard to prove yourself": experiences of Black nursing students in a Western Canadian province. Int J Nurs Educ Scholarsh 2023; 20:ijnes-2022-0094. [PMID: 37294866 DOI: 10.1515/ijnes-2022-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/20/2023] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This study explored the experiences of Black students in two western Canadian undergraduate nursing programs. METHODS Using a qualitative focused ethnography design grounded in critical race theory and intersectionality, participants were recruited using purposive and snowball sampling. Data were collected through individual interviews, and a follow-up focus group. Data were analyzed using collaborative-thematic analysis team approaches. RESULTS n=18 current and former students participated. Five themes emerged: systemic racism in nursing, precarious immigrant context, mental health/well-being concerns, coping mechanisms, and suggestions for improvement. CONCLUSIONS An improved understanding of Black student experiences can inform their recruitment and retention. Supporting Black students' success can potentially improve equity, diversity, and inclusivity in nursing education programs and/or their representation in the Canadian nursing workforce. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE The presence of a diverse nursing profession is imperative to meet the needs to provide more quality and culturally competent services to diverse population.
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Affiliation(s)
- Florence Luhanga
- School of Nursing, Saskatchewan Polytechnic, Regina campus, Regina, SK
| | - Sithokozile Maposa
- College of Nursing, University of Saskatchewan, Prince Albert Campus, Prince Albert, SK, Canada
| | - Vivian Puplampu
- School of Nursing, Saskatchewan Polytechnic, Regina campus, Regina, SK
| | - Eunice Abudu
- School of Nursing, Saskatchewan Polytechnic, Regina campus, Regina, SK
- University of Regina, Regina, SK
| | - Irene Chigbogu
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
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Grinspun D, Perry L, Abu-Qamar MZ, Stannard D, Porritt K. Nursing crisis: Challenges and opportunities for our profession after COVID-19. Int J Nurs Pract 2022; 28:e13075. [PMID: 35713391 PMCID: PMC9349996 DOI: 10.1111/ijn.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tomblin Murphy G, Sampalli T, Bourque Bearskin L, Cashen N, Cummings G, Elliott Rose A, Etowa J, Grinspun D, Jones EW, Lavoie-Tremblay M, MacMillan K, MacQuarrie C, Martin-Misener R, Oulton J, Ricciardelli R, Silas L, Thorne S, Villeneuve M. Investing in Canada’s nursing workforce post-pandemic: A call to action. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the review to arrive at recommendations and actions that are presented in this policy brief. The findings and recommendations from this policy brief are meant to inform a national and sustained focus on retention and recruitment efforts in Canada.
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Affiliation(s)
- Gail Tomblin Murphy
- VP Research, Innovation and Discovery and Chief Nurse Executive, Nova Scotia Health, Halifax, NS B3H 1V7, Canada
| | - Tara Sampalli
- Senior Scientific Director, Research, Innovation and Discovery, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Lisa Bourque Bearskin
- Associate Professor, and Researcher, Thompson Rivers University, School of Nursing, Kamloops, BC V2C 0C8, Canada
| | - Nancy Cashen
- Interim Director, Nursing and Professional Practice, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Greta Cummings
- College of Health Sciences, and Professor, Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Annette Elliott Rose
- VP Clinical Care and Chief Nurse Executive, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Josephine Etowa
- Professor at the University of Ottawa’s Faculty of Health Sciences, School of Nursing, Ottawa, ON K1H 8M5, Canada
| | - Doris Grinspun
- Chief Executive Officer of the Registered Nurses’ Association of Ontario, Toronto, ON M2P 2A9, Canada
| | - Esyllt W. Jones
- Professor of History, University of Manitoba, Winnipeg, MB R3T 2M5, Canada
| | - Mélanie Lavoie-Tremblay
- Associate Professor and Vice-Dean research, innovation and entrepreneuriat, Faculty of Nursing, University of Montréal, Montréal, QC H3T 1A8, Canada
| | - Kathleen MacMillan
- Adjunct (retired) Dalhousie University, School of Nursing; Adjunct, University of Prince Edward Island, Faculty of Nursing, Charlottetown, PE C1A 4P3, Canada
| | - Cindy MacQuarrie
- Senior Director, Interprofessional Practice and Learning, IWK Health, Halifax, NS B3H 2Y9, Canada
| | - Ruth Martin-Misener
- Professor and the Director of the School of Nursing and Assistant Dean, Research, at the Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Judith Oulton
- Former Executive Director, Canadian Nurses Association, Ottawa, ON K1Z 7M4, Canada
| | - Rosemary Ricciardelli
- Professor, Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Linda Silas
- President of Canadian Federation of Nurses Unions, Ottawa, ON K1V 8X7, Canada
| | - Sally Thorne
- Professor, School of Nursing and Associate Dean, Faculty of Applied Science, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Michael Villeneuve
- Chief Executive Officer, Canadian Nurses Association, Ottawa, ON K1Z 7M4, Canada
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