The reinstatement of social activism as a central feature of nursing practice has been advocated by nursing scholars and is consistent with contemporary conceptualizations of primary health care and health promotion that are rooted in critical social theory's concept of empowerment. Advocacy oral history from a feminist postmodern perspective offers a method of research that has the potential and purpose to empower participants to transform their political and social realities and may, therefore, be considered social activism. A recent study of public health nurses who had experienced significant distress through the reduction and redirection of their practice is provided as an exemplar of advocacy oral history. Philosophies underpinning the research method and characteristics of feminist postmodern research are reviewed and implications for the use of this methodology for social activism in nursing are drawn.
Following health reform, nurses have experienced the tremendous stress of heavy workloads, long hours and difficult professional responsibilities. In recognition of these problems, a study was conducted that examined the impact of the working environment on the health of nurses. After conducting focus groups across Canada with nurses and others well acquainted with nursing issues, it became clear that the difficult work environments described had significant ethical implications.
The aim of this paper is to report the findings of research that examined the moral habitability of the nursing working environment.
A secondary analysis was conducted using the theoretical work of Margaret Urban Walker. Moral practices and responsibilities from Walker's perspective cannot be extricated from other social roles, practices and divisions of labour. Moral-social orders, such as work environments in this research, must be made transparent to examine their moral habitability. Morally habitable environments are those in which differently situated people experience their responsibilities as intelligible and coherent. They also foster recognition, cooperation and shared benefits.
Four overarching categories were developed through the analysis of the data: (1) oppressive work environments; (2) incoherent moral understandings; (3) moral suffering and (4) moral influence and resistance. The findings clearly indicate that participants perceived the work environment to be morally uninhabitable. The social and spatial positioning of nurses left them vulnerable to being overburdened by and unsure of their responsibilities. Nevertheless, nurses found meaningful ways to resist and to influence the moral environment.
We recommend that nurses develop strong moral identities, make visible the inseparability of their proximity to patients and moral accountability, and further identify what forms of collective action are most effective in improving the moral habitability of their work environments.
Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå SE-901 87, Sweden; The Graduate School of Gender Studies, Umeå University, Umeå, Sweden. Electronic address: firstname.lastname@example.org.
To elicit pregnant women's perceptions of childbirth as expressed in their birth plans, and through a feminist lens analyse their wishes, fears, values, and beliefs about childbirth, as well as their expectations on partner and midwife.
This study used qualitative content analysis, identifying subcategories, categories, and an overall theme in data gathered from women's written birth plans. A feminist theoretical framework underpinned the research.
A middle-sized city in northern Sweden.
132 women who gave birth in an obstetrician-led hospital labour ward between March and June 2016 and consented to grant access to their birth plans and antenatal and intrapartum electronic medical records.
Three categories emerged: 'Keeping integrity intact through specific requests and continuous dialogue with the midwife', 'A preference towards a midwife-supported birth regardless of method of pain relief", and '"Help my partner help me" - Women anticipating partner involvement.' The overall theme linking the categories together was: 'Autonomous and dependent - The dichotomy of birth', portraying women's ambiguity before birth -expressing a wish to remain in control while simultaneously letting go of control by entrusting partner and midwifewith decision-making regarding their own bodies.
Women primarily desired a natural, midwife-supported birth and favoured a relationship-based, woman-centred model of care, based on the close interaction between woman, partner, and midwife. Midwives need to be aware of women's ambiguous reliance on them and the power they have to influence women's birth choices and birth experiences. Feminist theory and values in midwifery practice may be useful to inspire a maternity care based on women's wishes and expectations, acknowledging and valuing women's voices, and embracing the sanctity of birth and of the birthing woman's body.
Within medical schools and within research concerning the ethical questions of health care, basic care and its allied participants have not been stressed enough. The aim of this paper is to emphasise the practice of basic care and some moral problems in connection to this practice. Basic care is the care-provider's providing assistance for patients with bodily dysfunction. The relationships between patient and care-provider in basic care have many substantial similarities with other close social relationships. Thus, the interactive relationships in basic care are an important matter of public concern. Seen from an ethical perspective, its significance due to the welfare-aspects of society is obvious. Patients and professionals in basic care have together a unique knowledge about the meaning of being. Ethics is much more than following theories, rules, and principles and this article presents an alternative to the dominant approaches of health care ethics.
This article critically examines a feminist, collaborative research method that was intended to be political in standpoint, gendered in focus, reflexive in process, and transformative in outcome. By incorporating collaborative elements into a qualitative, three-step research design, the author hoped to challenge both what was known about nurses' job displacement and how that knowledge was produced. This article explores the contradictions between the author's best laid plans and the actual process of discovery. Recommendations for future research include considerations about the social and political context in which the research takes place, cautions about gender inclusivity in the research population and analytic frameworks, strategies for encouraging participants' critical thinking, and a caveat with regard to transformative outcomes.
For the experience of end-of-life care to be 'good' many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse-next of kin relationship. Little is known about difficulties in this relationship, when the next of kin are seen as separate from the patient.
From the perspective of nurses: What are the ethical challenges in relation to next of kin in end-of-life care?
A critical qualitative approach was used, based on four focus group interviews.
A total of 22 registered nurses enrolled on an Oncology nursing specialisation programme with experience from end-of-life care from various practice areas participated.
The study was approved by the Norwegian Social Science Data Service, Bergen, Norway, project number 41109, and signed informed consent obtained from the participants before the focus groups began.
Two descriptive themes emerged from the inductive analysis: 'A feeling of mistrust, control and rejection' and 'Being between hope and denial of next of kin and the desire of the patient to die when the time is up'. Deductive reinterpretation of data (in the light of moral distress from a Feminist ethics perspective) has made visible the constraints that certain relations with next of kin in end-of-life care lay upon the nurses' moral identity, the relationship and their responsibility. We discuss how these constraints have political and societal dimensions, as well as personal and relational ones.
There is complex moral distress related to the nurse-next of kin relationship which calls for ethical reflections regarding these relationships within end-of-life care.
Research on the process of leaving an abusive male partner has focused on surviving abuse and the crisis of leaving. Little is known about the experience of women who have left abusive male partners and not gone back. In this feminist grounded theory study of women leaving abusive partners, the researchers discovered the basic social-psychological process of reclaiming self in which women voyaged through 4 stages: counteracting abuse, breaking free, not going back, and moving on. The focus of this paper is the last stage, moving on, during which women move beyond framing their lives as survivors of an abusive relationship through the processes of figuring it out, putting it in its rightful place, launching new relationships, and taking on a new image. The findings extend our knowledge of the leaving process by delineating the ways in which the abuse experience and the survival process are displaced as the centre of the woman's intra-psychic, interpersonal, and social existence. Questions are raised about how nurses and other health professionals can avoid revictimizing women who have moved on.
Comment In: Evid Based Nurs. 2002 Apr;5(2):6011995663