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Nurses see. We must not be silenced.

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A nursing student's hand reaches out to touch the imprint of hands in a sculpture at a community drop-in centre. Image credit: Cathy Crowe

Nursing Week has come and gone. The theme this year was "We Answer The Call." The theme of course references nurses stepping up in the pandemic. For me the phrase sounds like a military recruitment message, which is fine because this has been a war. However, I suspect the organizers saw it more as a message about nurses' selfless commitment to caring for others. 

I've rarely been impressed with Nursing Week themes. In 2015 the theme was "Nurses: With you every step of the way." Not so much. Nursing has often ignored the needs of the racialized, Indigenous communities, and people who are homeless.

I wrote my thoughts about the status of nursing in my rabble blog that year.

"Sadly, in many ways nursing has contributed to its own demise. The gendered nature of nursing including its historical link to maternal feminism, the military and the church have meant that nursing has often been forced to look externally for its value and for advancement of its role in the health-care system. The increasing professionalization of nurses, which includes the emphasis on higher education (university degree as entry to practice), the creation and obsession with nursing diagnoses and nursing theories, even the nurse practitioner movement, have all occurred at the expense of the development of critical analysis that would integrate economics, political ideology in nursing work."

As with other social issues (long-term care, housing and homelessness, schools, working conditions) the pandemic only exposed pre-existing inequities.

So, too, with nursing.

We Answer The Call included nurses working long hours, understaffed, without adequate personal protective equipment, and in many cases unvaccinated until recent months. 

We Answer The Call did not include paid sick days for part-time or contract nurses.

We Answer The Call did not include nurses sitting on governments' COVID tables. We certainly were not seen by mainstream media as a legitimate and competent source of calm and clear information on public health measures, including infection prevention, vaccination, seniors' support, children's mental health and more. 

On top of that Ontario nurses face ongoing labour disputes and economic restraints. 

From the Ontario Nurses Association (ONA) website:

"In 2019, the Ford government introduced and passed Bill 124, wage-suppression legislation negatively impacting registered nurses, nurse practitioners, and health-care professionals. This bill limits wage increases to a maximum of one per cent total compensation for three years.

ONA also believes the bill interferes with charter rights to freely bargain. ONA has launched a charter challenge against this bill."

I'm sure there are similar regressive policies towards nurses and other health workers being implemented across the country. 

My mother, a fierce advocate and emergency room nurse, used to say, "nurses eat their young," and she warned me about the hierarchical nature of the health-care system. Despite her sharp criticisms of nursing, I went into nursing. It was imprinted on me by my mom at an early age that to be a nurse was to see but not remain silent. (Note: the Mack School of Nursing slogan used to be "I See and am Silent.")

In my nursing practice, I came to understand the reality of nursing work life: few accommodations for changing family circumstances, extraordinary physician control over nurses' job descriptions, de-skilling of nurses' work, minimal workplace support for professional development and ongoing education, and silencing of advocacy efforts.

Nursing education, which should be providing young nurses with the skills to survive, critique, strategize, and advocate is sadly missing in action, with the exception of usually one activist professor per university. Medical education, on the other hand, has seen a revolution in health justice teachings and practice.

By necessity my nursing practice over the years evolved into what I call "political nursing." It was young nursing students' curiosity and thirst for learning about social justice that inspired me to write my nursing memoir A Knapsack Full of Dreams: Memoirs of a Street Nurse. I wrote it during a four-year period of unemployment where I believe I was blacklisted for my strong opinions and advocacy.

The book covers everything I allude to here and more. It covers my journey joining with other nurses to fight the return of the death penalty in Canada, fighting for peace and against militarization during the Cold War, fighting apartheid, and of course, the homeless disaster. All the while, a group of us were trying to build socially progressive nursing organizations like Nurses for Social Responsibility and the Street Nurses Network that would address nursing's role in social justice.

To my surprise and disappointment, publishers refused to accept my book. While they appreciated my care for the "underclass of society" (yes, that was said) it wasn't something they felt people would want to read. So, I self-published. The reviews speak for themselves and are on my website. 

However, organized nursing ignored my book, with two exceptions -- the United Nurses of Alberta and the Canadian Federation of Nurses Unions. Every other provincial and national nursing organization ignored Knapsack Full of Dreams despite my outreach to them. No announcement in their newsletters or publications, no reviews, no bulk purchases, no speaking requests. I mean my actual nursing outreach knapsack is now in the Museum of History in Gatineau. 

The silencing was deafening. Same for university schools of nursing.

I do see signs of hope. Student nurses and young nurses show signs of social justice engagement, and it should be a call to action for professional nursing bodies to step up to their needs, to keep them in the profession, to give them the skills they need to be part of the change in health care for all our future.

Two young nurses are trying to shake up the profession through the critical lens of journalism. Amie Varley and Sara Fung are the Gritty Nurse Podcast and their name says it all. Follow them! You can listen to their podcast with me to learn more.

Maybe next year Nursing Week's theme will be Stand Up Fight Back.

Cathy Crowe is a street nurse, author and filmmaker who works nationally and locally on health and social justice issues.

Image credit: Cathy Crowe

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