For what do we stand?

With Brexit in the UK, a Trump presidency in the USA, and an upsurge of protectionism worldwide in response to the massive migration of people no longer safe in their homelands, it seems timely to reflect on what values nursing represents beyond our individual political parties and persuasions. The January 2017 Women's March on Washington and in hundreds of communities worldwide exemplified a new wave of social organizing (Stuart, 2017). It brought together an impressively diverse array of established social policy groups as well as vast hordes of everyday citizens not normally affiliated with special causes, all rising up to express a shared hunger for a more compassionate and caring society than that which seems to be gaining ground among those who promulgate a politic of fear and division (Slater, 2017). It was a moment in history that will undoubtedly serve as the focus of study long into the future, not only for its remarkably effective grass roots and social media organizing capacity, but also for its audacious branding of a universally recognizable message through the unlikely symbol of hand-knit pink pussy hats (Chenoweth & Pressman, 2017). Participation in those marches brought a whole new generation into the act of standing up and being counted. And the optimism engendered by having been part of it will have left a lasting impression on many who might otherwise have fallen into despair. In the context of these unusual times, nurse leaders Peggy Chinn, Leslie Nicoll, and well over a thousand others (as of the time of writing) have articulated a strong statement on behalf of the profession, calling on their colleagues to ‘stand together, act to resist that which harms health and well-being, protect those who are harmed, and build coalitions that move forward the ideals we seek’ (Chinn et al., 2017; np). In so doing, they have brought to the foreground a long-standing and solidly rooted foundation within our discipline that recognizes social justice as core to the ontology of the discipline and fundamental within its epistemology and practice (Thorne, 2014). And while this does not mean all nurses enact social justice action as a discernable element of their everyday practice, it does imply that the same level of commitment to humanistic compassion that the profession considers central to the nurse–patient interaction is also applicable to policy enacted at the societal level. Nurses are, after all, brilliant at figuring out how to provide exemplary care to all patients, including those who may seem unpleasant, difficult, or even frightening. As a condition of entry into the profession, we learn how to manage across lifestyle, language, and cultural boundaries, and to find that place of human connection that builds the trust and confidence we consider central to our capacity to provide care. We pride ourselves in being able to surmount the inevitable negative thoughts and visceral responses that can arise when we encounter that which seems disfigured, malodorous, or distasteful in the clinical context. We search out and focus upon the human being within the diseased condition, finding those points of meaningful human interaction that make our work so fulfilling. This skill set is essential to the provision of good care to all. And it is just what we do. In times like these, society needs the capacity that nurses embody to imagine a mechanism for expressing humanity across difference. For nursing, questions such as who deserves to receive care and what society's responsibility ought to be toward its most vulnerable are not matters of political persuasion but rather fundamental commitments aligned with the profession's tradition and societal mandate (Hussey, 2012; Sellman, 2011). As Browne and Reimer-Kirkham have pointed out, ‘we participate in praxis toward the transformative ideals of human flourishing and social justice, seeking inclusive communities with democratic, respectful engagement’ (2014, p. 25). Because these ideals are fraught with difficulties—because of course there never are sufficient resources for all, and choices have to be made in such matters as service delivery—nursing has led the way in theorizing social justice at the applied level. It does so with a moral fortitude that embraces an understanding that, although there can be no absolute certainty about the path forward, the shared ideal allows it to work collectively to create the conditions under which justice-enhancing responses (c.f. Sen, 2009) can be found in relation to particular problems. The fear that we see in so many sectors of society these days is an outcome of many social and political forces, not the least of which is insufficient understanding of complexity and insufficient will to think deeply. Protectionism, racial profiling, and the ideology of defending the privilege of some over the basic human rights of others are all products of the inability to move beyond simplistic thinking and into the domain of values, virtues, and high ideals. They reflect an immaturity of the human spirit, focusing on the self rather than the other, privileging the moment over the long game. It is not at all difficult to see how the story unfolds when the forces of fear, hatred, intolerance, and privilege gain influence at the expense of decency, compassion, and mutual respect. Clearly there is a need for the skill set that nurses so clearly exemplify in their individual practice context to be enacted at the societal level. Not only do we need to support and encourage those among us who do this kind of work as their practice—work such as refugee and immigrant health, harm reduction, reproductive rights advocacy—but we also need to champion the values that underpin this work within the larger community. We need to help teach society how to overcome fear, distrust, and personal insecurity in order to do what is right, to meet the call of those who are the most small and vulnerable among us, and to enact those central ideals that are consistent with valuing health for all. Chinn et al. (2017) crystallize a vision of what nursing stands for in their declaration of solidarity and resistance. They remind us that nursing believes in the right of all persons to health and well-being of mind, body, and spirit and that all persons deserve access to affordable quality care. They also remind us that oppression, discrimination, intimidation, and violence are inherent threats to health. They further confirm that the integrity of the environment, including the social environment, is integral to health and well-being and that a holistic approach to nursing care derives from a firm foundational trust in how science, in all of its manifestations, informs it. These core values underscore a social justice ideal that cannot remain silent in the face of public policy that runs counter to the health of populations. We find ourselves in an era when nurses need to be proud of and inspired by their history and their social justice tradition. They need to dig deep into what they know about what is right and proper on behalf of society when one accepts the privilege of being a professional. By re-grounding in their intellectual and ethical tradition, and by surfacing that which they know to be true, nurses can draw upon their creativity and disciplinary imagination to find opportunities within their own families, communities, and spheres of influence to ensure that the kinds of values that will make the world a better place for all are not sidelined but rather brought back to center court. To manage the epidemic of fear and intolerance that seems to be advancing more and more deeply into its social fabric during these complex times, the world badly needs a good strong dose of what our profession stands for.