Louise Racine

Unmasking the predicament of cultural voyeurism: a postcolonial analysis of international nursing placements.

The growing interest in international nursing placements cannot be left unnoticed. After 11 years into this twenty-first century, violations of human rights and freedom of speech, environmental disasters, and armed conflicts still create dire living conditions for men and women around the world. Nurses have an ethical duty to address issues of social justice and global health as a means to fulfil nursings social mandate. However, international placements raise some concerns. Drawing on the works of postcolonial theorists in nursing and social sciences, we examine the risk of replicating colonialist practices and discourses of health in international clinical placements. Referring to Bakhtins notions of dialogism and unfinalizability, we envision a culturally safe nursing practice arising from dialogical encounters between the Self as an Other and with the Other as an Other. We suggest that exploring the intricacies of cultural and race relations in everyday nursing practice are the premises upon which nurses can understand the broader historic, racial, gendered, political and economic contexts of global health issues. Finally, we make suggestions for developing culturally safe learning opportunities at the international level without minimizing the impact of dialogical cultural encounters occurring at the local and community levels.

Applying Antonio Gramsci's philosophy to postcolonial feminist social and political activism in nursing

Through its social and political activism goals, postcolonial feminist theoretical approaches not only focus on individual issues that affect health but encompass the examination of the complex interplay between neocolonialism, neoliberalism, and globalization, in mediating the health of non-Western immigrants and refugees. Postcolonial feminism holds the promise to influence nursing research and practice in the 21st century where health remains a goal to achieve and a commitment for humanity. This is especially relevant for nurses, who act as global citizens and as voices for the voiceless. The commitment of nursing to social justice must be further strengthened by relying on postcolonial theories to address issues of health inequities that arise from marginalization and racialization. In using postcolonial feminist theories, nurse researchers locate the inquiry process within a Gramscian philosophy of praxis that represents knowledge in action.

Putting the world as classroom: an application of the inequalities imagination model in nursing and health education.

This article focuses on the description of an educational initiative, the Interdisciplinary Population Health Project (IPHP) conducted in the academic year of 2006-2007 with a group of nursing and health care students. Inspired by population health, community development, critical pedagogy, and the inequalities imagination model, students participated in diverse educational activities to become immersed in the everyday life of an underserved urban neighborhood. A sample of convenience composed of 158 students was recruited from 4 health disciplines in a Western Canadian university. Data were collected using a modified version of the Parsell and Bligh’s Readiness of Health Care Students for Interprofessional Learning Scale. A one group pretest–posttest design was used to assess the outcomes of the IPHP. Paired t tests and one-way analyses of variance were used to compare the responses of students from different academic programs to determine if there were differences across disciplines. Findings suggest that students’ readiness to work in interprofessional teams did not significantly change over the course of their participation in the IPHP. However, the inequalities imagination model may be useful to enhance the quality and the effectiveness of fieldwork learning activities as a means of educating culturally and socially conscious nurses and other health care professionals of the future.

Reviewing Chinese immigrant women's health experiences in English-speaking Western Countries: a postcolonial feminist analysis

Considering the growing size and diversity of Chinese immigrant populations in English-speaking Western countries, as well as the socioeconomic vulnerability of immigrant women, this integrative review aims to provide a critical analysis of research on the health experiences of the recent wave of Chinese immigrant women. Fifty-six peer-reviewed research articles, written in English and published between 2000 and 2014, formed the sample for this review. Four themes emerged through postcolonial feminist analysis: (1) dichotomy between Chinese “culture” and Western medicine, (2) essentialization of health beliefs and practices, (3) critique of Western healthcare services delivery from Chinese immigrant womens perspectives, and (4) erasure of institutional responsibilities. The conclusion points out some limitations of this review and discusses the implications these themes suggest for strengthening healthcare systems in English-speaking Western countries where Chinese immigrant womens health experiences are shaped.

Article Commentary: The Enduring Challenge of Cultural Safety in Nursing

Cultural differences, cultural diversity, and cultural safety have been discussed lucidly in the pages of CJNR on many occasions (Allen, 1999; Anderson, 2004, 2006). They have been recurring topics for good reason: the challenges around cultural issues in contemporary nursing practice and research continue. In the 21st century, the digital revolution has brought many positive changes, including increased access to nursing education for students living in remote areas and for a growing number of international students (Racine, Springer, & Udod, 2013). Similarly, globalization and technological advances have facilitated, among inter national colleagues, the sharing of common interests in global health (Mill, Ogilvie, Astle, & Opare, 2005). Environmental sustainability, health inequities, nurse migration, and privatization of health and social services are global issues affecting health-care delivery (Dominelli, 2010). Given these complex contexts, the delivery of culturally safe care remains an unachieved goal. Cultural safety is defined as “nursing or midwifery action to protect from danger and/or reduce risk to patient/ client/community from hazards to health and well-being” (Papps & Ramsden, 1996, p. 493). Consequently, any action or lack of action that does not respect the ethnocultural background of individuals, groups, and communities or demeans their racial background is culturally unsafe (Papps & Ramsden, 1996). The investigation of cultural safety has revealed racial, ethnic, class, and language discrimination in nursing and in other health professions. There has been remarkable growth in research and writing on this topic in nursing. Cultural safety is now embodied in standards of practice and codes of ethics set by nursing regulatory bodies and professional associations in Canada and abroad. One might assume that culturally safe care is everyday practice for all nurses. But is it? The expressions of racial and ethnic intolerance in our discipline that I witness in my research and in other areas of my professional life remain very distressing. Very little appears to have changed since the publication CJNR 2014, Vol. 46 No 2, 6–9

Case Study: Internationally Educated Nurses Working in a Canadian Healthcare Setting

Anita is a 21-year-old nurse who recently completed her baccalaureate in nursing from a nursing school in Manila. Anita has aspired to pursue a nursing career abroad to avail of better working conditions, better pay, and a chance to pursue higher nursing education. She decided to immigrate to Canada and settle in a western Canadian province. She needed to have her credentials reviewed and approved by a provincial regulatory body to determine her eligibility to take the Canadian licensure exam (NCLEX) for entry to practice as a registered nurse/RN in Canada. Anita passed her NCLEX exam. She benefitted from the financial support of her Canadian employer. The employer paid Anita’s fees to write her NCLEX as it did for all recently hired internationally educated nurses. The employer provided a 6-month allowance to pay Anita’s rent. Anita stays in a rented apartment with other Filipino nurses. Anita has very few Canadian friends outside work. Anita is fluent in English, and she does not have problems communicating with her patients in English.