A sense of injustice is essential to the survival of the human race. Current events re-enforce the sense that some behavior breeches the social contract that professionals have with those in their charge. The phrase “to protect and serve” can apply to all professions, including nursing. Racism, gender bias, ageism, and any traumatizing of our vulnerable clients is abhorrent.
Freedom, liberty, and our future as both a profession and a people depend on us having a well-developed sense of injustice. In society, social injustice is never totally vanquished. There are and will be oppressive forces in some person’s natures that push them to violate the rights and autonomy of others. In healthcare, nurses are the witnesses of these injustices. We try to protect our patients’ autonomy and to do good and no harm, but in some cases, the organizational structures of our systems make peaceful protest necessary. Our systems, including the healthcare system, are only as beneficent and just as the people administering and working in them—that includes you and me.
Nurses are in an ideal position to defend the rights of all patients. We work in many settings in which human rights should take precedence. We work in physical and mental health settings. We work in prisons and nursing homes, hospitals, and residential care. If every nurse stood up or spoke up when witnessing injustice, the entire healthcare system would change and improve.
Why should elders die from COVID-19 in large numbers when we provide the care at these institutions? Why should persons addicted to opioids be civilly committed for treatment? Why should prisoners lose their jobs and, even in some cases, homes, after only 10 days of incarceration?
We learned as students that nurses are change agents. That we are the professionals who interact with all others in healthcare. That we are the eyes and ears of our organizations. When so much is at stake, we need to amplify our status as peacemakers and coordinators of humane care. As citizen nurses, we need to assume our role as coordinators of compassionate care.
We are citizens of change. We suffer not only for ourselves but for our patients, residents, families, friends, and neighbors. As nurses, we do no harm and do good, promote justice, and protect autonomy. The sense of injustice pushes people to act and with this conviction make changes. Now is the time for nurses to join their activated citizen patients in making changes.
All lives matter. Black lives and racial justice is imperative, and in my experience the old, young, white, Black, Hispanic, prisoners, Native Americans, mentally ill, immigrants, jobless and the poverty stricken all have legitimate claims to our compassion. In most cases, these communities have no one to speak for them. Nurses need to become the voice for the concerns and cares of the variety of persons we see who have no voice.
In most cases the sense of injustice originates from an extreme violation. A violation so extreme that it affects the very identity of the person violated. When it’s so extreme, the sense of injustice affects whole masses of people, as we have seen. As nurses we need to build on that sense of injustice to bring about social change.
We live in a global society witnessing protests around the world that signify the sense of injustice related to the violation of the inalienable right to life, liberty, and the pursuit of happiness. These rights depend on having a sense of autonomy and a belief that all professionals with whom we interact will protect and preserve this autonomy.
Whether autonomy is seen as the right to free association, as a right to free speech, or as due process and equal protection under the law, all forms of restriction and violation of autonomy must be addressed. Nurses are in a place in the organization where we can make a difference for those considered “different” by some segments of society.
We are one of the most trusted professions. We have it within our power to intervene when we witness unjust actions, policies, or procedures. As citizens, we can protest in the streets if we wish. But as professionals, we can do as much to promote egalitarianism, social justice, and humane treatment in our own microcosm of work. We are change agents because we see and hear all aspects of our organizations. We are the care coordinators responsible for the continuum of care.
One must see everyone’s rights as defensible. Everyone’s life matters. The concern is that most of the vulnerable have no voice. We as nurses can be the voice or a translator and interpreter of the voices of the suffering many.
For centuries some have been injured by systems set up to benefit some and disadvantage and disenfranchise others: Slavery; Native-Americans driven off their land; the mentally ill caged, abused and drugged; immigrants of all cultures denigrated. Years ago, immigrants were separated from society and today Hispanic families are torn apart with children separated from parents and sometimes sent back to countries where they are abandoned.
In the movie Apocalypse Now, Marlon Brando describes “the horror” of the Vietnam War. We witness “horror” everyday but may not recognize the depths of despair of those experiencing it. The sense of injustice is a reaction to suddenly feeling one’s own or another’s horror. We as nurses have the opportunity to speak up or stand up within our places of work. Will we?
Mary Ellen Wurzbach is John McNaughton Rosebush Professor Emerita, University of Wisconsin – Oshkosh in Oshkosh Wisconsin.