Witness: The Canadian Journal of Critical Nursing Discourse

Journal Information
EISSN : 2291-5796
Current Publisher: York University Libraries (10.25071)
Total articles ≅ 37
Current Coverage

Latest articles in this journal

Josephine Etowa, Bagnini Kohoun, Egbe B. Etowa, Getachew Kiros, Ikenna Mbagwu, Mwali Muray, Charles Dabone, Lovelyn Ubangha, Hilary Nare
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 124-130; doi:10.25071/2291-5796.84

Despite the universal healthcare system in Canada, Canadians of African Descent (CAD) still face numerous problems that place them at higher risk to pandemics such as COVID-19. From the struggles of working as frontline workers, to challenges compounded by pre-existing chronic medical conditions such as Diabetes, CAD may face unique issues, further weighing on their existing and potential health outcomes. This situation calls for closer attention to the specific needs of CAD who may be at greater risk of late diagnosis and delayed treatment for COVID-19. Historically, marginalized communities such as CAD must be included in healthcare considerations and planning, so as to avoid further leaving them behind during and after the storm. Past evidence has shown that structural inequities shape who is affected by disease and its economic fallout. Therefore, the unique needs of CAD must be considered in healthcare planning with the ongoing COVID-19 response. Keywords: pandemic, marginalized, healthcare, COVID-19, Canadians of African Descent
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 104-123; doi:10.25071/2291-5796.62

Despite advancements in research and medicine, health inequities and disparities among First Nations peoples (FN) in Canada are well documented and continue to grow. Once virtually unheard of, cancer now is a leading cause of death among FN. Many factors contribute to cancer disparities, but FN face unique challenges in accessing healthcare. In this critical review and analysis, we explore potential links between cancer disparities and poor access to cancer care among FN. Research suggests FN experience difficulty accessing cancer services in several ‘places’ of care, including screening, diagnosis, treatment, survivorship and palliative care. Furthermore, there are notable ‘spaces’ or gaps both within and between these ‘places’ of care likely contributing to cancer disparities among First Nations. Gaps in care result from jurisdictional ambiguities, geographical location, unsafe social spaces, and marginalization of FN ways of knowing, and can be linked to colonial and neocolonial policies and ideologies. By drawing attention to these broader structural influences on health, we aim to challenge discourses that attribute growing cancer disparities among FN in Canada solely to increases in ‘risk factors’.
Susana Caxaj , Amy Cohen, Bonar Buffam, Oudshoorne Abe
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 92-103; doi:10.25071/2291-5796.69

In 2018, over 70% of the 69,775 temporary migrant agricultural labourers arriving in Canada participated in the Seasonal Agricultural Workers Program (SAWP). Despite having legal status in Canada, these individuals are often systematically excluded from community life and face barriers when accessing health and social services. SAWP workers’ exclusion from many public spaces and their incomplete access to the benefits of Canadian citizenship or residency provide us a unique opportunity to examine social and political mechanisms that construct (in)eligibility for health and protection in society. As individuals seeking to care for the sick and most marginalized, it is important for nurses to understand how migrant agricultural workers are positioned and imagined in society. We argue that the structural exclusion faced by this population can be uncovered by examining (1) border politics that inscribe inferior status onto migrant agricultural workers (2) nation-state borders that promote racialized surveillance and; (3) everyday normalization of exclusionary public service practices. We discuss how awareness of these contextual factors can be mobilized by nurses to work towards a more equitable health services approach for this population.
Michelle Danda
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 20-28; doi:10.25071/2291-5796.71

In recent decades scholars have begun to question the value of mental health nursing. The term has lost both conceptual and explanatory power in the modern globalized world in which multidisciplinary teams now carry out many functions once unique to the specialization, yet its distinction persists. The purpose of this paper is to explore an emerging research methodology, duoethnography, as an avenue to revive mental health nursing, by subverting the dominant post-positivist, scientifically driven, medically framed, evidence-based practice perspective, to gain greater understanding of the nuances of mental health nursing practice. Duoethnography offers promise in challenging nursing research norms embedded in an empirically based medical model, however the newness of the method poses potential methodological issues. Duoethnography is a methodology well-suited to explore the question of whether mental health nursing is an outmoded tradition too deeply entrenched in the institutional past, or an emerging profession leading mental health care.
Myriam Kaszap, Dave Holmes
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 54-75; doi:10.25071/2291-5796.78

La situation actuelle en milieux de psychiatrie légale ne permet pas aux patients d’exprimer pleinement leur sexualité durant leur hospitalisation. Dans certains cas, les relations sexuelles sont tout simplement interdites. Non seulement, les politiques institutionnelles en place briment, en partie, les personnes dans l’exercice de leurs droits fondamentaux elles manquent aussi de clarté au regard de la façon dont le personnel infirmier devrait gérer les besoins des patients. Une étude ethnographique critique a été conduite dans un centre de psychiatrie légale canadien. La collecte de données a inclus des entrevues semi-structurées, la collecte de documents institutionnels et l’observation du milieu. Nos résultats s’articulent autour de trois thèmes: situer la sexualité en contexte médico-légal, faire l’expérience de la sexualité en tant que patient et gouverner la sexualité des patients. Les données récoltées permettent de constater que ces discours façonnent les croyances et les actions des patients, des infirmières et des autres professionnels tels que les psychiatres, les éducateurs et les psychologues.
Dave Holmes, Amélie Perron
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 1-2; doi:10.25071/2291-5796.85

Michelle Danda
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 29-53; doi:10.25071/2291-5796.75

While there is a growing body of research available on general restraint intervention in acute adult psychiatric settings, relatively little is known about nurses’ experiences of administering chemical restraint. The research question explored in this study was: what are mental health nurses’ experiences of using chemical restraint interventions in times of behavioural emergency on adult inpatient acute mental health units? Through this Canadian study understanding of direct care nurses’ first-hand experiences of the use of chemical restraint interventions was sought. Eight adult acute inpatient mental health nurses were interviewed using hermeneutic phenomenological method. Two major themes that emerged from data analysis are explored to illuminate the existing tension between therapeutic, person-centred care and coercive control to maintain safety: taking control to maintain safety and working within constraints. Integral ways that nurses make meaning from administering chemical restraint were found, as well as some of the complex clinical and ethical decision-making aspects involved in psychiatric nursing care. Implications for practice, education, and policy are discussed. Research findings indicated a need for further focus on medication best practice, policy development and nurse education. These exploratory research findings can be used to both inform and challenge dominant inpatient mental health practice to guide nurses, health care leaders, and policy makers by increased understanding of the complex ethical decision making required for use of chemical restraint interventions.
Margaret Lebold, Judith MacDonnell
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 76-91; doi:10.25071/2291-5796.76

The advent of “the abortion pill” (Mifegymiso) in 2015 has shaped the contemporary context of access to abortion in Canada. In this paper, we highlight findings of a literature review that uses a gender and intersectional lens and critical discourse analysis to explore contemporary abortion access and implications for nursing. The discursive dynamics influencing nurses’ understandings of abortion, that is, the contexts in which some discourses are privileged over others yet often operate at the unconscious level to influence everyday knowledge and practices, are important to discern to work towards social justice goals. Findings suggest that normative and contradictory features of discourses such as women’s health, motherhood, and abortion access are relevant. Given the relative silence of abortion in nursing literature and prevailing gender normativity in nursing, there are compelling reasons to apply a critical feminist lens to deepen nurses’ understandings and critical reflection about abortion. There are implications for current education, research, and nursing practice.
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 3-19; doi:10.25071/2291-5796.72

In this article, our aim is to provide a critical analysis of the phenomenon of judiciarization of people suffering from a mental illness and its impact on nursing practice. To explore the issues inherent to this phenomenon, we employed the methodology of discursive analysis greatly inspired by the work of French philosopher Michel Foucault. The results of this analysis push our reflection on the experiences and practices that take place at the psychiatric and judicial interface, engaging in a critic of underlying goals of public protection, social control, and coercion being incorporated to nursing practice. While acting in seemingly humanistic and therapeutic roles of care, nurses are simultaneously and inevitably fulfilling a mandate to social control which, to date, remains relatively under documented.
Kim English
Witness: The Canadian Journal of Critical Nursing Discourse, Volume 2, pp 122-133; doi:10.25071/2291-5796.50

This reflection paper represents my own efforts at personal reconciliation as a settler nurse educator. A portion of these efforts include my analysis and experience of the current state of nursing academia within the context of our profession’s necessity to meet relevant calls to action stated within the Truth and Reconciliation Commission’s report. Key issues such as problematic texts accepted as ‘nursing fundamentals’, the invisibility of Indigenous knowledge coupled with the perpetuation of colonial stereotypes are discussed within the context of Nbwaa-ka-win. The application of post-colonial theory as part of a strengths-based approach to the decolonization of nursing education is presented.
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