Action Nursing? Addressing politics and ideology?

I read this http://www.cost-ofliving.net/a-case-for-action-sociology/ a while ago, and I published this on the one dimensional state of UK nurse education, http://www.nurseeducationtoday.com/article/S0260-6917(11)00135-3/abstract back in 2011. Graham Scambler’s outline of an action sociology (AS) made me think about an ‘action’ nursing. To use/paraphrase Graham:

 So what might action sociology/nursing deliver? It has a number of discernible properties:

It is intrinsic to the sociological/nursing project: in any era sociologists will find themselves contesting ideologies (that is, erroneous worldviews or theories that sanction or provide cover for financial, business or political interests). Sociology’s very rationale is to oppose forces that suppress truths about the societies we inhabit: pace Habermas, it is necessarily oriented to justice and solidarity. It is active not passive: it lives or dies as a form of intervention against – Habermas again – ‘distorted communication’.

Nursing similarly has an ethical dimension to it, to confront the same forces, and to fulfil its role in public health at individual, community and population levels. This has never been developed fully in Nursing theory because the discipline has been focused on other laudable aims. The result is a large number of workers in the NHS have no analytical tools or critical thought in which to contextualise and critique their experiences with vulnerable people.

‘AS’ therefore contests the ‘taming’ of sociology in the post-1970s neo-liberal era, including a shying away from contentious or ‘risky’ issues.

This taming has certainly occurred in Nursing as it is largely bereft of critique.

Sociology’s focus is the study and theorizing of what Comte called society’s ‘statics’ and ‘dynamics’ in general, and of collective action to accomplish change in particular. This encompasses recruitment, context, and the dialectics of framing and implementing strategies. Same goes for Nursing?

Sociology’s brief extends to forays into Giddens’ ‘utopianrealism’, involving the mapping of alternative futures. This may well involve challenging or superceding the discourses or narratives for change on offer at any given time. An example of utopian realism would be a model for an NHS beyond the truly iniquitous Health and Social Care Act. There is a lack of positing alternative futures by nurse scholars that is leaving the field to others.

Scambler argues: “The Health and Social Care Act, designed to re-commodify health care in England, will accentuate health inequality.  It is a paradigmatic example of policy-based evidence. The data do not speak loud enough for elite politicians, let alone their financial and business masters, to bend their ears in fear of a crisis of legitimation. So how to remove from the statute book an Act inimical to the wellbeing of most citizens?  An action sociology cannot shrug its shoulders. It has to dwell on and exploitation and oppression. It is the actions of the wealthy and powerful that condemn those in low-income households to suffer more than their share not only of long-term but of acute illness and to die prematurely, as the likes of Engels and Virschow who charged rulers with ‘murder’ recognized in the 19th century. And health inequalities afford but an illustration here: we could have pinpointed welfare as a whole, education, housing and so on with the self-same consequences. Action sociology offers resistance to ‘formal’ democracy in the name of ‘substantive’ democracy. It underwrites ‘effective’ as opposed to symbolic resistance”.

 

This aspect (e.g. health inequalities, social determinants of health, ecological pubic health) of action sociology surely should resonate with nurses? We have been interested in how the social sciences inform nursing education and practice, well this is one way. What we do not have perhaps is a journal which is read by nurses which will focus on critical theorising and exploration of the context of nursing practice. The Sociology of Health and Illness often does a sterling job but do you think there is a gap here? if so how might we go about filling it? My very small sphere of influence is nurse education and arguing for a more fully rounded curriculum, so I’m feeling my way forward for an ‘action nursing’. Thoughts? Of course I almost blush at such a ‘radical’ action is suggesting a ‘journal’, the anthropologist David Graeber at the LSE (http://www.thewhitereview.org/interviews/interview-with-david-graeber/), or of course C Wright Mills,  might laugh at such a ‘bold’ move.

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