Article for Nurse


From Oppression to Freedom:
Nursing’s challenge in a new era of healing


Aila Accad, RN, MSN


“Experience teaches me that nursing and medicine must never be mixed up. It spoils both…” Florence Nightingale

Florence Nightingale warned us about keeping the integrity of the nursing profession distinct from medicine.

Through Nightingale’s observations, she documented that when nurses enter the hospital setting, more people get well! The value of modern nursing begins here.

Nursing’s difference makes a difference in healing.

In the hospital setting, nursing slowly subsumed itself under medicine and began to display the characteristics of an oppressed group, described by Paulo Freire in his classic ‘Pedagogy of the Oppressed’.

Characteristics of Oppressed Groups

• Dominant group determines valued attributes of the oppressed group
• Oppressed internalizes values and norms of the dominant group
• To be successful the oppressed must look like the dominant group
• Leaders become ‘marginal’ – not accepted as members of dominant group, yet deny identification with oppressed group.
• “Marginal” status results in decreased self-esteem & self hatred
• Feelings of self-hatred lead to “Horizontal Violence”, (exemplified by statements as “Nurses eat their young”, “Nurses are their own worst enemy”)
• This leads to lack of unity and an inability to organize (although nurses are the largest group of health providers, few nurses are members of a professional association to make their collective voice heard)
• Members become passive-aggressive due to fear of punishment from the oppressor.

Nurses who expand knowledge and action into the medical model are rewarded and valued by medicine, and lose their connection with their peers who are grounded in nursing values and practice.

I remember one of my student’s who said, “My proudest moment was when, doctor x complimented me on my understanding of the diagnosis”. My greatest moment was when the patient said, “Thank you for listening, you really helped me understand what’s happening and what I want to do next”.

Nursing cost/value is identified as ‘room and board’ on most hospital bills. Who knows what nurses do besides fulfill doctor’s orders? Stressed and frustrated nurses are spending less time at the bedside doing what satisfies their mission.

Grounding in Nursing Theory, Research and Practice is not exclusive of understanding bio/medical processes and procedures. And, Nursing is not medical practice. It is easy to lose site of this distinction in a system that does not recognize the value nursing brings to the healing perspective.

We did not keep vigil over the differences in the value of nursing as a separate science, art and practice from medicine as Nightingale admonished.

The time has come in the chaos of health system change to reclaim Nursing’s distinct place in the healing arts.
How does an oppressed group regain its autonomy and value?

Liberation of an Oppressed Group

• Dispel the myth that the dominant group is superior
• Re-develop pride in its own unique group characteristics
• Develop leadership who value their group
• Develop an identity distinct from the dominant group

It is time to regain connection to Nursing theories, arts and practice.

Do you have a nursing theory that guides your practice? Do you read nursing research? Do you ask practice questions that nurse scholars can research?

Re-identifying with a renewed pride in Nursing is the key to making our greatest contribution to health care in the new age of healing.

Re-identifying with a Culture of Nursing

• View of Individual as whole
• Focus on Life as a Creative Process
• Nurturing through Humanistic Interaction
• Aware of Cyclic & Creative Forces in Nature
• Systems Perspectives (individual, family, community….)
• Intuitive Knowing
• Receptivity

Nursing’s systems perspective tells us that the best time to evaluate and implement changes is when a system is in chaos.

Now is that time!

© 2008 Aila Accad

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Aila Accad, RN, MSN known as ‘The De-Stress Expert’, is a professional Nursing Speaker, Trainer and De-Stress Coach. She presents innovative Nurse De-Stress & Lead Programs . You can learn more by contacting her for speaking , workshops , retreats and personal coaching by using the Contact Form below.



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