Social justice, ethics, and the nursing profession

When we discuss social justice, we are referring to the fair and equal treatment of individuals; where their rights are protected, there is equitable distribution of resources, and decisions are unbiased. In healthcare we often frame this in terms of health equity, which is the work of reducing health disparities and the goal that all individuals achieve their highest level of health. Historically, people of color, women, LGBTQ+ groups, and those from lower socioeconomic standings have either not had access to healthcare or have experienced trauma in healthcare systems.

Nurses are in a unique position to drive social justice and equity in healthcare, due to the level of trust and interaction they have with patients. Our holistic training and adherence to the ethical principles of nursing make us ideal social justice advocates. Our profession has consistently ranked #1 most ethical and honest profession and the American Nurses Association statement on Ethics and Human Rights calls for nurses to advocate, protect and amplify human rights and social justice concerns.

A history of social justice in nursing

Our history as a profession is based on social justice activism. Florence Nightingale worked to improve conditions for women and was an advocate for hunger relief in India. She is just one in a long list of nurses who have sought to improve access and create health equity. Other examples include Lillian Ward and Mary Brewster who created the public health nurse role. This role was founded with the idea that nurses must treat social and economic health problems first in order to treat sick people and preserve human dignity. Estelle Massey Riddle who worked to change discriminatory policies in both nursing schools and the National Nursing Council for War Service.

Most recently, nurses have raised their voices to cry out about unethical practices regarding medication costs and pharmaceutical companies, protested environmental health issues like the Dakota Access Pipeline (DAPL), and marched against racial injustice with the Black Lives Matter (BLM) movement. The nursing profession will be key to find the way forward during this current pandemic and the impact it has had on underserved groups. We have the voice and reputation to educate communities on safe practices to reduce Covid-19 transmission and increase vaccine compliance.

Striving for social justice

Yet how does the nursing profession strive for social justice especially in a time when burn-out is high and resources seem limited? My short answer is we must celebrate the small wins and the big wins.

• We must remember that nurses are innovators, the MacGyvers of the healthcare team. How many times have we (nurses) done the improbable during a shift?
• We must cheer for ourselves and our colleagues when they find resources we did not imagine existed and overcome barriers we did not think could be broken down.
• We must cheer for the big win California nurses obtained regarding Covid testing of all health care staff and patients.
• We must also equally cheer for ourselves and our colleagues, who find vaccines for patients struggling to navigate the system, nurses who volunteer to give vaccines and the nurses who pick up extra shifts across the country.
• We must participate and review policies at the hospital and government level to ensure that we do not create more inequities.
• We must celebrate that a nurse was appointed to the Covid-19 advisory board, after we raised our voices in protest that it was necessary.
• We must not through silence be complicit even though we are tired, because unfortunately the consequences are too great.

Nurses more than ever before must be social justice advocates in the face of overwhelming odds and use our voices to amplify the need for change in our healthcare system. 2021 continues the theme the Year of the Nurse and the expansion of Nurses Week to Nurses Month, we were called to nursing; we are powerful, and we will create a system of health equity. This is our time.