Conceptualizing structural violence in the context of mental health nursing

Abstract

This article explores how the intersections of gendered, racialized and neoliberal dynamics reproduce social inequality and shape the violence that nurses face. Grounded in the interviews and focus groups conducted with a purposeful sample of 17 registered nurses (RNs) and registered practical nurses (RPNs) currently working in Ontario's mental health sector, our analysis underscores the need to move beyond reductionist notions of violence as simply individual physical or psychological events. While acknowledging that violence is a very real and disturbing experience for individual nurses, our article casts light on the importance of a broader, power structure analysis of violence experienced by nurses in this sector, arguing that effective redress lies beyond blame shifting between clients/patients and nurses. Our analysis illustrates how assumptions about gender, race and care operate in the context of global, neoliberal forces to reinforce, intensify and create, as well as obscure, structural violence through mechanisms of individualization and normalization.

Enhancing our Understanding of Emancipatory Nursing

“…28 Feminist political economy concerns itself with the conditions, pressures, and structures that shape environments and practices and the relevance of gender in that context. 29 Applying an intersectional lens that foregrounds race and gender shaped a grounded theory pointing out notions of agency for racialized immigrant women, a fresh approach to studies that focus on immigrant women's mental health. 30 There is transformative potential in showing how counterdiscourses challenge taken-for-granted knowledge and practices at the structural level and illuminate actions consistent with social justice.…”

A critical review of knowledge on nurses with problematic substance use: The need to move from individual blame to awareness of structural factors

“…Numerous structurally situated factors influence nurses' work lives have been highlighted in the broader nursing literature as being significant contributors to their risk environments (Anderson et al., McGibbon, Peter, & Gallop, 2010). These include: hierarchical and gendered power inequities arising from the historical legacy of patriarchy and the privileging of the medical profession (Choiniere, MacDonnell, Campbell, & Smele, ; Dossey, ; McGibbon et al., ); crushing workloads and poor working conditions resulting from oppressive corporate management strategies (Rankin, ) that unduly predispose them to physical injuries (Shields & Wilkins, ); devaluation of their caring work and emotional labor (Choiniere et al., ; McGibbon et al., ; Rankin, ); high levels of emotional, physical, and horizontal violence in their workplaces (Hesketh et al., ; Longo & Sherman, ); and being subject to secondary traumatic stress (Dominiquez‐Gomez & Rutledge, ) and moral distress (Pauly, Storch, & Varcoe, ).…”

Violence committed against nursing staff by patients in psychiatric outpatient settings

“…Choiniere et al . () demonstrated that increased workload, a changing work environment, and lack of resources increased emotional stress, and this emotional stress influenced nursing staff members’ experiences with violence. Blando et al .…”

“…Violence against nurses has increased in healthcare settings (Choiniere et al . ; Gillespie et al . ) and particularly in psychiatric nursing (Maguire & Ryan ; Nolan et al .…”

“…According to studies, nursing staff require professional skills and the ability to use different kinds of preventive interventions to manage violent situations (Choiniere et al . ; Irwin ).…”