Entanglements, shadows, and dissonance: Formations of socio-political knowing in nursing. A critical inquiry.

Abstract

<p><strong>Social-political knowing in nursing involves looking beyond therapeutic relationships towards the circumstances that compromise health and wellbeing and contribute to social injustice. Such knowing, or the “where-in” as proposed by Jill White (1995; 2014), is foundational to acting against inequities and influencing policy. However, limited research related to socio-political knowing exists in nursing to inform practice and education. This qualitative study aimed to discover how registered nurses understand, use, and communicate their knowing of contemporary societal and political issues impacting on the health and wellbeing of those they care for. The research design employed a critical constructivist methodology, one that presupposes that the relationship between the knower and what is to be known, is a mediated process that develops through experience and is influenced by interactions with societal structures. Engagement with participants developed through interviews, focus groups and key informant interviews with registered nurse participants (n = 26) who worked in a range of settings in Aotearoa, New Zealand. Emergent themes, developed from phase one interviews, were subsequently discussed and refined by focus groups and key informants. These findings were then analysed through the lens of the symbolic lifeworld as proposed by the philosopher Jürgen Habermas. The findings revealed that registered nurses’ epistemological relationship with socio-political knowing is instrumental to preserving the status quo and entangled with scarcity, institutional racism, and emotional distress; shadowed by epistemic injustices and inhibited by a sense of dissonance. To reform nursing socio-political knowing there is a need for nurses to rebuild the disjuncture between social and political knowing by developing communicative action or processes of mutual understanding, to identify ‘hotspots’ where nursing knowledge interests are subsumed, and to critique the influence of systematic and administrative mechanisms that disrupt meaningful practice for social justice. With this knowledge, recommendations for change involve recognising the conditions that tie, obscure and fragment nursing knowledge interests in health care systems.</strong></p>