National Nurses United

CE_Sept 10/5/10 2:57 PM Page 22 Lavinia Dock positioned nursing as political and she commissioned nurses to extend their traditional values of caring to include a social responsibility for society to secure the overall bio-psychosocial well-being of individuals, society, and the world. However, nurses cannot assume the sole responsibility to bring about this ideal of a social democracy; the endeavor requires participation of all individuals in society. Dock's quest, as those of many other progressive women, provides valuable insight on how some late 19th and early 20th century women, and nurses in particular, grappled with issues of subordination to patriarchal domination and effected social reforms to improve democracy and society. Indeed, patriarchal conceptions of society have traditionally dominated nursing's philosophy of education and practice in the United States and many other countries. The late 19th and early 20th centuries can be regarded as the "golden years" for the discipline of nursing, because many nurses challenged and subverted patriarchal social constructs which oppressed them and curtailed their role in society. Dock perceived that women and their traditional "housekeeping" values of rearing, nurturing, caring, collaboration, and their appreciation of communal virtues were better positioned to achieve changes in society. This endeavor required the enfranchisement of women, which would provide them with the power to effect compelling social reforms. Dock was active in several venues to crusade for social reforms, such as settlement work, writing, teaching, union work, and membership in many civic and professional organizations both at national and international levels. Her ideas of holistic caring and social responsibility are most relevant in light of today's healthcare reality, which fragments the medical treatment of individuals and limits access to quality healthcare to many members of society. Organizing for Solutions "Without claiming the gift of prophecy, one can foresee that our sins, political and social, must recoil upon the heads of our descendants. We commit ourselves to any wrong or degradation or injury when we do not protest against it." —Lillian D. Wald Through political action, nurses should strive for congruence between their professional values, practice, and politics to subsequently effect change and improve health outcomes. According to the American Association of Colleges of Nursing, the explicit values that form the cornerstone of professional nursing are autonomy, altruism, human dignity, integrity, and social justice. Nurses need to be caring at the bedside and beyond, and we need to commit ourselves to challenging and changing exclusionary social, economic, and health policies. Our shared values guide us to an understanding of what ought to be in regards to human behavior. Values only become meaningful when they are reflected in a nurse's behavior. Value-based behaviors should be the foundation for practice and a guide for interaction with our patients, colleagues, friends, family, neighbors, and the public. Critical thinking, reflective practice, and political action are required to create a more equitable and socially just healthcare system that works for everyone. Social justice is doing what's best for a person or group of people, based on their needs and the fundamental principle that human beings have inalienable rights. If an RN believes in the premise that all persons have the right to access basic healthcare, and to be treat22 N AT I O N A L N U R S E ed with respect and dignity, then his or her behavior will be more likely to be congruent with this belief. The belief that human beings are essentially interdependent and are entitled to the same fundamental rights creates the basis for advocacy for these rights, not only for one's self, but also for others. Patients who need medical care are among the most vulnerable of human beings; they deserve our protection and depend on our advocacy. Conclusion "When you get into a tight place and everything goes against you till it seems you could not hold on a minute longer, never give up then, for that is just the place and time that the tide will turn." —Harriet Beecher Stowe (1811-1896) Lavinia Dock and Lillian Wald are significant historical role models for our profession.  They were American nurses, educators, settlement workers, feminists, suffragists, pacifists, social activists, writers, and historians. As settlement workers they believed that the dignity of a job was pivotal to rescue individuals from poverty. Hence, their efforts centered on keeping the destitute healthy, educating them, and providing them with skills training. Dock believed that poverty was not a moral failure, and she was adamant that the government was responsible for enacting social reforms to secure the well-being of all its citizens. Dock and Wald envisioned nursing and caring as a social responsibility and recognized the implications of this conceptualization for democracy, as an expression of citizenship based on social responsibility for the welfare of others. Their ideal of democracy embraced women's values and ways of being in the world: shunning individualism and competitiveness, privileging communal values, collaboration, inclusion, and diversity. They envisioned the world as a global democracy beyond national boundaries and other differences which often separate individuals. In particular, Lavinia Dock believed that her ideal of a social democracy would not be achieved under the patriarchal conditions that ruled society. Indeed, we recognize that some of these same conditions exist today and they continue to have an impact on our ability to organize and advocate in the exclusive interests of the patients we serve. She blamed the patriarchal discourse for privileging values of individualism, competition, and detachment that set the stage for the widespread social injustices at the turn of the 20th century. (Some of these "social evils" included poverty, child labor, malnutrition, pandemics, prostitution, slavery, overcrowded living conditions, and lack of equal access to education and a lack of social regulations to protect women, children, and the underprivileged). Dock became a relentless, militant social activist and devoted suffragist because she believed the enfranchisement of women would provide them with the power to effect compelling social reforms. She stated: "…As the modern nursing movement is emphatically an outcome of the general woman movement and as nurses are no longer a dull, uneducated class, but an intelligent army of workers, capable of continuous progress, and titled to comprehend the idea of social responsibility, it would be a pity for them to allow one of the most remarkable movements of the day to go on under their eyes without comprehending it…What is to be our attitude toward full citizenship? Shall we be an intelligent, enlightened body of citizens, or an inert mass of indifference?" W W W. N A T I O N A L N U R S E S U N I T E D . O R G SEPTEMBER 2010

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