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Witnessing Social Injustice Downstream and Advocating for Health Equity Upstream: “The Trombone Slide” of Nursing

Falk-Rafael, Adeline PhD, RN, FAAN; Betker, Claire MN, RN, CCHN(C)

doi: 10.1097/ANS.0b013e31824fe70f
Health & Human Rights

Two aspects of a study examining the congruence of critical caring theory with public health nursing practice are reported. They confirm a congruence between expert public health nursing practice and the theory in terms of (a) a caring/social justice ethics that underpins practice and (b) the relevance to their practice of the carative health promoting process of contributing to the creation of supportive and sustainable physical, social, political, and economic environments. Public health nurse participants encountered many barriers to a practice underpinned by a caring/social justice ethic, some of which limited their moral agency.

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School of Nursing, York University, Toronto, Ontario (Dr Falk-Rafael); and College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Ms Betker).

Correspondence: Adeline Falk-Rafael, PhD, RN, School of Nursing, Faculty of Health, York University, Health, Nursing & Environmental Studies Bldg, Room 301A, 4700 Keele St, Toronto, ON M3J 1P3, Canada (

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The authors gratefully acknowledge funding in partial support of this research from the Social Sciences and Humanities Research Council of Canada and Sigma Theta Tau International, Iota Omicron Chapter.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.