Recently, several of us had the opportunity to read and discuss the article, “Caring as Emancipatory Nursing Praxis: The Theory of Relational Caring Complexity,” by Ray and Turkel1 in the April-June 2014 issue of Advances in Nursing Science. We commend the authors for their moving discussion of the importance of social justice, human rights, and caring as an emancipatory nursing praxis (ENP) despite the sometimes dehumanizing impact of economics, technology, and bureaucratic systems. The authors suggest that when nurses practice from a principled, philosophical, ethical, and socially just perspective, they will realize the full potential of their “power” to positively affect patient care. We agree with the authors' hopeful and optimistic message and many of their recommendations that are solidly grounded in their theory of relational caring complexity. It is their position that through ENP, nurses can transform health care environments within complex organizations to create better outcomes for patients, employees, families, and themselves.
We took issue, however, with examples of ENP suggested for hospital settings. Some of these included the creation of “caring-healing rooms” for patients with aromatherapy and music, implementing “code lavender” for nurses needing support from colleagues, and hosting “bake sales” to raise money for bus passes for family members. While well intentioned, these suggestions lack pragmatism and expediency in the face of heavy workloads and limited resources and fail to address the systems that undermine caring praxis. We question if nurses would find these overly simplistic strategies helpful or useful and if being tasked with additional caregiving responsibilities is in itself a socially just action. As doctoral students of nursing, we explored how best to broaden an understanding of the importance of ENP so that other nurses would participate in the movement. We offer the following suggestions:
- Coach currently practicing nurses in the process of appreciative inquiry where they examine fully what has worked in the past for the successful achievement of ENP by identifying moments they have experienced increased energy and reciprocal empowerment following interactions with patients.2 Nurses on the “front lines” will offer valuable insight into what is realistic and effective in a variety of health care environments.
- Inspire nurses to publish articles that describe instances of success in achieving ENP, as this will shed light on practices already in use. Offer hands-on support and venues to assist nurses with the writing process in the generation of these articles. This will lead to the development of new knowledge and hypotheses testing in future research.
- Encourage scholars and researchers to collaborate with nurses working in a variety of health care environments on research efforts focused on the study of ENP.
- Identify and challenge workplace and health care delivery policies that undermine the nursing professions' ability to achieve ENP and work to change these policies by developing and implementing efficacious strategies that facilitate and promote high-quality caring environments.
We thank the authors for bringing an important theory and practice to our attention. This area certainly warrants ongoing research and further examination. We look forward to future opportunities to engage in dialogue necessary for the provision of ethically minded and socially just nursing care.
—Tara Mariolis, MS, RN
Raeann G. LeBlanc, DNP, GNP-BC, ANP-BC
Sherrie McNamara, BSN, MBA, RN
Genevieve E. Chandler, PhD, RN
College of Nursing
University of Massachusetts
1. Ray MA, Turkel MC. Caring as emancipatory nursing praxis: the theory of relational caring complexity. ANS Adv Nurs Sci. 2014;37(2):132–146.
2. Whitney C. Appreciative Inquiry a Positive Revolution in Change. San Francisco, CA: Berrett-Koehler; 2005.