Running Head: Oppression in the Nursing Field

Oppression in the Nursing Field: A Review of Literature

Rebecca Ramos
University of Texas at El Paso
Veronica Cruz
RWS 1302

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Abstract

Nursing is a profession that has been in the health care field for many years. Many people
find the nursing profession to be honorable; it is a profession that is centered on putting anothers
needs before oneself. This field has made advancements throughout the years, but as
advancements are made, oppositions rise. Nurses find themselves multitasking between
providing care for various patients. Each patient that is cared for comes from varying
backgrounds, cultures, spiritual influences, and many other elements of life. With multiple
patients, care plans, doctors orders, scheduled medications, and so much more; nurses may be
providing physical care but not ethical, moral, or cultural care. This literature review will discuss
the rising issue of oppression in nursing. Through the use of multiple sources and interviews this
review will explore the ethics behind nursing, how society may be oppressed by nurses, and
provide a local level perspective of this issue.

Oppression in the Nursing Field

Oppression in the Nursing Field: A Review of Literature

Nursing has become an increasingly popular field within the health care system since the
19th century when Florence Nightingale became the first nurse. Selanders (2015) explained that
Nightingale was in charge of restoring the British and allied soldiers back to health during the
Crimean War. Not only did this woman help during war time, she developed the Nightingale
School of Nursing in London in 1860, and was the first woman to receive the Order of Merit in
1907. Years following Nightingales significant contribution to the medical field, nurses have
represented a symbol of health, hope, and restoration. Nurses hold the life of their patients in
their hands. It is their duty to respond to any suffering or pain that their patients may be
experiencing. Though this may be true, times are changing, and advancements in the health care
system are being made. Since the start of the 21st Century, news have spread that there is a
shortage of nurses. As a result of this shortage, nurses find themselves to be busier than ever
before. The real question is: are the patients receiving the proper care and attention they deserve?
Oppression in nursing is an issue that is slowly arising and it does have to ability to take
quite a toll on patients. The last intention of a nurse should be to oppress an individual that is in
their care. Nurses go through extensive training and schooling to learn and comprehend how to
provide proper care. Many questions may arise when discussing this topic, but this review will
examine this topic using three questions:
1. Society perceives oppression in various ways. In what manners are patients feeling
oppressed due to the actions or procedures carried out by a nurse?

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2. Ethics plays a rather large role when it comes to the issue of oppression in nursing. When
it comes to caring for a patient, what are the pros and cons concerning ethics when
conducting a certain procedure or action?
3. Does the Chief Nursing Officer of University Medical Center in El Paso see oppression
in nursing as a rising issue within the medical field, and if so what improvements can be
made to reduce the amount of oppressing occurring in the nursing field?
These questions will help focus the literature review more on its purpose by providing various
perspectives, including: views from society as a whole, an ethical view, and from the lens of a
local health care professional.
Society perceives oppression in various ways. In what manners are patients feeling
oppressed due to the actions or procedures carried out by a nurse?
Oppression is perceived in various manners; for example, a typical procedure a nurse
may be conducting may not seem oppressive to him/her self, but to the patient, it may be
disrespectful or cause suffering. When discussing the care of patients, Benjamin and Curtis
(2010) stated, To care for a sick individual as a person, then, is to place his or her values and
plans, so far as possible, in the center of the picture and to attempt to preserve his or her sense of
capacity for reflective choice (p. 59). In the medical field, nurses come in contact with
individuals from various cultures; and if nurses are unaware of how to properly communicate
with the patients culture, it can take a toll on both the nurse and patient. When discussing this
concept, Thompson, Melia, Boyd, and Horsburgh (2006) mentioned; On the contrary, as our
societies become increasingly multicultural, it is all the more important to understand the
distinctive emphases and moral priorities of other people (p.36). Oppression does not only
occur from an ethical stand point, but a moral stand point as well.

Oppression in the Nursing Field

Source: Benjamin, M.,& Curtis, J. (2010). Ethics in nursing: Cases, principles, and reasoning (4th ed.).
New York, NY: Oxford University Press Inc.

The image presented above displays a simplified version of the three main elements in a
working moral framework. Based on varying cultural backgrounds, each patient has acquired
different morals based on the elements of the image. When entering a nurses care, patients do
not know what to expect. When discussing the concept of unavoidable trust, Butts and Rich
(2005) claimed; When patients are in need of help from nurses, they frequently feel a sense of
vulnerability and uncertainty (p. 41). Upon entering the care of a nurse, it is the nurses duty to
ensure that their patient is properly taken care of, but at times oppression can find its way in.
Oppression in nursing does not always need to pertain to a physical aspect; rather, it can occur
when patients are afraid to speak up. This concept can be shown in the words of Locsin and
Purnell: Although nurses were more likely to be viewed as equals and therefore approachable in
the eyes of patients, patients found that nurses were often so occupied with their tasks that they
dared not disturb them (Locsin & Purnell, 2009, p. 452). At times, patients may feel like a
burden and do not wish to disturb the nurses, which can lead to the neglect of a patients needs
and cause suffering. On the other hand, the tables could be turned; for example, Just as a parent

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may force an unwilling child to go to bed at a certain hour or take bitter medicine, so too, it is
argued, a nurse may sometimes force an unwilling patient to get rest or receive treatment
(Benjamin & Curtis, 2010, p.58). In this case, nurses can be the ones oppressing the patients and
neglecting their needs. Nurses must remember that no one knows the patient better than the
patient themselves. According to Locsin and Purnell (2009), If we want our nursing care and
caring to accomplish the patients goals, we must step aside and let the patient be the knower
(p.166). It is vital for nurses to listen to their patients and allow them to be the knower. When
nurses take the time to listen to their patients they may learn more about the health status of the
patient; for example, do they tend to feel nauseous, confused, and so on. Though this may be a
vital concept, nurses must intervene when necessary. For example, a patient might feel able to
walk but physically struggles; at this point precautions must be taken. In this situation a bed
alarm could be set to inform the staff when the patient rises off the bed; this method does not
physically restrain the person and may not seem oppressive to patients.
Ethics plays a rather large role when it comes to the issue of oppression in nursing.
When it comes to caring for a patient how is ethics involved when conducting a certain
procedure or action?
Ethical dilemmas occur constantly in the nursing field. Ethics plays a significant role in
the issue of oppression in nursing. According to Butts and Rich (2005), The questions What is
the right thing to do? and What ought I do in this circumstance? are ever-present in nursing
(p.17). Nurses must be quick to act in cases of emergencies, and caring for individual patients.
At times when duty calls, nurses need to act on behalf of the patients and decide what is needed,
whether it may involve avoiding certain ethics. The film Code Gray provides insight into the
ethical dilemmas of nursing through the use of personal testimonies from nurses. This film also

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provides the viewer with insight into how nurses solve these dilemmas. Achtenberg and Sawyer
(1983) declared, You cant be constantly examining, how do I feel about this, or you would be
diverting your attention away from the job at hand (B. Achtenberg & J. Sawyer, film, 1983).

Source: Thompson, I. E., Melia, K. M., Boyd, K.M., & Horsburgh, D. (2006). Nursing Ethics (5th
ed.). Philadelphia, PA: Churchill Livingstone Elsevier.

The image above presents the models for professional ethics and their use along with
their meaning. When discussing how nurses can become aware of their actions and oppressions,
Orlando (1990) stated; First she may act or attempt to act, and then find out whether the patient
was not helped or at least not distressed by it (p.91). It is important that if at any time after a
nurse feels that he/she has oppressed a patient and has not followed appropriate ethic standards,
the patient is to be asked if they were okay with any actions taken. It is important that nurses
provide care, as long as ethics are not overruled.

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Does the Chief Nursing Officer of University Medical Center in El Paso see
oppression in nursing as a rising issue within the medical field, and if so what
improvements can be made to reduce the amount of oppressing occurring in the nursing
field?
When asked this question, Joe Garcia, the Chief Nursing Officer at University Medical
Center, claimed that he did not see the profession of nursing as oppressive. When discussing the
matter of oppression Garcia stated The Nightingale Pledge is a statement of ethics and
principles of the nursing profession (Personal communication, April 2, 2016). When
discussing the pledge, Garcia went on to say, The pledge includes that nurses abstain from
anything mischievous and to nurse those who are ill or in need (Personal communication, April
2, 2016). It can be understood that this pledge does encourage nurses to provide care to the best
of their ability, without hurting their patients. The Nightingale Pledge is similar to an oath taken
by nurses to protect and serve.
To receive an outside perspective of oppression in nursing, Becky Ramos, a licensed
clinical social worker, was interviewed. Ramos is a former employee of the psychiatric ward at
University Medical Center; she also mentioned that she had the opportunity to work with
multiple nurses. When asked about oppression in nursing, she said that there is no sign of
oppression in nursing, but understood where the question arose from. Ramos expressed that,
Nurses rush and do not have enough time to develop a relationship with the patient (Personal
communication, April 2, 2016). As previously discussed, it is important for nurses to
comprehend the increasing multicultural society and Ramos agrees with this. Ramos emphasized

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that, Nurses need to learn about cultural sensitivity, because that can make a difference
(Personal communication, April 2, 2016). Nurses deal with patients originating from various
cultural backgrounds and oppression can occur if the patient and their values are not considered.
Both Joe Garcia and Becky Ramos did not see any signs of oppression within the field of
nursing, but both did mention steps that can be taken in order to prevent this issue from arising.
Garcia mentioned, In order to prevent the possibility of oppression, nurses must be more
involved in lobbying and becoming board members. All boards benefit from the unique
perspective of nurses to achieve goals of improved health at local, state, and national levels
(Personal communication, April 2, 2016). Mr. Garcia encourages nurses to be the change they
want to see in their field of work, and they can make all types of improvements within the health
care system. Ramos, on the other hand, approached the topic differently when she declared,
Nurses need to communicate with the patients and family, along with taking time to know their
patients. Getting to know their patients can make a difference (Personal communication, April
2, 2016). Ramos focuses more on the caring aspect in order to prevent oppression. Nonetheless,
both Joe Garcia and Becky Ramos agree that there are ways to prevent a future up rise in
oppression in nursing; however, it is currently not an issue that is in need of attention.
Considering that both Garcia and Ramos have been employed within the medical field and
University Medical Center there may be some bias within their statements. Both declared that
oppression in nursing is not a current issue; on the other hand, each individual did provide
prevention methods. If prevention methods are created for an issue that may arise in the future,
what is it to say that the issue may be currently present but not prominent.

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Conclusion

The issue of oppression in nursing is still rather debatable, but it is an issue that can
become more prominent in the nursing field if not taken care of. From this review of literature, it
can be concluded that ethics play a significant role when providing care for patients, which is
why it is important for nurses to acquire skills such as cultural sensitivity. The nursing profession
is challenging, yet rewarding when a patient is properly taken care of. Though professionals may
not perceive oppression in nursing as a rising issue it is still important. This issue still requires
extensive research, but oppression has no place within the field of nursing. Nurses heal not
oppress, and this needs to be addressed.

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References

Achtenberg, B. , & Sawyer, J. (1983). Code gray [Video file]. Retrieved from http://0docuseek2.com.lib.utep.edu/view/check/143742169810000000245100000594/1/0/0
Benjamin, M.,& Curtis, J. (2010). Ethics in nursing: Cases, principles, and reasoning (4th ed.).
New York, NY: Oxford University Press Inc.
Butts, J., & Rich, K. (2005). Nursing ethics: Across the curriculum and into practice. Sudbury,
MA: Jones and Bartlett Publishers, Inc.
Locsin, R. C., & Purnell, M. J. (2009). A contemporary nursing process: The (un)bearable
weight of knowing in nursing. New York, NY: Springer Publishing Company, LLC.
Orlando, I. J. (1990). The dynamic nurse-patient relationship. New York, NY: National League
for Nursing.
Selanders, L. (2015). Florence Nightingale | English nurse. Retrieved from
http://www.britannica.com/biography/Florence-Nightingale

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Appendix A
Interview Questions

This appendix consists of multiple interviews. When the interview process was started the
participants were asked questions pertaining to the issue of oppression in nursing. Both
participants were employed at University Medical Center and are unaware of one anothers
identity. Similar conclusions pertaining to oppression in nursing were derived from both
participants.
Participant 1: Joe Garcia
Oppression in Nursing Interview
This interview was conducted through email on April 2, 2016. The participant gave a
concise and well-rounded answer. The participant stayed on the topic of the question and
answered it fully, along with providing vital information from the Nightingale Pledge.

Does the Chief Nursing Officer of University Medical Center in El Paso see oppression in
nursing as a rising issue within the medical field, and if so what improvements can be made to
reduce the amount of oppressing occurring in the nursing field.
No, as the Chief Nursing Officer, I do not see nursing as being oppressed, in fact, nursing
is, the profession or practice of providing care for the sick and infirm. In fact, the literature
states that, The Nightingale Pledge is a statement of the ethics and principles of the nursing
profession. It included a vow to "abstain from whatever is deleterious and mischievous" and to
"zealously seek to nurse those who are ill wherever they may be and whenever they are in need."
In a 1935 revision to the pledge, (Gretter, 1953) widened the role of the nurse by including an
oath to become a "missioner of health" dedicated to the advancement of "human welfare"an

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expansion of nurses' bedside focus to an approach that encompassed public health. To prevent
the possibility of oppression, nurses must be more involved in lobbying and becoming board
members. All boards benefit from the unique perspective of nurses to achieve the goals of
improved health and efficient and effective health care systems at the local, state and national
levels.
As for the plan of care, that is specific to the patient based on the nursing diagnosis after
being assessed. Its a process and is a clinical judgment about individual, family, or community
experiences/responses to actual or potential health problems/life processes. If a nurse believes
that a treatment is cruel, that is more on a personal level, for example, abortions. That is the
deliberate termination of a human pregnancy, most often performed during the first 28 weeks of
pregnancy. The key word is deliberate. Again the nursing care plan helps nurses instantly write
customized care plans for their patients. It includes care plans for medical-surgical nursing,
maternity, pediatrics, and psychiatry.
Participant 2: Becky Ramos
Oppression in Nursing Interview
This interview was conducted on April 2, 2016 through phone call due to limited
availability. The participant answered the question concisely and did not stray from the topic.
The participant also provided insightful information on the importance of cultural sensitivity.

Is oppression in nursing a rising issue and if it is ,society perceives oppression in various ways;
in what manner are patients feeling oppressed due to the actions or procedures carried out by a
nurse?

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Oppression in nursing is not a current issue in the nursing field, but it can be prevented.
For some time now there has been a shortage of nurses in the health care field. Due to this nurses
rush and do not have enough time to develop a relationship with the patient. Nurses need to
communicate with the patients and family along with taking time to know their patients. Getting
to know their patients can make a difference. One other thing that is important is cultural
sensitivity. Nurses need to learn about cultural sensitivity; they are caring for so many patients
from various backgrounds. Learning about this will help nurses provide better care and prevent
oppression from rising. As I said before oppression in nursing is not a current issue but it can be
prevented, in fact nurses need to be made aware of it.