Chrissy Hembrook

N-557 01
06/08/2021
Upstream Nursing Practice, Social Justice Advocacy Discussion

In part, nurses work to: build rapport, assess a patient’s health, determine potential risk

factors, and provide education. However, I would also argue that nurses have a unique

opportunity to do more than just the tasks outlines above. Nurses have the intelligence,

compassion, and resources to assess the patient holistically. They must identify social

determinants of health, as well as interpret how these determinants play a role in the patient’s

daily life, and ultimately assess this impact on their health outcomes. Social determinants of

health include level of educational attainment, economic stability, access to healthcare,

community context, and the built environment or neighborhood setting.

Bekemeier’s statements mirror my thoughts, as she asserts that: nursing cannot neglect to

address the social determinants of health if it intends to optimize health promotion for all

individuals within a community (Bekemeier, 2008). The readings provided this week illustrated

that we must not only address the social determinants of health, but we must also use this

information to foster conversations and collaborate with other nurses. In other words, nurses are

additionally responsible for spreading the word between colleagues to bring these issues into the

forefront of the healthcare provider’s mind.

However, she continues to delve into how nurses can make a positive impact to help

provide lines of resistance against these social stressors, stating that: nurses are obligated to

participate in the political process, because it holds the power needed to address these upstream

concerns, also described as the root cause(s) of public health crises; even going as far to say that,

“the public should (and perhaps does) expect this of us[nurses]” (Bekemeier, 2008). I fully agree

with this statement because social justice advocacy requires the unique perspective of the nurse,
Chrissy Hembrook
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and her participation, to be the most effective. The reality is that nurses cannot accomplish

systemic change alone; they must collaborate with others to bring about political change in

reference to upstream determinants of health. It’s important to reiterate that social justice

advocacy is not necessarily straightforward. It requires nursing leaders to first “determine how

social justice advocacy can be operationalized and remunerated” (Paquin, 2011).

When I become a Registered Nurse, social justice advocacy will be prioritized in the

ways in which I provide care for my patients. I will be an advocate for the individuals in my

community by making sure to ask questions that address the social determinants of health. As

well, I will work with nurses on my floor to share the current upstream stressors that are the most

significant for the current period. I will encourage my peers to participate in collaboration with

outside organizations that will help us provide legitimate, up-to-date information to

representatives and policy makers.

Chrissy Hembrook
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06/08/2021
References

Bekemeier B. "Upstream" nursing practice and research. Appl Nurs Res. 2008

Feb;21(1):50-2. doi: 10.1016/j.apnr.2007.11.002. PMID: 18226764.

Paquin SO. Social justice advocacy in nursing: what is it? How do we get there? Creat Nurs.

2011;17(2):63-7. doi: 10.1891/1078-4535.17.2.63. PMID: 21563632.