Extending the boundaries: Using critical social theory to improve understanding of violence in nursing as a cultural phenomenon

Critical social scholars acknowledge that in a world where injustice exists, power and privilege are produced and reproduced in order to maintain the status quo (Brookfield, 2005). However, when exploring the concept of hegemony, as developed by Antonio Gramsci (1971), it is possible to see how dominant ideas may be assimilated in peoples’ minds unconsciously. This uncritical acceptance of the status quo means that often, people fail to see injustice and may perpe- tuate it unconsciously. Within nursing, where experiences of injustice and adversity are common, it is important to extend the boundaries of knowledge around sources of violence so that change can be facilitated. This presentation discusses a critical social science study that explored nursing students’ experi- ences of adversity. Numerous studies focusing on professional socialisation of nursing students have revealed issues such as belittlement, isolation, and moral suffering and the negative impact on their learning. In keeping with the change agenda of critical social science, an important aim of the project was to elicit stories of adversity from nursing students, con- vert them into narratives, and embed them within lesson plans that could be used to prepare future nursing students for adverse conditions on clinical placement. A significant finding from the study has been that, for some students, the research process that facilitated reflection on their experi- ences of adversity raised their awareness of violence in health care settings. This new knowledge prompted a resolve in themselves to find solutions to manage future hostile encounters in a constructive manner. Students have been equipped with foresight, an important resilience resource. Another significant finding in this study is that both nursing students and educators agree that teachers need facilitative skills to help nursing students fully engage in learning about how to cope with culturally driven adversity. Thus, it is not just the preparation of lesson plans and learn- ing objects that are key to adversity awareness, but the skills of an empathetic and engaged educator.