Advocacy is intrinsically bound to nursing though our history and the principles of the Nursing Code of Ethics (ANA, 2015). The American Nurses Association and the American Association of Colleges of Nursing state that nurses must advocate for social justice. The AACN Essentials of Baccalaureate Education defines social justice in nursing as exemplified by nurses acting “in accordance with fair treatment regardless of economic status, race, ethnicity, age, citizenship, disability or sexual orientation” (AACN, 2008 p. 28). Thus, nurses must not only understand the concept of social justice, they must be aware of health disparities and unconscious bias that can become a barrier to treating all clients with respect, dignity, and equality. This begins with developing self-awareness and advocacy skills to support recognition and a desire to act to confront and ameliorate social injustices nurses encounter in practice (Einhellig, Gryskiewicz & Hummel, 2016).
Unconscious bias, stigma, and fear create barriers to providing empathic interventions for incarcerated individuals in healthcare settings (Marlow et al., 2015). Care provided tends to be perfunctory rather than altruistic (Crampton & Turner, 2015). Judgments and stereotyping create a context in which care is devoid of compassion and social injustice can flourish (Ashton, 2017). This qualitative study explored the impact of teaching a social justice and advocacy course using an immersive, experiential pedagogy within a prison. The course was designed to promote self-awareness, self-expression, empathy, and authentic connection while exploring social justice through the lens of privilege and oppression.
Methods:
This qualitative descriptive study explored the impact of teaching a social justice and advocacy course using the Inside Out pedagogy (http://www.insideoutcenter.org). Course impact papers from 29 undergraduate nursing students enrolled in an Inside Out Prison Exchange Course on social justice and advocacy were analyzed to identify themes. The resulting thematic analysis was linked to Segal’s (2011) model of social empathy.
Results:
Themes included: empathy/connection, self-other awareness, transformation, macro perspective shifts and insights, and igniting passion/desire to advocate for social justice. Findings provided evidence of student transformation from fear of “other” to one of empathic connection and understanding of the lived experience of incarceration. This resulted in student commitment to social justice principles and embracing the role of advocate and change agent.
Conclusion:
Experiential learning offers the opportunity to challenge assumptions and biases, providing a place of possibility for connection, social empathy and stimulating a desire among nursing students to advocate for social justice. Students developed a contextual understanding of the experience of incarcerated individuals which led to the development of social empathy and provided a transformative educational experience. Students left the course reporting an understanding of the importance of social justice in nursing with a reported passion to advocate for compassionate care of incarcerated individuals.