Health is not a purely physical matter. It is strongly linked to a person’s life circumstances, collectively known as the social determinants of health (SDOH). The World Health Organization defines SDOH as “the conditions in which people are born, grow, live, work, and age that impact their health.” Examples include employment conditions, early childhood development, gender equity, public health programs, urbanization, among others.
Depending on a person’s life situation, their SDOH can lead to marked advantages or disadvantages in the health arena. Socially disadvantaged patients often face unfair burdens and obstacles and may have poor health literacy. Nurses, who treat people from every walk of life, are uniquely positioned to see these challenges. A strong sense of social justice, or the belief that all individuals deserve fair treatment regardless of their circumstances, can help nurses provide the best possible care for every patient in their charge.
When undergraduate nurses learn about social justice, they develop empathy. Because undergraduate nursing education provides the foundation for forensic nursing, learning about social justice is paramount to expanding the nursing specialty.
Integrating social justice concepts into the nursing curriculum and teaching nurses empathy is therefore a prime goal for nurse educators. The lessons are particularly important for undergraduates, who are absorbing the basics that will apply to possible future paths, including forensic nursing.
Knowing how to develop a productive learning environment that teaches social justice concepts is a skill that future nurse educators can obtain through academic programs such as Duquesne University’s online Master of Science in Nursing. Duquesne’s online master’s in nursing helps prepare students pursuing MSN careers for success in a variety of endeavors.
Social Justice in Forensic Nursing
A recent article on the website American Nurse looks at the role of social justice in forensic nursing. It discusses two completely opposite areas where forensic nurses can benefit from a strong foundation in social justice:
Dealing with crime victims.
Forensic nurses may be called in to help victims of violent crimes. They may, for example, serve as sexual assault nurse examiners (SANEs) for rape victims. In this capacity they must exercise extreme empathy for the patient while also collecting evidence for use in legal proceedings. A keen sense of the wrong the patient has endured can help the nurse provide compassionate care.
Forensic nurses may also encounter cases where abuse or violence is suspected. They must interact with potential victims to uncover the truth. Alternately, they may train other nurses to perform these functions. A concerned, caring nurse can be the difference between abuse going unnoticed or being reported.
Dealing with crime perpetrators.
Some forensic nurses work with prisoners in the corrections system. They may, for example, work with patients in prison medical or psychiatric wards. They may also perform psychological evaluations of death row inmates and other serious criminals, then report whether mitigating circumstances exist that might call for lightening the perpetrator’s sentence.
Although nothing can change the fact that these people committed crimes, a good forensic nurse understands the role that SDOH plays in each case. “Many perpetrators of violent crimes were victims of violence as children,” says Kathleen Sekula, forensics nurse expert and professor at Duquesne University. “That doesn’t excuse what they’ve done, but to help them you can’t lose sight of the fact that their psyche has changed because they were victims of violence themselves.”
Given the benefits of social justice awareness to all nurses, not just forensic nurses, nurse educators should understand the importance of integrating this content into educational programs at the BSN and even graduate levels. The Online Journal of Issues in Nursing offers a series of practical ways to make such a plan work:
Interprofessional education and collaboration.
Interprofessional education brings together students from different programs to solve problems. For example, nursing students might work with dentistry students. This approach brings different perspectives and skills to the table. When the problems to be solved involve SDOH, students gain a broader understanding of the issues.
Simulation exercises immerse students in scenarios that mimic the real world through props, actors, and other embellishments. Nursing educators can devise simulations involving patients affected by various SDOH. Students’ reactions can be noted and used as a springboard for discussion, teaching, and increased awareness.
Motivational interviewing and empathic enquiry.
Motivational interviewing is a technique used to question patients in a way that increases awareness of their own SDOH and possible solutions to issues. Empathic enquiry melds motivational interviewing with trauma-informed care for an even higher level of care and empathy in especially sensitive cases. Teaching these techniques gives students the tools to handle such situations in their future careers.
Student nurses benefit hugely from working directly with vulnerable and marginalized populations. By seeing SDOH and social injustice in action, they develop greater understanding and empathy for the people they serve.
These ideas are just a start. Creative nurse educators might take advantage of “flipped classroom” techniques where the students take the reins. They can also find ways to tuck social justice discussions into most topics, even when the lesson is not directly related to SDOH. By tackling this subject early and often, educators prepare future forensic nurses—and those heading to other specialties as well—to face the challenges of real-world patients in real-world situations.
About Duquesne University’s Online Master of Science in Nursing Program
Duquesne University’s MSN curriculum helps prepare RNs for a range of advanced nursing careers.
In addition to nursing education, Duquesne’s MSN program offers five other tracks: FNP, Forensic Nursing, Psychiatric-Mental Health Nurse Practitioner, Adult-Gerontology Acute Care Nurse Practitioner, and Executive Nurse Leadership and Healthcare Management.
The coursework is presented entirely online, so students can maintain their work and personal responsibilities while pursuing their educational goals.
For more information, contact Duquesne University today.
Social determinants of health and importance in nursing – Online Journal of Issues in Nursing
Importance of SDOH in forensic nursing – American Nurse
Social justice in forensic nursing – American Nurse
Curriculum integration – Online Journal of Issues in Nursing