Caring beyond nursing: politics from the South

In two previous editorials, ‘Parallel worlds’ and ‘The globalisation of Nursing Inquiry’, Sioban Nelson raises the issue of diversity in nursing thought across the world. I would like to pursue this idea by giving an example of how plurality embedded in distinct political, economic and geographical contexts can enrich nursing scholarship. Much has been said about globalisation and its adverse effects. In academic terms, the globalisation of nursing scholarship risks undermining local thinkers and treating nurses from less-industrialised countries merely as a group of epistemological consumers/readers. In the globalised world, academic knowledge might provide much-needed insight into nursing scholarship and practice, but might also disseminate neo-colonial truths which promote technological and informational dependency. Fortunately, reality is far more complex than our sloganised versions of it. Globalisation also means easier access to information and greater exposure to plurality in thinking. Whilst in Brazil recently, I went looking for what was new. I learned from a colleague that a new book (in its 4th printing) has been of great interest for nurses. The book, written by 1, prestigious thinker of the theology of liberation, is called Saber Cuidar[‘Knowing how to care’]. It is not a publication for academics, but rather is aimed at a broader audience. Caring, for many the central concept of nursing, is presented in the book as an essential human attribute. Using ecological–feminist ethics and a highly interdisciplinary approach, Boff conceptualises caring as affection as much as politics. He questions the current logic of work organisation and economic accumulation. He points out that caring became synonymous with femininity, nonobjectivity and inefficiency. Therefore, the fulfilment of the professional duty of caring is unachievable without a concurrent critique of the organisational structure of healthcare work and of the economic models attached to it. Whilst reading Boff’s work, which does not mention nursing, I could identify many issues of relevance to nursing scholarship, which is far too often apolitical in its view and analysis of care. From his perspective, the notion of caring is incongruent with the fragmentation of care provided by nurses and other professionals. For example, can we call it ‘caring’ when we provide technical and emotional support for patients who are later discharged to face deprivation in the inner city? ‘Caring’ also needs to relate to the ecological commitment that those who care should have. Caring requires a critical analysis of the effects of caring as a discourse — e.g., are we promoting high levels of consumption that are unaffordable to many as well as harmful for the environment? An issue regarding the politics of caring centres on the relationship between countries. Caring for the sick and poor of ‘Third World’ countries should entail changing the exploitative economic and cultural systems that perpetuate huge inequalities between countries and between groups of citizens within countries. Boff is just one example of how plurality can enrich nursing scholarship. The same politics that he identifies in caring is present in the ways we produce knowledge. In acknowledging the political nature of nursing thought and practice we have an opportunity to challenge the orthodoxy of neutral caring — an opportunity to understand nursing in its relationship to society and nations.

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