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Posts tagged ‘Lucy Mkandawire-Valhmu’

Emancipatory Cultural Competency in Nursing

We are delighted to introduce the current ANS featured article, titled “An Emancipatory Approach to Cultural Competency: The Application of Critical Race, Postcolonial, and Intersectionality Theories” authored by Linda M. Wesp, MSN, RN, FNP-BC; Victoria Scheer, BSN, RN; Ashley Ruiz, BSN, RN; Kimberly Walker, MSN, RN, CHPN; Jennifer Weitzel, MS, RN; Leslie Shaw, MSN, RN, ACNP-BC; Peninnah M. Kako, PhD, RN, FNP-BC; and Lucy Mkandawire-Valhmu, PhD, RN. In this article the authors address the critical need for approaches in nursing education, research and practice that uphold the core nursing value of commitment to social justice.  Download a copy of this article at no cost while it is featured, and share you comments and ideas about these ideas on this blog!  Here is more information about this work from the authors:

Linda M. Wesp

Emancipatory \ i-​ˈman(t)-​sə-​pə-​ˌtȯr-​ē\ (adjective): freeing from any controlling influence1

As peers pursuing a PhD in nursing at University of Wisconsin-Milwaukee, we have found common ground with our professors Dr. Lucy Mkandawire-Valhmu and Dr. Peninnah Kako in a passion for learning about and using critical and feminist theory to shape our thinking and our work, especially intersectionality, critical race theory, and postcolonial feminisms.  The idea of this paper was originally born from several brainstorming sessions between Linda Wesp and Victoria Scheer. As we sat and talked and thought, we kept coming back to our common frustration that the theories we were finding so helpful

Victoria Scheer

and informative in our research were not being talked about in nursing or health care at all, outside of a few PhD level classes.

Early in 2018, Dr. Mkandawire-Valhmu encouraged the group of us using critical theories in our research to join forces with one another and challenged us to think about how we could take these theories and apply them.  The special ANS issue on emancipatory nursing seemed like the perfect fit for the ideas we were already tossing around about various areas of the nursing profession that would benefit from a more critical approach.  Each of us brought a specific working knowledge about the various

Ashley Ruiz

theories we used for this paper, whether intersectionality theory, critical race theory, or postcolonial feminist theory.  One of the main goals of our project was to intentionally and carefully distill the main ideas of these theories and make them understandable and applicable for nurses who may be unfamiliar with them (see Figure).

As we considered our experiences as clinicians, educators, and scholars, we decided that the way nursing approaches “cultural competency” could benefit greatly from the tenets outlined in the various critical theories.  As it is currently conceptualized, “cultural competency” in nursing (and across all health care settings) does not

Kimberly Walker

provide nurses with the tools to identify and disrupt the major structural processes and oppressive ideologies that create marginalization and inequity.  These ideologies are a controlling influence on our profession and health care as a whole. And so, we thought, what if we could outline specific ways to bring an emancipatory approach to our current understanding of cultural competency?  We began in our knowledge of the theories that seek to disrupt oppression and hegemonic thinking that create health inequities, and used this to come up with tools to equip nurses with new ways of thinking about and caring for populations that are different from them (even, and especially, for nurses who are well intentioned and think they are being “culturally competent”).

Jennifer Weitzel

Diving deeply into the theories as we prepared this paper meant we had to do our own personal work about how power and privilege works in our own lives, and think about our own approach to caring for people who are different than us. We also thought a lot about the ways that power and privilege play out in the academy and in our health care institutions, and what that means for us as nurses occupying positions that are generally considered “less powerful.”  These are not always easy realizations,

Leslie Shaw

especially for people who benefit from having more power and privilege because of the color of our skin, or our gender identity, or the country where we were born, or the letters behind our name.

We do not take lightly the magnitude of the emancipatory approach we are proposing here, and yet we feel deeply that we must continue to push for change.  We as nurses must continue to understand how power and privilege work to create and maintain difference and inequality in our

Peninnah M. Kako

world.  Continuing to approach difference in the ways we always have will mean that we completely misunderstand and erase certain populations (e.g. people of transgender experience) and/or that we continue to create unintentional and implicit bias for other populations (e.g. people who experience racialization and are therefore considered “racial or ethnic minorities” in the U.S.).

We hope that this paper is just the beginning of a larger conversation within our profession that can create much needed dialogue and change.  Also, we have so many more ideas to talk about!  We hope to spark ongoing

Lucy Mkandawire-Valhmu

ideas, that might begin with questions like: Where else have nurses already been applying an emancipatory approach to cultural competency, as we suggested here, in our educational and clinical programs?  What does it look like for nurses to remain self-reflexive about our own biases?  How does implicit bias contribute to inequitable patient outcomes?  What would it look like for the nursing profession to shift from the phrase “cultural competency” to the concept of cultural safety2, which more accurately represents the emancipatory approach we suggest here?

What have you already been doing or thinking about in this area? We would love to hear from you. As the largest health profession in the U.S., we can create a slow and steady shift that leads to lasting change and health equity for all people.  Please share your thoughts, publish your experiences, and let’s keep the conversation going!


  1. Merriam-Webster Dictionary. Available at: Accessed October 31, 2018.
  2. Mkandawire-Valhmu L. Cultural Safety, Healthcare and Vulnerable Populations: A Critical Theoretical Perspective: Routledge; 2018.



Global Policy and Women’s Health

Our first feature from the latest issue of ANS is titled “Raising Questions About Capitalist Globalization and Universalizing Views on Women: A Transnational Feminist Critique of theWorld Development Report: Gender Equality and Development” by Victoria L. Scheer, BSN, RN; Patricia E. Stevens, PhD, RN, FAAN and Lucy Mkandawire-Valhmu, PhD, RN. The article is available to download at no cost while it is featured!

The authors offer a critique of an important global policy document focussed on women’s health, and the way in which this policy document problematically represents women living in low-income countries.  The authors offer an alternative policy approach, emphasizing the important role that nurses can play in creating better global policy. Victoria Scheer sent this message about her work in this area, and invites readers to engage in discussion of their ideas:

It is a great honor to have this article chosen to be highlighted in the Advances in Nursing Science blog. This article was originally conceived from a project taken on as part of my doctoral course work. While taking a

Victoria Sheer

Victoria Scheer

feminist theory course offered in the Women’s and Gender Studies department, I found there to be a disconnect between the critical feminist standpoints I was reading, and what I often read within nursing literature. Specifically, I found there to be a dearth of critical analyses of international policies drawing on transnational and postcolonial feminist perspectives.

Given the recent release of the Sustainable Development Goals, an agenda undertaken across the globe, it seems both timely and imperative to integrate a perspective that centers women and focuses on the social, economic, and political determinants of health within the context of transnationalism and globalization.

With guidance and collaboration from co-authors Dr. Stevens and Dr. Mkandawire-

Lucy Mkandawire-Valhmu

Lucy Mkandawire-Valhmu

Valhmu, we are pleased to offer this critique of the World Bank’s 2012 World Development Report: Gender Equality and Development. Framed through a transnational feminist lens, we challenge the capitalist framework underpinning the agenda outlined in the Report, as well as the language used that we argue problematically represents women living in low-income countries. Through this analysis, we sought to demonstrate how economic globalization, unabated development, and misrepresentation may have negative implications in the lives of the world’s most marginalized women.

Nurses have a significant role to play in the international policy arena, and I hope this

Pat Stevens

Pat Stevens in Malawi

article provides a persuasive example of how a transnational feminist viewpoint may prove useful to advancing gender equality and social justice for women located in resource poor-countries, as well as those located in high income countries yet excluded from the benefits of modern capitalist states. We would also like to thank Dr. Chinn for the opportunity to share this article and look forward to hearing any feedback!

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