Grant: Travel Awards - Institute Community Support

In Canada like elsewhere, social inequalities in health are threatening population health. Given this situation, what are the practices of nurses working in community health to ensure greater health equity? My doctoral research project combined oral history (12 interviews) and collaborative ethnography (420 hours in the field) with the nurses of the Pointe-Saint-Charles Community Clinic. 21 nurses and 11 ex-nurses from the Clinic participated in this research, from 2016 to 2018. Results highlight the contribution of personal (reciprocal relationship and therapeutic use of the self) and aesthetics (intuitions induced by experience) knowledge to the development of health equity practices. When confronted to people's living conditions and through exchanges with citizens, nurses open their scope of evaluation to include problems in the social and physical environment, as well as a consideration for people's life paths. They also shift the paradigm of intervention, from a controlled and predictable process of care to one that deals with unpredictability, while making themselves available in time, place and approach. Nurses then craft generic nursing interventions learned in school to adapt people's reality. Because the bureaucratic health care system fails to answer urgent needs of people living at disadvantage, nurses will often take immediate actions to alleviate scarcity of material resources and advocate for access to healthcare. At a collective level, nurses also initiate actions on social determinants of health. Through this presentation, I intend to restore the place of nursing knowledge historically undervalued within the nursing profession. Submerge in a liberal system of care, acting according to values of equity, inclusion, non-judgement and respect for the right to self-determination represents a political stance of nurses in favor of social justice.