2nd Edition - Nursing advocacy is not only about reacting — it’s about reimagining what could be.
hUGO tAM
Ontario Tech University
Student Representative on the Board of Directors, Registered Nurses' Association of Ontario (RNAO)
Chair of the Nursing Students of Ontario, RNAO
To the Nursing Student reading this,
As nursing students, we are often immersed in our textbooks, clinical placements, and skills check-offs - but what if we broadened our views and considered ourselves as the architects of health systems that determine our health? Looking beyond vitals, charting, and bedside care lies a nearly infinite possibility: shaping health policies and systems that can influence health outcomes for entire communities. It is the hope I hold for our nursing students and those considering nursing as a career to find their voice.
Nurses make up the largest proportion of our healthcare systems globally and spend hours working closely with those we care for, from home care to hospitals, and long-term care. We witness firsthand how inequities, improper staffing ratios, and structural gaps - just to name a few, are detrimental to health outcomes. Our lived experience even prior to licensure gives us a deep understanding of patients' needs gives us a unique and essential voice to help shape health policy.
Yet despite our experience, most students are unprepared or unsure of how to engage in health policy and advocacy work. Current nursing curricula may include structured education in preparing students for health advocacy and policy engagement, the competence required to create real change remains indeterminate. Without increased foci on structured opportunities and framework development, ideas often go undeveloped.
Shifting our mindset away from just textbooks, clinical practice, and skills check-offs but instead, considering ourselves to take on broader roles to contribute to systems-level changes will help pave the way into a more equitable and just healthcare system. Influencing health policy does not take away our practical skills but rather - it strengthens our ability to be effective. Our shared compassion to care for others will be amplified through structural changes.
Rather than dream, we can create a future where nursing students do not just follow or react to policy changes. Instead, they will be the ones to inform, develop, and challenge them. However, to achieve this we must see ourselves beyond simply as just a nursing student as a mentor has told me in the past. We must shift our mindset and leverage our unique experiences and perspectives to address health inequities and injustices within healthcare.
Power to You all,
Afreen Kaur Gill
Douglas College Psychiatric Nursing Student
To the Nursing Student reading this,
If I could alter one mindset within nursing and health care, it would be the stigma surrounding mental health, as its implications go beyond health care professionals, patients, and the psychiatric nursing profession. Significant detrimental effects are also extended to societal systems, including public resources, the criminal justice system, and the general population.
Mental health stigmatization often leaves patients feeling marginalized, dismissed, misunderstood, or labeled rather than holistically cared for. This can result in delayed therapeutic interventions, compromised patients’ trust in the healthcare system, and clinically adverse results. Patients can sense judgement around mental health and may hesitate to disclose symptoms or seek help at all, especially if they believe their condition may not be treated with equivalent weight as a physical medical condition. Stigma also results in the fragmentation of care, where mental health is treated as separate or less legitimate than other sections of healthcare. Additionally, stigma can generate task-focused care, where patients are perceived as diagnoses or checklists instead of whole people with lived experiences, beliefs, and emotions. Connecting to the person beyond pathology and the diagnosis is vital to constructing effective therapeutic relationship, fostering dignity, and facilitating holistic patient-centered care.
Additionally, mental health stigma extends to psychiatric nursing as a professional specialty. Psychiatric nursing is frequently perceived as practicing in a “lesser” field, despite their skill sets for managing complex, high-risk, and clinically significant patient care. Such misperceptions may discourage nurses from entering the specialty, resulting in inadequate resource allocation for mental health services, and reinforce the misconception that psychiatric care is less essential than other areas of nursing. These consequences impact health care as a whole, as shortages of adequately trained psychiatric nurses may result in registered nurses and other providers assuming responsibilities for which they may have limited specialized mental health training. Registered psychiatric nurses attain expertise in attending the intersection of mental health conditions and medical comorbidities, which is not as extensively emphasized in general nursing education. Destigmatizing mental health care would therefore not only benefit patients, the psychiatric nursing profession, and health care as a whole, but many interlinked systems within the society and the general public.