1. Brown, Doris MSN

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This letter is in response to the April-June 2017 article, "Returning to the Profession's Roots: Social Justice in Nursing Education for the 21st Century." I read with great interest the authors call for nursing to return to its roots and agree wholeheartedly with the authors that it is necessary to integrate social justice as a core concept throughout the nursing curriculum. Integration of social justice into the nursing school curriculum is not a unique concept; however, the authors did a phenomenal job of laying out the case for integration, and this new passionate call for action is greatly needed.


It is my belief that the focus has already shifted toward integration of social justice within the curriculum of prelicensure nursing programs. Social justice was embraced within the American Nurses Association's 2015 Code of Ethics With Interpretive Statements1 and is one of its priorities. The American Association of Colleges of Nursing (AACN) "The Essentials of Baccalaureate Education for Professional Nursing Practice"2 2008 document, Essential Eight, postulates that "professionalism and the inherent values of altruism, autonomy, human dignity, integrity, and social justice are fundamental to the discipline of nursing."(P4) That may have been the catalyst, since most undergraduate nursing program curriculum objectives now include social justice as part of their outcomes. However, although AACN Essentials document "serves to transform baccalaureate nursing education by providing the curricular elements and framework for building the baccalaureate nursing curriculum for the 21st century," it does not provide a well-articulated strategy for developing a social justice curriculum. Nursing education is now challenged to effectively weave social justice into its curriculum with a pedagogical approach that provides students with a professional foundation that is inclusive of the skill set required to ignite activism. They are being charged to do this without specific guidance and must be cognizant of the substance of the prelicensure social justice student competencies and point of introduction into the curricular content.


An area of great importance that was not covered in this article are the challenges to the integration of social justice content throughout the nursing curriculum. "Racism and all its manifestations are an integral part of workplace settings, especially in higher education institutions."3 The elephant in the room is institutional racism in academia, which must be investigated and eliminated before there can be successful integration of social justice within the nursing curriculum. Also, as the authors clearly acknowledged, once nurses leave the prelicensure program, they work within the oppressive institutional structure that dictates their work environment, which makes social justice engagement difficult. Elimination of institutionalized racism within health care systems is perhaps the greatest challenge that we must overcome in order for nurses to become more actively engaged in social justice actions. I wonder what would be the impact if organizations such as The Joint Commission stipulates the demonstrations of social justice outcomes as one of its requirement. Undertaking social justice curriculum initiatives comes with the challenge of getting all faculty members on board and then training and equipping the faculty with the tools to effectively cultivate social justice skills. Decision on the most effective method to present social justice content while building a more inclusive campus environment also comes with its challenges. Continuous improvement and ongoing professional development are an expectation; all nurses including nurse educators and I agree with the authors suggested use of continuing education to improve educator's knowledge and expertise.


I am grateful to the authors for their leadership in bringing this topic to the forefront once more. Social justice actions are critical to the obliteration of the various injustices that adversely impact the marginalized in our society, and reshaping the nursing prelicensure program curriculum to include social justice is crucial. I propose that the AACN do more than espouse social justice as part of its essentials; it should provide more leadership by synthesizing all the various evidence-based social justice educational strategies and put forward specific guidelines to assist and streamline the integration of social justice throughout the prelicensure nursing curriculum. I also challenge institutions offering nursing programs to devise strategies to overcome barriers to the integration of social justice content throughout the nursing curriculum.


-Doris Brown, MSN


College of Nursing


Barry University


Miami, Florida






1. American Nurses Association. Code of ethics for nurses with interpretive statements. Published 2015. Accessed July 9, 2017. [Context Link]


2. American Association of Colleges of Nursing. The Essentials of Baccalaureate Education for Professional Nursing Practice. Washington, DC: American Association of Colleges of Nursing; 2008. [Context Link]


3. Wingfield AH, Alston RS. Maintaining hierarchies in predominantly white organizations: A theory of racial tasks. Am Behav Sci. 2014;58:274-287. [Context Link]