Rogers' Science of Unitary Human Beings (SUHB) and several theories that emanate from Rogers' work contain foundational concepts that may lend themselves toward nursing actions to address important social justice mandates, to advocate and to act for equity, and to uproot systems of oppression and racism in nursing. However, at the same time, theoretical concepts such as power arising from ascendant theories of SUHB are often used with little to no critical reflection for past and present-day histories of racism and power inequities in nursing and in society writ large. Using concepts related to SUHB such as integrality, turbulence, power, and patterning, we critically explore the potential of developing anti-racism reflections and actions through 3 theories: Barrett's Knowing Participation in Change; Butcher's Kaleidoscoping in Life's Turbulence; and Smith's Turbulence-Ease in the Rhythmic Flow of Patterning. We acknowledge that SUHB was/is largely developed within a framework of whiteness by scholars who were/are working from academic positions and social identities of societal safety and privilege. This requires nurses to reflect on how that history shapes SUHB. We also acknowledge the urgent need for ongoing anti-racism and justice work by nurses. As a call to action, we suggest a start by critically building upon existing theoretical foundations in SUHB to develop a more explicit anti-racist theorizing-praxis in nursing for the wellbecoming of humans and nonhumans alike.
Nou pa ka separe pwoblèm sante ak pwoblèm sosyal nan mond lan. [English translation: Health problems cannot be separated from the world's social ills].
Creole
Ideas for this article arose in the summer 2020 -- the epoch of the COVID-19 pandemic, in reaction to multiple police murders, and the unending pattern of violence toward Black people in the United States and around the planet. We authors understand the dominating forces of white supremacy and structural racism also impact Latina/o/x, Indigenous and First Nation People, and other People and Nurses of Color. We acknowledge that the discipline of nursing and nurses themselves participate in and contribute to racist and violently oppressive systems. We understand an anti-racist present/future in nursing is urgently needed and that change is necessary and possible. We suggest critically building upon existing theoretical foundations in Science of Unitary Human Beings (SUHB) to develop a more explicit anti-racist theorizing-praxis in nursing for the wellbecoming of humans and nonhumans alike. But before we start, we feel it is important to situate our ideas in current and historical contexts.
Nurses are currently living and working within complex structures that create and uphold social, economic, and health inequities with grim manifestations for the people and communities we care with and for, and for nurses as well. Collectively, as nurses living and working in the United States, we witness the overturning of decades of legal precedents that protected basic civil rights, bodily rights, and environmental and multispecies protections. We note rising political and ideological authoritarianism, persistent economic inequities, escalating gun violence, and a once-in-a-century pandemic. In the United States, human and nonhuman alike currently confront living in a rapidly deteriorating planet because of persistent human actions, inactions, and denial. In 2021, one in 3 Americans live in a county hit by a disastrous weather event, with deaths disproportionately affecting historically excluded and structurally underserved groups, including nurses.
State legislatures, and national and local organizations, have and are enacting authoritarian movements to restrict teaching or talking to students about historical racism in places of learning. The erasure of history past and present creates forbidden knowledge that impacts nurses, the nursing profession and the people and communities for whom we care (see AAPF.org/truthbetold). The confluence of planetary and sociopolitical events shines a light on an unsettling pattern of disparity and inequity that impacts many people and communities who are Black, Latina/o/x, Indigenous and First Nation People, Asian, Pacific Islander, and other People of Color in the United States. Inequity impacts nurses who died of COVID-19 at disparate rates in the United States, especially Filipino and Black nurses. The urgent question for nurses interested in actions for health equity and social change is how can nurses use thinking practices such as Roger's SUHB, and the theories emanating from it, to address critical issues of anti-racism, equity, and justice for human and nonhuman environment wellbecoming? Rogers taught us that the past is present in the now and in the future. Critical historical reckoning alongside anti-racism theorizing and practice are nursing modalities based in unitary integrality with potential for anti-racism actions that can be actively applied to praxis, research, education, and policy.
We briefly outline Rogers' SUHB using core concepts of integrality and related concepts of turbulence, kaleidoscoping, and power. We focus on 3 theories emanated from SUHB that can provide philosophical and theoretical connections to address important social justice mandates, to advocate and act for health equity, and to uproot systems of oppression and racism in nursing. We start by examining Barrett's Power as Knowing Participation in Change and then Butcher's Kaleidoscoping in Life Turbulence. We end with Smith's Turbulence-Ease in the Rhythmic Flow of Patterning.
OUR POSITIONALITY
Together, we authors are the embodiment of SUHB -- unitary open energy fields, unpredictability, pandimensionality, and patterning. Leveille-Tulce is a Black Haitian woman born in the first free Black republic, labeled the most impoverished country in the Western hemisphere. Hopkins-Walsh is a white woman born in the United States, one of the most privileged and powerful nations. When Haiti gained independence from colonial rule in 1804 after the successful revolution of formally enslaved people, the US government stubbornly refused to acknowledge Haiti's freedom years after it was declared free. Current events reveal persistent anti-Black power dynamics between the United States and Haiti. For example, Haitian people who are immigrants, migrants, and asylum seekers to the United States currently experience some of the most violent border policing and border discrimination practices today and were publicly disparaged by a former president. These historical and current-day entanglements within racist and oppressive pattern shape our collective positionalities, as well as inspire and inform our commitment to social justice work in nursing. We used SUHB as a framework for our nursing doctoral research while working alongside historically marginalized and structurally excluded populations.
DEFINING KEY TERMS
Our definition of anti-racism draws upon the work of Dr Camara Jones and Dr Ibram X. Kendi. Jones urges scholars to ask "How is racism working here," a question that can be framed in SUHB as "What are the catalysts and the pattern manifestations of racism?" From Kendi we draw upon the idea that there is no in-between space between being racist and nonracist. There is only racism and anti-racism. One is either racist endorsing racial hierarchy or anti-racist where you understand racism as embedded in systems of power and policy and actively work to undo those systems. Applying an anti-racist approach to nursing requires deliberate and intentional cultural shifts. Jones' and Kendi's definitions of anti-racism are action oriented and link to uncovering root causes of racism found in unequitable and historically oppressive systems of power. Social justice is defined using the definition from the John Lewis Institute for Social Justice as equity in the distribution of wealth, opportunities, and privileges, including physical, emotional, and spiritual safety within a society. We draw upon the definition of health equity from Jones and Jones et al: "Health equity is a process, including assurance of the conditions for optimal health for all people, which requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need."
BRIEF BACKGROUND ON THE SOCIAL JUSTICE IDEAS WITHIN SUHB
Martha Rogers is often described as a visionary nurse leader and a radical thinker for her time. In Rogers' 1970 book An Introduction to the Theoretical Basis of Nursing, Rogers commented on sociopolitical issues, inspiring a call to nurses for social justice action. Rogers developed the foundations of SUHB for nurses to be cognizant of and to engage together in the struggle for social justice. Rogers' 1970 book extolled that nursing must also address prevention and correction of health problems and especially the problems that emanate from social inequities. Rogers also added the importance of paying attention to the complexities of technological advances and contemporary events to maintain and promote health. Rogers wrote: "To maintain and promote health we must add prevention and correction of health problems including those stemming from social inequities, technological advances and other events on the public scene." More than 50 years after this publication, nurses can build connections to current social, technological, and environmental patterns. For example, descriptions of technological inequities today would be disadvantages that economically oppressed and historically excluded communities have with regard to nonequitable access to broadband internet services. This "digital divide" is framed as not merely a technological problem but a social problem. Inequitable access to broadband internet exacerbated health and educational inequities, made especially visible during the COVID-19 pandemic where vast regions of the United States were unable to access online school options and virtual telehealth care. Systems of oppression in technology discriminate both by intention and by design, perpetuating power imbalances and social inequities. Building upon Rogers' vision for social justice creates a broad range of opportunities in SUHB for nurses to reach across disciplines to use the artscience of nursing and to guide their research and practice to develop modalities for human environment wellbecoming. Although Rogers encouraged nurses to attend and act upon social inequities, we see that the justice thread in her work seemed to drop after the 1970 book.
A core assumption of SUHB is that unitary humans, and the science and theories themselves that evolve from the science, are not fixed or static but always changing and moving forward, dynamic, and unpredictable. We authors continue to ground our thinking in witnessing the social and economic inequalities that exist in the past and present-day planetary tumult, and we intend to apply critical analyses to concepts of power. We situate our theorizing in material time space, as witnesses to the open systems that are the integral human-nonhuman planetary environment. Importantly, we must remember that the goal of anti-racism theory and practice for nursing is not abstract. It is not simply to expand creative potential, to educate ourselves, or to invite intellectual curiosity. The goal of anti-racism work by nurses is harm reduction and improved health equity. As Rogers wrote, it is nursing people in their world. Locating and naming the inequity are not enough. This urgent call to action for anti-racism work in nursing, for critical theorizing and praxis cannot wait. The gravity of this call to action must not be minimized, ignored, or silenced. Critical historical reckoning alongside anti-racism theorizing and practice are nursing modalities based in unitary integrality.
BRIEF REVIEW OF SUHB
Rogers' 1992 principles of homeodynamics are foundational to SUHB and to the 3 theories that are discussed in this article. Despite the inspiration for social justice action that we authors glean from the Rogers' 1970 book, present-day Rogerian scholars argue that Rogers' 1992 article Nursing in the Space Age is the preferable -- some even say the only acceptable -- citation to understand the updated theoretical principles and postulates, especially for scholars who are new to the science. Rogers' 1992 article outlined differences in the "older and newer world views" and introduced new terminology for SUHB such as pandimensional, integral, and becoming. Using the 1970 book before one gets familiarized with the newer 1992 article may rob new scholars of the evolution of the principle and postulates and appreciation of the knowledge shift from the old to Rogers' newer worldviews. Phillips wrote extensively about the changes that occurred after Rogers' 1970 book, describing SUHB as an evolving science and outlining how important concepts such as pandimensionality advanced between the time frame of the 1970 book and the publishing of the 1992 article. The updated principles Rogers outlined in the 1992 article define resonancy, helicy, and integrality. Rogers described these as:
Resonancy: continuous change from lower to higher frequency wave patterns in human and environmental field; Helicy: continuous innovative unpredictable, increasing diversity of human and environmental field patterns; Integrality: continuous mutual human field and environmental field process.
The 3 principles of resonancy, helicy, and integrality form the basis of many theories that emanate from SUHB. What SUHB principles share is an emphasis on the word "continuous" in relation to wave pattern, human environment pattern, and processes. Furthermore, Rogers' writing suggested that the unitary underpinnings of SUHB do not preclude us from looking at the specific, and this idea is a key concept of anti-racism theorizing and action. Unitary does not imply universal or universality. Unitary implies integrality that is situation and context specific, unpredictable, diverse, and unique. Our entry into unitary anti-racist nursing praxis in this article is through the SUHB principle of integrality.
INTEGRALITY
Integrality implies that we are integral. "Planet earth is integral with the larger world of human reality." In our view, Rogers was suggesting that we -- humans and multispecies alike -- are evolving in mutual process and what affects one affects all and our environment. Nurses are increasingly advancing Black feminist thought and critical posthuman theorizing to decenter assumptions of Eurocentric humanism in nursing, in favor of nonhierarchical integral planetary human multispecies frameworks. Sanderson et al outline how traditional teachings of Indigenous Peoples "offer compelling solutions towards health for all." SUHB assumptions support nonhierarchical integrality of humans and all matter of the environmental field. This theorizing flows with philosophies of traditional ecological knowledges of Indigenous and First Nations Peoples; yet, connections to traditional knowledges in SUHB are underdeveloped, uncited -- erasures that reinscribe whiteness and Eurocentric theorizing.
In moving the principle of integrality within SUHB toward more explicit and intentional anti-racist theorizing, we critically note that the pattern manifestation may not be the same for all, including the idea that power field pattern is not equitable. Feminist philosopher Rosi Braidotti refers to this idea as: We are in this together but we are not the same. This article highlights the anti-racism potentials in understanding the integral connections of all people, all matter, and environment. Also, it critically examines power and the implications for wellbecoming found in SUHB, while understanding integrality as "change begets change, and change in any parts creates change in the whole." Rogerian scholars have expanded upon Rogers' idea of integrality, as boundarylessness -- a world of no boundaries -- human-nonhuman planetary environment. For example, Newman noted that "others support the premise of no boundaries," citing Cowling, who wrote: "All things are integral -- what appears to be boundary is really artificial -- there is no true local event in a world of integrality." Integrality then becomes a way of critically explaining and acting upon and within contemporary life worlds including social inequities, racialized injustices, the experience of living in the COVID-19 pandemic, global climate disaster, and planetary destruction.
The energy field that consists of the human field and the environmental field is a key idea within the principle of integrality in SUHB. Energy field is the "fundamental unit of the living and the nonliving." The fields evolve in continuous mutual process. This idea centers integral oneness and expands views of human-nonhuman integral environmental welllbecoming.
The SUHB concepts we just described are integrated into the 3 theories that we review next. All 3 theories relate to 1 or more of the principles of homeodynamics, resonancy, helicy, and integrality.
BARRETT'S KNOWING PARTICIPATION IN CHANGE
Barett's Power as Knowing Participation in Change emanates from Rogers' SUHB and is rooted in attention to people's ability to knowingly participate in change. Barrett stipulates that power is an innate attribute that everybody has; however, at times depending on situated life circumstances, people may experience feelings of powerlessness. Although Barrett acknowledged the different forms of power such as constructive versus destructive, beneficial versus detrimental, she nevertheless stressed that the focus should not be on the forms of power but rather on the differences. For example, in 2015, Barrett mapped out the similarities and differences between power as control and power as freedom and warned us as nurses to differentiate between them. Both types used the 4 dimensions of power -- awareness, choice, freedom, and involvement in creating change. The difference in power stems from the intention with which power is used and its manifestation. Power as control seeks to control and is causal, and power as freedom seeks to liberate and is acausal. To measure power, Barrett first developed the Power as Knowing Participation Tool Version II (PKPCT VII).
Later, Barrett and Malinski developed the short form of the tool. Barrett assumes that power can be enhanced by health patterning, which increases potential for change by exploring the different ways people experience these changes. Health patterning modalities are tools to facilitate potential for change and "help people use their power in new ways." The theory has been widely used in nursing. It is estimated that the power theory and the tool have been used in about 90 studies in the United States and other countries.
The tool is translated in several languages such as "Japanese, Korean, Swedish, Danish, Portuguese, French, and German" and in Haitian Creole. Barrett successfully used health patterning modalities such as guided imagery and the tool in her private nursing practice to help people identify their power profile and actualize their wellbecoming.
The epistemological and ontological underpinning of Barrett's theory makes it a suitable framework for studies that examine people's and nurses' ability to knowingly participate in change related to racism, social inequities, inequalities, and their ill manifestations. It is also well suited to frame modalities that mutually engage nurses and people in creating change for the wellbecoming of people and communities most affected by inequities of power. We propose the use of modalities that center lived experiences, storytelling, and guided imagery framed within a unitary context to increase nurses' awareness about their own racism.
Barrett's theory has been successfully used in quantitative and qualitative research to examine the importance of health patterning modality in enhancing power in historically marginalized, underserved, and disadvantaged populations. Joseph used Barrett's theory to demonstrate the importance of folklore as a health patterning modality with Afro-Caribbean people. Her research findings suggest that health care professionals should acknowledge the use of folk medicine and encourage patients to use folk medicine alongside traditional treatments. She was able to demonstrate how the use of folk medicine among this population is anchored in self-awareness. Leveille-Tulce used the theory to develop a health patterning modality and frame her nursing research to measure power of a disadvantaged and underserved sample in Haiti. The research not only revealed high power profiles for participants before their participation in the health patterning modality but also showed a significant increase in power after participants' participation in the health modality. It suggests the innate characteristic of power as freedom and the importance of using health modalities that encompass education and resources to support and enhance power.
To ground future work in anti-racism, nurses must critically attend to the nuances between power as freedom and power as control within structures and systems, as well as examine the forces, laws, and policies that keep them apart. Racism hurts both the victim and the perpetrator and is anchored in power as control. Actions that rectify the destructive and harmful manifestations of racism are anchored in power as freedom. According to Barrett, power as freedom liberates and power as control constrains.
BUTCHER KALEIDOSCOPING IN LIFE'S TURBULENCE
Butcher contributes to SUHB through dedicated SUHB research and scholarship, creatively blending theory with both the science and the art of nursing. His writings and presentations weave nature narratives with metaphor and connections to human, nonhuman matter in unitary oneness. For example, the "timeless shimmering dance of turbulence that springs from Seurat's painting" inspired Butcher to further develop the concept of kaleidoscoping into a theory grounded within SUHB. Kaleidoscope is a metaphor used by Rogers to convey the continuous changing nature of pattern. According to Rogers, organization of the living system is kept afloat through kaleidoscoping alterations in patterning of the system. The nature of this unitary field patterning is unpredictable and creative. In her 1992 article, Rogers mentioned kaleidoscope to convey the immeasurable and diverse potentialities of SUHB, which according to Rogers flows from multiple knowledge and sources. In similar theorizing, Butcher likened knowledge to pattern and described it as "dynamic, rhythmical, continuously changing and unpredictable."
Further exploration of the ontological and epistemological roots of kaleidoscoping as conceived by Rogers and Butcher is necessary to critically explore the relevance of the theory for addressing issues of racism, inequities, and inequalities. Butcher defines kaleidoscoping as "flowing with turbulent manifestations of patterning." Kaleidoscoping incorporates 3 subconcepts -- turbulence, patterning, and flow. Turbulence is related to pandimensionality and helicy and is a "human experience integral to the life process of human beings..., a dissonant commotion in the human-environmental field process characterized by chaotic and unpredictable change." Patterning is related to pattern and resonancy and is "the nature of change in the mutual human/environmental field process." Moreover, flow is related to openness and integrality, and flowing is the "process of total involvement in times of turbulent change, and flow, the intense harmonious involvement in the human-environmental field mutual process."
Kaleidoscoping in life turbulence can be appreciated and patterned through Butcher's proposed practice methodology, which is an adaptation from Csikszentmihalyi's flow model and structured according to Barret's 2 processes practice model. The practice methodology was revised by Barrett and later by Butcher to reflect Cowling's practice methodology. The 2 processes are titled (1) Pattern Manifestation Knowing and Appreciation and (2) Voluntary Mutual Patterning. The 2 processes are neither sequential nor separate; they are integral. This approach provides methods of connecting to subjective material and situated experiences in ways that allow nurses and other health care providers to locate and act upon structural inequities that have roots beyond the individual.
Nurses, alongside the people and communities they nurse, are equal participants in the process of appreciating experiences and perceptions. The role of the nurse is to facilitate an encounter where people feel and experience openness and freedom and freely engage in knowing participation in change for wellbecoming. The process of kaleidoscoping is transformative. Kaleidoscoping facilitates the transformation of experiences that are chaotic, painful, unpredictable, and diverse into experiences that are harmonious, pleasurable, and opportunities that are beneficial. Connections for anti-racism praxis include forging resolve and cultivating purpose that can be experienced through patterning with flow. The process of flow as conceived and adapted by Butcher is one that brings meaning to turbulent and unpleasant experiences. To facilitate the flow of turbulent events into healing experiences and manifestations of wellbecoming, nurses must be able to recognize, mitigate, and address the pattern manifestations of turbulent events. This may be possible by collaboratively facilitating the identification of goals, development of actions, and involvement and immersion in an action scheme.
Thinking critically, we suggest that nurses further explore kaleidoscoping in life turbulence and reflect how the theory may be developed, explored, and applied in an unjust and inequitable social, economic, and political system. We ask: What is kaleidoscoping in life turbulence when practicing, educating, and doing research with people and nurses who have experienced historically inequitable power, people who are oppressed, victims of police violence, those systematically stripped of voting rights under systems of white supremacy, or those people who have unequal or nonexistent access to health care? What is harmony in an unfair, unjust, and inequitable system? Can turbulence in this context be smoothed as Butcher suggests by gentle actions, or do nurses need to be embodied and engaged as active participants in disruptive political actions that are effective enough to unsettle the root causes of oppression and inequalities? Root causes are the upstream political, economic, and social forces that are pattern manifestations of turbulence. Exploring kaleidoscoping and harmony within anti-racism praxis requires more explicit nursing action for systemic, structural, political, and social changes.
All care, including nursing care, can be framed as an "ethically and political charged practice." Care and caring are intrinsically political, integral, material, embodied, and embedded.
SMITH'S TURBULENCE-EASE IN THE RHYTHMIC FLOW OF PATTERNING
Smith further built upon Butcher's concept of turbulence flow to develop the concept of turbulence and ease. Turbulence-ease unitary perspective built its foundation through SUHB postulates and principles. Turbulence as defined by Smith is a "dissonant commotion in the flow of human-environmental field patterning characterized by chaotic and unpredictable rhythms" and ease, a "resonant harmony in the flow of human-environmental field patterning characterized by calm and familiar rhythm. According to Smith, "The faster the changes in the human-environmental field, the greater are the possibilities for more turbulent patterning." Turbulence and ease are the rhythmic reflection of flow. Both are important for wellbecoming, and nurses can participate in shifting the rhythm of flow for wellbecoming.
To facilitate this, Smith proposes exploring patterning of turbulence-ease with people in order to appreciate manifestation of turbulence and ease and recognize the importance of facilitating knowing participation in change for wellbecoming. She cautioned not to "label turbulence as unwelcome" as "turbulence may be an invitation for change, growth and healing." Inspired by Rogers' assumption, that the purpose of nursing is to provide care to human beings wherever they are, Smith asserts that "professional nursing practice is promoting symphonic patterning in human-environmental fields, to strengthen knowing participation in change that facilitates patterning for wellbecoming." Her inquiries about nurses' abilities to accomplish this suggest it can be done by engaging with people in their turbulence-ease rhythm, acknowledging their unique and individual perception of wellbecoming, and exploring patterning with them.
Linking Smith's theory to anti-racism, health equity, and social justice is an opportunity for nurses and the nursing profession to be intentional, purposeful, and revolutionary in developing modalities that disrupt the system and facilitate turbulent ease flow. In critical reflection, Smith herself acknowledges that modality such as meditation may not be sufficient to ease moments of turbulence and shift illness manifestations. This suggests that nurses can disrupt the status quo and bring significant changes to facilitate the process of turbulent ease and increase potential for patterning manifestation of ease. Political action, solidarity, advocacy, protest, and accompaniment are all potential modalities for justice action for turbulence and ease. The role of nurses has always been to support people to live their healthiest lives wherever they are. The Future of Nursing 2021-2030 emphasizes the role of nursing in advancing health equities and suggests that nurses not only engage in actions that promote and facilitate health equity but also engage in self-care to be more apt at tackling these important issues. Beyond chair massages and pizza parties, we suggest purposeful and intentional attention to social injustices such as racism and other inequities, engaging in policymaking and leadership both in the public and private sectors. Addressing racism head-on is imperative, although one must be aware that doing so may bring comfort and peace for some and unrest for others and, in some cases, both at the same time.
LOOKING TO PAST TO LOOK FORWARD
Rogers, like other early nurse theorists, lived and theorized within a time in US history when Black and other Nurses of Color were systematically excluded from universities and colleges of nursing and from professional organizations such as the American Nurses Association. Rogers championed university-based education for all nurses, but her writing does not contextualize the systematic educational exclusion that was experienced by Black and other Nurses of Color during the time before and after the civil rights movement when SUHB was being developed. Rogers' relationship to feminist ideas or civil rights movements of her time is unknown to us as authors and scholars, though she strongly championed the need for nurses to address the issues of inequalities and inequities that loom around the world and affect wellbecoming. Today, 50 years later, in the United States, the United Kingdom, and beyond, nurses holding position of power and policymaking, faculty of nursing education and leadership, remain largely nondiverse, aligning with nursing's historic norms around whiteness, cis-heteronormativity, and feminity. The risks of maintaining the status quo in nurse theorizing, education, and leadership are clear. Policies, theories, and philosophies developed within this current system continue to uphold intersectional oppressions around power, race, gender, sexuality, disability, and class, unless the structures and systems change, and the workforce of nursing becomes more intentionally and explicitly anti-racist. Nurses must dismantle epistemic injustice whereby people and communities who are situated within intersectional layers of oppression find themselves silenced, ignored, devalued, often entirely missing from knowledge-making apparatus of academia, research, and care. For example, although Barrett assumed that the capacity to participate in change for wellbecoming is innate and everybody has equitable power, she designed the PKPCT VII to be used with people who have a high school equivalency or higher. Difficulty using the tool was reported even with people with the recommended level of high school education or higher. Nevertheless, some nurse researchers have used it with people who have less than a high school equivalency. In addition, translation of the tool in other languages extends its use to more diverse populations. Despite these developments, nurses must continue to acknowledge the societal oppressions that nursing participates in within the United States and around the planet, acknowledgment done in alliance with those affected and with exploration of the structural factors influencing what Barrett coined as power as freedom and power as control.
As nurses, we risk making errors of assumption by only looking at societal-level power inequities at the expense of individual power as control. One example is nurses who perpetuate patriarchal savior approaches in nurse care and research -- versus analyzing how the individual power of change is present in every individual. It becomes essential to frame modalities that convey: let's do it together, do it with me, don't come and tell me what to do. All 3 theorists discussed here propose a practice model with potential to guide nurses to support anti-racist actions through collaborative care such as Pattern Manifestation Knowing and Appreciation and Voluntary Mutual Patterning. This anti-racist approach can be used to disrupt power inequities and point toward participatory action models of accompaniment.
We encourage nurses to revisit Rogers' 1970 book to reconnect to the philosophical and ontological underpinnings of the SUHB, as well as to rekindle and advance the theoretical and practical connections for anti-racism potential, including integral planetary worldviews. In the 2 years since the conference presentations that sparked this article, many nurses have written about structural racism in nursing, erasure of the contributions of Black nurses, and outlined explicit actions needed for anti-racism work in nursing. Building upon this scholarship, we suggest that nurses using SUHB also thread with anti-racist philosophies that critique power such as ecofeminism, Black feminism, queer studies, disability studies, and other anti-oppression and anti-colonial thinking practices that decenter white Western view of humanism. Thinking and doing practices in nursing must be reconstructed from diverse worldviews and more explicitly and intentionally center anti-racist ideas and knowledge.
CLOSING THOUGHTS
In this article, we propose 3 theories that evolved from SUHB to build anti-racism actions for thinking, knowing, being, and doing in nursing. We acknowledge that SUHB was/is largely developed within a framework of whiteness by white scholars who were/are working from academic positions and social identities in the United States of societal safety and white privilege. This requires nurses to reflect on how that history and positionality shaped/shapes SUHB. We also acknowledge the urgent need for ongoing anti-racism and justice work by nurses. We used examples of concepts such as integrality, turbulence, power, freedom, and patterning arising from Barrett's Knowing Participation in Change, Butcher's Kaleidoscoping in Life's Turbulence, and Smith's Turbulence-Ease in the Rhythmic Flow of Patterning to explore potential building blocks for future anti-racist work in nursing. In summary, Barrett, Butcher, and Smith linked their perspectives to SUHB, including attention to human environment integrality, and the capacity of humans to knowing participation in change for wellbecoming. All 3 brought attention to the importance for people and nurses to pattern the integral human-nonhuman environment knowingly and intentionally in mutual process for wellbecoming. Smith proposes "developing a rhythm profile of turbulence-ease as part of the human-environmental field pattern appraisal," and both Barrett and Butcher propose the use of Barrett's 2 processes practice model -- Pattern Manifestation Knowing and Appreciation and Voluntary Mutual Patterning -- to appraise individual ability to participate in change for wellbecoming and facilitate engagement in change. "Barrett's power theory practice methodology helps people to understand their pattern manifestation of unknown strengths and their choices to let go of traditional power as control to participate meaningfully in the transcendence of their energy spirit, where living in the universe is infinite and eternal." "Everyday events, examined through this new worldview, provide a fresh perspective, raise new questions, and allow new explanations."
Importantly, future work for nurses must more fully explore power from multiple intersectional non-Western contexts, locations, and perspectives to build actions for radical social transformation, without perpetuating and reinscribing existing oppression and inequities. Lett et al provide suggestions on how nurses and other health care providers may engage in high-quality community-centered health equity work through a set of principles designed to guide novice equity researchers and theorists.
We close by circling back to our proposal that SUHB contains potential for anti-racist philosophizing and theorizing that can be critically adapted by nurses to uproot oppressive pattern and to act to create a more just path forward for radical change. Nurses, including Iradukunda and others critically address actions and imperatives for nurses to intentionally decenter whiteness. We encourage nurses to read widely, connect to outside disciplines as Rogers modeled for us. Intentionally cite and trace knowledge centering Black and Indigenous scholars and others from the Global South and Latin America, amplify their voices, especially those who are doing anti-racism action. In addition, support local groups and organizations that are actively doing the difficult and often dangerous physical and emotional labor of health, social, economic, and climate justice work. We see this article as a call to action, a necessary step in the evolution of SUHB, and we invite you to join in advancing an anti-racism project of nursing theory for the integral wellbecoming of multispecies and the planet.