Poetry, epistemic justice and exploring the potential of connectivity

Reflecting on her four-decade nursing career, Sue Spencer uses poetry to explore justice, values and change.

I read an earlier version of this poem at an event I organised that “celebrated” 40 years since I qualified as a Registered Nurse. In my poetic inquiry (Faulkner 2020) I have sought to ask some tough questions about why I stayed in the profession so long and why it took me four decades to extricate myself from oppressive relationships and the tyranny of never feeling I was good enough. I now realise that I have done well to survive an environment of comparison and competition.

Over the last decade, poetry has been a means to express myself and articulate specific facets of my experience – exploring specific events and enabling the investigation to be universal. It hasn’t resulted in a neat, linear narrative; it has been more a meander and wander – sometimes fragmented and incoherent.

In presenting my poetry to an audience, I have begun to identify threads of thought. One has been about my frustration and irritation with what types of knowledge are valued and utilised in health care. Hierarchies exist within professions and this gets played out with what gets known, what and who gets listened to and who has the power – issues of epistemic and social justice.

In writing poems about my professional experiences, I have surfaced issues about how we are all very human in health care interactions but that I have witnessed care provision becoming more transactional and commodified. I had been hoping for an evolution or revolution to more reciprocal, balanced and thoughtful relational offerings but this now feels a long way off.

I am troubled by what I have observed over the last decade and am now unable to work in either health care or higher education. Both environments diminish my energy and leave me depleted and exhausted. This leads to feeling overwhelmed and my emotions become more difficult to regulate. I become “challenging”, “sensitive” and “hard to manage”. Does this sound familiar?

Writing poetry then reading that poetry to an audience has required me to encounter dark corners and shadows of my own practice. It has also obliged me to grapple with diverse theoretical ideas so I might find provisional answers to what is going on and why. Why do people ignore bad behaviours? Why are people so busy? Why are people so focussed on ambition and recognition? Why in health care can we not be kinder to each other? Why is there so much knowledge on library shelves that appears to be disregarded? Why are certain sources of knowledge privileged over others – how experiential and personal knowledge is overlooked or ignored – academic research knowledge relied upon instead of blending knowledge generated in human encounters with that extensive academic knowledge? Why do I see the biases and averted gaze, but so few colleagues seem to get what I am talking about?

Two females, sitting, in discussion.
Kate Fox (left) and Sue Spencer in conversation. Courtesy of the author.

What I wanted to do in marking four decades of nursing was to open up the discussion in the room to think about actions and solutions. I wanted the audience to be enabled to interact and participate in knowledge creation. Watching the recording of the event has also justified my commitment to the necessity and value of including an interlocutor in the event. I asked Kate Fox (a performance poet and scholar) to be my mentor, supporter and inquisitor. After I read a poem she asked me questions about motivation, purpose and intention. Her skilled probing required me to think about the feelings and experiences that I felt were important to bring to the surface and why might that matter for an audience to consider.

Following much discussion, we found ourselves sharing a common purpose. Within the room there was a collective desire to imagine how we might make the healthcare environment a better place for ALL. As a nurse I had felt trapped and excluded, and the issues around agency and autonomy suggested the possibility of better alliances between professionals and recipients of care.

Many poems were about my inability to fit in and assimilate into the pervasive culture – feeling like an outsider all the time. My poetry explores my attempts to understand what was wrong with me and why I couldn’t adopt and adapt. In sharing those poems, I have begun to appreciate that invalidation and neglect might have been more pervasive than I had realised and that trauma may have contributed to my distress in recent years. There have been numerous friction points throughout my career and exploring them more fully within the containment of a poem has been an interesting learning curve.

Now I have the privilege of not working and having time to refract and diffract my experiences, I am keen to facilitate conversations about how we might do better – promote compassion and curiosity. I know that poetry can help us in this quest.

Footbridge in woodland, in the mist.
Poetry as a bridge. Courtesy of the author.

The universe has interesting ways to get me to pay attention and, in the same week of my own event, I was invited to speak about the power of poetry at an international compassion in health care education conference (C4CHEd). Here I expressed the wish to discover whether other people use poetry to help them take stock and regroup in busy and complicated environments. I have become less apologetic about my passion for poetry and bolder about letting people know about my own learning. I believe poetry has a unique role in helping us make sense of complexity. It doesn’t demand tidy answers and narrative coherence. It can often feel that writing poetry helps me grasp illusive fragments that might otherwise hide in the shadows or lurk in the edgelands.

If any of this resonates and you feel we might explore it more fully I would really love to have that conversation. At the BMJ Medical Humanities journal we advocate for amplifying marginalised voices and asking awkward questions and I would love to be part of that movement. I welcome conversations that might discomfort and cause unease. I am hopeful that my own experience might open up discussions about potentially unpopular and transgressive viewpoints.

I am confident that I am not alone in thinking that there are ways to promote a more just and compassionate culture in health care and that poetry can be a way to build bridges to shared understanding and braver conversations. If reading this, you feel you can help then please get in touch. I would like to explore how me might augment and intensify some of the troublesome issues that we often avoid, deny and disavow. I end with a quote from Donna Haraway – inklings of what I would like to write about.

“It matters what matters we use to think other matters with; it matters what stories we tell to tell other stories with; it matters what knots knot knots, what thoughts think thoughts, what descriptions describe descriptions, what ties tie ties. It matters what stories make worlds, what worlds make stories” (Haraway 2016, p.12).


Faulkner, Sandra L. 2020. Poetic Inquiry Craft, Method and Practice. London: Routledge.

The Collaboration for Compassion in Healthcare Education (C4CHEd)

Haraway, Donna. 2016. Staying with the Trouble. Durham, NC: Duke University Press

About the author

Sue is an Associate Editor for the BMJ Journal Medical Humanities and is a passionate advocate for exploring intersectional ideas in healthcare – particularly in investigating how we can promote epistemic justice. Sue has worked as a senior nurse in the NHS and the third sector. She also worked as an academic in interprofessional working and practice development, most recently in the Faculty of Arts and Humanities at Newcastle University. While there, she offered poetry sessions as an antidote and remedy for stress, overwhelm and busyness.

Sue has worked with a wide range of professionals to augment reflective practice and practice/professional development using creative writing and expressive visual art practices. She is keen to broaden the discussions about this and to enhance the evidence base for these activities in continuing professional development.

Twitter: @kind_curious

Personal blog: https://kindandcurious.wordpress.com/

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