We Refuse to Cope! The Vitruvian Nurse, the Code of Conduct, and Nurses’ Lived Knowledge

University of Edinburgh
Charité – Universitätsmedizin Berlin
Jamie.smith@charite.de

We, as nurses, refuse to cope. In this editorial style piece we discuss the ongoing crisis in nursing and the ways in which this situation is being produced. We discuss the metaphors with which nursing is produced in the UK and US and how these metaphors produce an idealized version of nurses and nursing that is impossible. We situate this metaphor in critical posthuman theory by drawing comparisons to Braidotti’s (2013) understanding of the idealised human as an axiom of social production under advanced capitalist societies. We make comparisons of this idealized person with the idealized nurses that are captured in nursing codes of conduct and practice. We then suggest ways in which we can resist and diffract metaphors in nursing to produce affirmative futures.

We refuse to cope! We have had enough, we are pissed off, and we’re not alone. In the United States, around 2 percent of the working-age population are registered nurses; 9 out of 10 of these people are women; globally, 60 percent of healthcare workers are nurses; and the same mood roars from them. With about 28 million nurses in the workforce globally, approximately 15 percent are born or trained in a country other than where they work as nurses, and on average 8 out of 10 are women (World Health Organization 2020, 69). Nurses around the world are pissed off. The International Centre on Nurse Migration estimates that 13 million nurses are needed over the next decade (Buchan, Catton, and Shaffer 2022). Where are these nurses going to come from? Who is going to train them? How will they be retained at the bedside under the terrible working conditions and inadequate pay, which have been made hypervisible through the COVID-19 pandemic? The reasons for this collective anger are multifaceted but go far beyond grumbling about pay and conditions—the problem is in the bones of nursing. The frameworks, expectations, and conditions with which nurses make their worlds are girdled in capitalism and rotten with patriarchy. When we look at the idea of the perfect nurse and contrast it with nursing practice and nurses’ regulatory framework, you will most likely be angry too. Not only because nurses are patronized but because they are reduced as vernacular experts to service providers and their lived knowledge is held back from (scientific) acknowledgement.

The metaphor of the Vitruvian Nurse is a uniformed woman who goes out of her way to attend to everyone’s needs in an unconditional and subservient way where her self-value correlates with her ability to serve others to the detriment of herself. The Vitruvian Nurse is achieved when she ceases to exist as a subjective entity, therefore becoming an impossibility. The image we work with in this piece is an example that imagines a feminine, perfect, and selfless nursing workforce. Rooted in Rosi Braidotti’s (2013) exploration of the Vitruvian Man, we believe that nursing is mostly oriented around the metaphor of the Vitruvian Nurse.

The metaphor of the Vitruvian Nurse is an imagined representation of the ideal nurse. We point towards this metaphor for three reasons. First, the metaphor is historically embedded in the theory of posthumanism with which we work. Braidotti (2013) draws from Leonardo da Vinci’s Vitruvian Man as a representation of the ideal human—able-bodied, white, muscular, strong (further implying cisgendered and heterosexual). Through this image, Braidotti demonstrates how most of us have grown up to (maybe unknowingly) internalize a particular ideal that is unattainable. One of the dangers of creating “the other” is that everyone who is other (than the Vitruvian Man) is less-than. The production of ideal and non-ideal hierarchies can lead to exclusion and to more or less subtle persecution of whole communities.

Figure 1. Leonardo da Vinci’s Vitruvian Man, c. 1490 (Wikicommons Media, Photographer: Paris Orlando, CC BY-SA 4.0).

The Vitruvian Nurse, then, is the collective metaphor of how the ideal nurse should be: In her uniform she floats between patients with a smile, prioritizing everyone’s needs over her own—especially her own. She becomes the Vitruvian Nurse as she negates herself through serving the needs of others.

Figure 2. Jamie B Smith and Eva Willis, This Won’t Hurt a Bit, art produced by AI, 2021. Courtesy of the artists.

Figure 3. Jamie B. Smith and Eva Willis, The Cruel Optimism of Nursing, art produced by AI, 2021. Courtesy of the artists.

Second, we work with the metaphor of the Vitruvian Nurse to point away from other metaphors that simply idealize nursing such as the superhero nurse, which has most recently been popular during the COVID-19 pandemic. Both metaphors (the Vitruvian Nurse and the superhero nurse) adore nurses because they are strong but, ultimately, harmless. However, the metaphor of the superhero nurse does not look at how this adoration and harmlessness are co-produced. The metaphor of the superhero nurse glorifies nursing without acknowledging the self-abandonment and the self-denial elements that are necessary to qualify for adoration by society. Third, the Vitruvian Nurse metaphor lets us look at the production of the ideal rather than the mere presentation and is, hence, a metaphor that relates closer to reality. The Vitruvian Nurse is a metaphor that embodies the selflessness and everydayness of nursing. Nurses are not simply put on a pedestal; instead, they chase the ideal that always seems to slip—giving nurses the impression that they are suboptimal, never enough.

We make the metaphor of the Vitruvian Nurse perceptible in two ways: through practice and regulatory frameworks.¹ In the first example, we explore the navigation of everyday practice of nurses to show the pressures that nurses endure whilst being overpowered by the impossibility of achieving the Vitruvian Nurse. We also show how the idea of the perfect nurse exists in nursing codes of conduct. Examining codes of conduct is important because these codes globally regulate nursing and are frameworks that reproduce ideas of the perfect nurse. The dangers of the ideals that are embodied in the nursing codes cause boredom and burnout because they are unachievable and unlivable. We show the impossibilities that are implied by juxtaposing parts of the UK code, The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing (hereafter the Code of Conduct), with the practice of everyday nursing.²

You might think that is a strong stance to argue that a metaphor of nursing is a mode of regulation. After all, it is just an image. What restrictions can a metaphor possibly produce? At first glance, it might seem wild to discuss a metaphor, yet we argue that it is valuable to look at the realities that metaphors create. The stakes are high! The policies that guide nurses are restrictive and restricted, reproducing narrow definitions of nursing care which is connected to creating idealized, docile patients (Smith and Willis 2020), and, overall, limiting what it is to be human (Haraway 2016). The importance of communal production of reality is obvious in many disciplines, including mathematics, education, sustainability studies, physics, philosophy, biology, and many more, but nursing philosophy and nursing theory have been surprisingly quiet on this topic.

It is vital to engage in our experiences as practicing nurses to advance towards an understanding of communal, more-than-individual, and more-than-human care. We move away from the narrow definitions of what a nurse is, and we speculate about affirmative alternatives. We argue that not taking a position is impossible and we show how nursing is pragmatically done. The metaphor of the Vitruvian Nurse is not only impossible to achieve; it is also disabling to a creative, diverse, pragmatic, lived practice, making it impossible to recognize nurses as vernacular experts and reducing nurses to submissive workers in extractive capitalism. We highly value the work and findings of academia and evidence-based research. Nonetheless, we believe that lived knowledge of nurses is kept invisible and held back from recognition in or beyond academia and evidence-based research. We believe it is important to look at facets of how the idealized nurse is produced because doing so forms our ability to imagine what nursing can become when it is not constrained by this impossible ideal.

We invite feminist STS scholars to engage with the rich lives of nurses all over the world, and we invite nurses to engage with the power of feminist STS, as a way to critically rethink how nursing is structured.

The metaphor of the Vitruvian Nurse is an imagined representation inspired by the image of the Vitruvian Man by Leonardo da Vinci. Braidotti (2013) uses the image as an example to illustrate the posthuman theory of how our minds can be colonized by certain ideals and how they implicitly exclude and oppress large (if not most) parts of society.

The image of the ideal human male reproduces a hierarchy that frames diverse forms of gender, race, body form, and people with disabilities as non-desirable. These values come to form the basis for social, cultural, and political production in post-Enlightenment Europe. The human is understood as an “intrinsically moral” being, functioning as an axiom of perfect rationality and reason. In this mode of thought, “man” is capable of an unlimited expansion toward “his” perfection and entitled to claim ownership of whatever objects or others “he” encounters along the way. This humanist ideology was adapted in Europe and the Global North post-Enlightenment as a cultural model that allowed Europeans to view themselves as an unequalled force on the planet, therefore entitled to use its resources as they see fit.

The Vitruvian Nurse then is produced with similar sentiment and was co-created as the role of nursing has become increasingly professionalized throughout the twentieth century and has entered the academy as an academic subject. The collective imagination of nurses and nurse work remains feminized with stereotypes such as “angel, handmaiden, battleaxe or whore” (Jinks and Bradley 2004). The metaphor of the subservient woman, the Vitruvian Nurse, can reclaim these stereotypes to refuse to cope with unrealistic ideals.

We as nurses reject the metaphor of the Vitruvian Nurse. And even though we want to provide great care, we refuse to cope with the conditions and expectations presented to us. All too often we are expected to lose ourselves in the needs of our individual patients. Frameworks of nursing suggest that patients should be the center of our thinking, minimizing ourselves as subjective entities. We are encouraged to hide our fullness of being—navigating the needs of twenty or more patients, other nurses, a multidisciplinary team, and the schedules of the institution.

To make the messiness of practice more perceptible, imagine the following: You are a staff nurse arriving on a morning shift to a ward. As you arrive, you can hear many patient call bells ringing, and you can smell various things from different parts of the ward as you make your morning coffee. You take handover from your colleagues on the night shift about what has been happening. You sit and take a report on the six patients whose care you will be responsible for today—you are allocated a bay (room) of four patients and two patients in single side rooms with the following main care needs:

Room	Main Care Need
1	Bed 1: Broken arm Bed 2: Heart attack Bed 3: Infected legs Bed 4: Awaiting home care package
2	Loose stools, limited mobility, falls risk
3	End of life care – COVID

How will a nurse navigate these parallel and sometimes conflicting needs? The nurse assesses the ongoingness of the situation and makes decisions about how to proceed through the day. In doing that, the nurse may prioritize the needs of one over others or delegate tasks if there are multiple urgent needs. However, the process of prioritizing means that some things will be addressed before others. The ways she might address things later or de-prioritize something is not addressed in the Code. The Vitruvian Nurse can prioritize all their workload! However, the way in which that means other things are de-prioritized is not addressed. We have to become perceptible to these omissions that produce the metaphor of the Vitruvian Nurse.

Imagine if nurses were taught to tell a patient to wait as other care needs might be higher on their priority list—to ensure safe patient care for all of their patients. If they were to communicate this, how were they taught to communicate priorities with their patients to not hurt their fragile individualistic sense of self? If you imagine being a patient, how would you feel if a nurse would communicate the complex navigation of your needs with others and you were aware that at some points (or most of the time, depending on circumstances and care needs) you are not in the center of this thinking? Can we imagine ways that all your needs are still met without you being at the center and having the highest priorities?

We seek to take a position on how nurse work manifests itself so we can carve out flows and flaws and speculate about affirmative alternatives. Through its professionalization, modern care is still woven with misogynist fabrics of society and is produced under the conditions of advanced captitalism that binds professional practice to individual practitioners. The focus of the Vitruvian Nurse as the societal ideal is on the individual nurse is problematic because it creates a massive frustration in nursing because it is an impossibility.

Nursing is not individual but a communal practice that has existed throughout centuries and is not inherently bound to the profession of nurses. The professionalization of nursing has captured care. We support the professionalization of nursing and we acknowledge that feminist histories of care are overwritten to produce care as a branded commodity—the Vitruvian Nurse.

The metaphor of the Vitruvian Nurse, however, is built on assumptions of the human as an individual not a dividual, meaning a single entity that cannot be divided (in-dividual) and alienated from the living situations they come from. Nurses, patients, friends, family, doctors are all dividuals. The individualistic nature of patient-centered care, as it is described in the UK and US nursing codes of practice, reveres the “autonomous” practitioner. The individual nurse is situated over the material-discursive practices of care that are co-produced. The UK code of conduct addresses the individual “you” and opens with “1. Treat people as individuals.” The US code of ethics also addresses the individual nurse (American Nurses Association 2015).³ These systems are not interested in our materialized perspectives and the rich histories that we bring. We believe that nurses are subjects who arose from many influences, relationships, and assemblages with other humans, places, more-than-humans, and their nursing practices are enriched by many experiences, always becoming more and different with the world they are in and the connections they make.

If we do not rethink what nursing is asked to be, we see an irrefutable future for nurses and patients, predetermined by the narrow philosophies of humanistic science—the human as a bound individual is privileged above everything else. In congruence with humanism, the Vitruvian Nurse is established as the idealized individual career, reproducing restrictive power relations to keep nurses (mostly women) in their place.

Although similar regulatory frameworks exist worldwide, having both practiced in the UK, we are experienced and implicated in this way of producing nurse work via The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates (Nursing and Midwifery Council 2015). Codes of practice for nurses are viewed by many as an integral part of professionalization, have existed for nurses since the late nineteenth century, and are seen as an “emancipatory” document that supports nurses to practice autonomously beyond the medical gaze (Esterhuizen 1996). These documents used beyond the circumstances of their production and in ways that shape how worlds are made.

What the professionalization of processes supports is the reorganization and redefinition of how the value of nurse work is produced. The Code is a cornerstone of nursing practice, education, and decision-making. The contemporary nurse is imagined in other ways but repeats and hides old issues in regulatory frameworks—a uniformed figure), who has no needs of her/his/their own and is always there to help.

How is the perfect nurse described in codes of conduct? Section 25.1 the Code states that a nurse’s goal is to “identify priorities … putting the needs of those receiving care or services first” (Nursing and Midwifery Council, UK 2015, 22). When the Code states we must prioritize, we are not guided how to identify priorities, and de-prioritization is not included either. The omission of these two factors, in connection with the call to prioritize the needs of the people we care for, puts extreme pressures on nurses. Implying that others always come first contributes to unsustainable demands of the nursing workforce.

And whilst the identification of priorities is encouraged, how does the Code support nurses to de-prioritize something (and communicate this to patients) while they address something else? The nurse is undoubtedly an “autonomous practitioner.” However, in this situation, autonomy is about self-determinacy and not self-sufficiency. In other words, the focus is on nurses making decisions, but the decisions they make depend on so much more than themselves. The way the autonomous practitioner is implied in the code of conduct does not take into account how the nurse has to maintain and nourish herself and other professionals to guarantee the long-term ongoingness of good care. Such a focus would demand taking herself into account in her decision-making and prioritizing her own needs first sometimes. We argue that the decisions a nurse can make are connected to and determined by her ever-changing environment, the resources, facilities, times, teams, and patients she works with.

The Code not only burdens the individual but also silences the responsibilities of the systems and management to set nurses up for success to provide the best care possible. An ethical code would instead include communicating de-prioritization and adapting the quality of care in the ever-changing environment. This would mean communicating limited capacities and responsibilities, and championing oneself and other staff’s self-care. How else can the profession of nursing become sustainable if the nurse is not encouraged to see herself as a subject worthy and in need of care?

Being not affected by any complaint is impossible. Section 24.1 states nurses must “never allow someone’s complaint to affect the care that is provided to them” (Nursing and Midwifery Council 2015, 21) This section produces a “them vs us,” implying we can clearly define where the nurse ends and the patient begins, rather than acknowledging the relationality that patients and nurses live in. How can we clearly divide the ones caring from the ones being cared for? Has a patient never offered you a candy, a kind word, or a gentle smile when you as a nurse had a hard day?

And what constitutes complaint? What about the complaint of a patient who is acting sexually aggressively against nurses? How can a nurse who has racial slurs thrown at her not be affected by them? What about complaints that are influenced by racist attitudes? The Code treats nurses as if they are not people, detached from their personhood and histories. Instead, it implies that nurses are self-sacrificing entities there to serve.

Nurses are more than their institution and profession: they have identities and past experiences that shape how they are and can become nurses. When the nurse puts on her uniform, she is not void of history and the systems of oppression she grew up in. They still matter. We argue that the deep and complex histories of race, power, age, migration, and gender in nursing cannot be overwritten by nursing as a professional brand. Not addressing these histories and opening possibilities to express them whilst valuing the patients’ complex subjectivities is vital in our vision of an affirmative nursing code. The existing code reproduces the image of a prescribed, singular, and fictional idea of what the perfect nurse is—it is the work of toxic metaphor. We are not a supermarket chain. The customer is not always right. Section 24.2 of the Code that nurses are to “use all complaints as a form of feedback and an opportunity for reflection and learning to improve practice” (Nursing and Midwifery Council 2015, ##21). Complaints do not equal truth but must be seen in context. Why would the section about complaint omit the possibility of unreasonable complaints or complaints that require you to adapt the way you approach the patient’s care? We argue that in the best case, this section is impossible to live by in everyday practice. In the worst-case scenarios, the section gaslights nurses, implying that nurses need to become better at suppressing their feelings of injustice in order to make the wheel run better. How can we manage and negotiate complaints to recognize the needs of patients yet make our situation and the scope of how we can care for them in that moment and during that day perceptible to patients? We believe a regulatory framework should give nurses the tools to make a reasonable assessment of a complaint and to communicate differences of perception in a way that reflects and navigates patients’ needs whilst also enabling nurses to have a voice.

The goverining metaphor of the Vitrivian Nurse makes it impossible to address the pragmatic, everyday complexity of nurses and nursing. The metaphor also comes with underestimating nurses’ potential as humans. As caring for others comes with power and access to others, the potential to harm and be harmed, and how to manage this potential, must be openly addressed and controlled.

We do not argue for a world without a regulatory framework for nursing. If we imagine that nurses are inherently good and therefore no regulatory process is required because nurses can do no harm, then we are negating a part of their potential humanness because part of being human is the potential to do harm. If we want to be informed by the past, we also see the necessity of a code. Imagining nurses as inherently good prevents accountability. We acknowledge that “nurses have a history of both upholding oppressive systems that disenfranchise segments of the public, usually poor, often People of Color, and engaging in innovative alternatives to the status quo” (Dillard-Wright and Shields-Haas 2021, 197). On the contrary, when we critique the metaphor of the Vitruvian Nurse because this metaphor influences policies, we advocate for policies that are ethical and affirmative, inviting and enabling multiple ways of being nurses whilst providing needed structure for patients, the public, and the nursing profession.

Informed by feminist standpoint theory (Harding 2004), we argue that everything is viewed from somewhere; therefore, we must become accountable for our position. If we do not make the ways in which we are implicated in the production of reality perceptible, then we risk being territorialized, overwhelmed, and restricted in different ways.

Regulatory frameworks are one way to represent nurses’ work; however, to accept them uncritically or ignore diffractive possibilities is not taking a position. Instead, taking a position is a contemporaneous and ongoing process because the world is never static, it’s ever-changing, and we have to ongoingly take a position in this dynamic (Deleuze and Guattari 1988).

In 2019 Romero-Brufau et al. showed that nurse worry is a better predictor for patients’ deterioration in the next twenty-four hours than vital signs (such as heartbeat, blood pressure, temperature, and respiratory rate), which are commonly used as a reliable and objective tool. Such studies suggest that the knowledge that nurses embody in their praxis has high value beyond that which is captured in supposedly objective measures. Nurses’ tacit and innate knowledges of the materiality of a situation might be as good or a better predictor when it comes to patient care. We need to research these knowledges and elevate and listen to the voices of nurses.

We aim to diffract these metaphors in care and nursing by understanding how they come to produce realities. The ethics of affirmation and joy, as we understood it through Genevieve Lloyd’s (1994) reading of Baruch Spinoza’s Ethics, is the process of becoming aware of the conditions of one’s own bondage. Shared understandings of these conditions create the ethics of joy. What metaphors and imaginations could support nurses to practice affirmative ethics within a code of conduct? How do we negotiate contradicting perspectives with patients and acknowledge long histories of care? When the nurse has a different understanding of what could be best for a patient’s health and well-being than the patient, how do we create possibilities in which the patient feels acknowledged and sees possibilities for themselves, in which and the nurse’s subjectivities and insights are not silenced in this process?

We suggest that future metaphors move away from emphasizing individual responsibility or perfection on nurses or patients. We argue that nurses should be accountable to their position but consider the paradigms of the dividual rather than the individual—that is to say, work with a regulatory framework that acknowledges and supports self-determinacy but not self-sufficiency. Care demonstrates how individuals (both nurses and patients) can be thought of as dividuals (Smith and Willis 2020)—not as isolated entities, rather deeply embedded in and produced through material and social relations (Deleuze and Guattari 1988). Critical posthumanism sees the bounded self as a site of reconfiguration. Hence, how we conceptualize the self is not as a fixed point but more a dynamic constellation of matter.

Nursing’s regulatory frameworks are iterative processes, which is a material benefit to acknowledge the ever-moving ethics of care instead of fixing a moral position. Therefore, future versions of the Code could better acknowledge this dynamism to include these diffractions by:

These suggestions would begin to create other conditions of possibility for nursing. It would create the possibility that the nurse is not responsible for everything, and is personally implicated in the production of care. It begins to diffract away from a neoliberal model of care, where the patients’ “wishes” replace others’ agency in a situation because the patient is the consumer. These suggestions would also create the conditions where a nurse could say no to a patient and not repeat the tropes of a servant or handmaid. However, the nurse and patient should franchise each other in their desires, wishes and possibilities to co-exist.

We hope that we have made the Vitruvian Nurse perceptible as a metaphor that is (re)produced in the media/everyday narratives and action and used as a mechanism to govern nurses and patients. We invite you to think with this metaphor and how it is used to create worlds—from where and how you are situated. During the COVID-19 pandemic, nurses and healthcare staff have been high profile and noticeably entangled in many lives. Alongside colleagues across the world, we are working to make nurse-work more perceptible to create more affirmative futures where survival is understood through collaboration. Through our collaborative projects, we are in the process of working with nurses, patients, families, institutions, the human, and the more-than-human to (re)imagine and (re)configure metaphors in nursing and we invite you on our journey. The analysis we have shared above guides this project and we hope you will join us.

¹ As this is a diffractive piece, interrupted by ideas, experiences, and emotions, we also write in a non-linear way, as nursing is a diffractive practice, rarely flowing from one situation into another.

² As we are embedded in British nursing practice, we chose the UK code. However, other codes across the Global North are similar and could also be used as examples, such as the Code of Ethics by the International Council of Nurses, American and Canadian boards of nursing, the German Nursing Act.

³ In comparison, the Canadian Code of Ethics for Registered Nurses produces and addresses the collective, starting every sentence with “Nurses…” (Canadian Nurses Association 2017).

Deleuze, Gilles, and Félix Guattari. 1988. A Thousand Plateaus: Capitalism and Schizophrenia. Translated by Brian Massumi. London: Athlone Press.

Dillard-Wright, Jessica, and Vanessa Shields-Haas. 2021. “Nursing with the People: Reimagining Futures for Nursing.” Advances in Nursing Science 44 (3): 195–209. https://doi.org/10.1097/ANS.0000000000000361.

Esterhuizen, Philip. 1996. “Is the Professional Code Still the Cornerstone of Clinical Nursing Practice?*.” Journal of Advanced Nursing 23 (1): 25–31. https://doi.org/10.1111/j.1365-2648.1996.tb03131.x.

Haraway, Donna J. 2016. Staying with the Trouble: Making Kin in the Chthulucene. Durham, NC: Duke University Press.

Harding, Sandra G., ed. 2004. The Feminist Standpoint Theory Reader: Intellectual and Political Controversies. London: Psychology Press.

Jinks, Annette M., and Eleanor Bradley. 2004. “Angel, Handmaiden, Battleaxe or Whore? A Study which Examines Changes in Newly Recruited Student Nurses’ Attitudes to Gender and Nursing Stereotypes.” Nurse Education Today 24 (2): 121–27. https://doi.org/10.1016/j.nedt.2003.10.011.

Lloyd, Genevieve. 1994. Part of Nature: Self-Knowledge in Spinoza’s Ethics. Ithaca, NY: Cornell University Press.

Romero-Brufau, Santiago, Kim Gaines, Clara T. Nicolas, Matthew G. Johnson, Joel Hickman, and Jeanne M. Huddleston. 2019. “The Fifth Vital Sign? Nurse Worry Predicts Inpatient Deterioration within 24 Hours.” JAMIA Open 2 (4): 465–70. https://doi.org/10.1093/jamiaopen/ooz033.

Smith, Jamie B., and Eva Willis. 2020. “Interpreting Posthumanism with Nurse Work.” Journal of Posthuman Studies 4 (1): 59–75. https://doi.org/10.5325/jpoststud.4.1.0059.

Jamie B. Smith works as a nurse between Edinburgh and Berlin. His PhD at the University of Edinburgh explored nursing, philosophy, and social justice. Jamie focuses on bringing strong critical posthuman theory to research using mixed methods of quantitative, qualitative, and post-qualitative approaches to his work. His work explores how people, places, and structures produce intimate relations and care.

Eva Willis is teaching and researching nursing at the Charité in Berlin. She gained her MSc in Sociology and Global Change at the University of Edinburgh. Her PhD focuses on nurses as organizations and organizational knowledge embodied in nursing praxis. She trained as a nurse in Germany and has experience in UK and German healthcare systems.

Jamie and Eva are friends and colleagues working as nurses and nurse educators in Berlin, Germany. They share migration experiences in Europe, are able-bodied, speak German and English, have working-class backgrounds, and hold nationalities that allow them to travel freely at the moment.