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Article

Getting to the Heart of the Planetary Health Movement: Nursing Research Through Collaborative Critical Autoethnography

by
Jessica LeClair
1,*,
De-Ann Sheppard
2 and
Robin Evans-Agnew
3
1
School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA
2
Adult Education and Community Development, Department of Leadership, Higher and Adult Education, University of Toronto, Toronto, ON M5S 1V6, Canada
3
School of Nursing and Healthcare Leadership, University of Washington Tacoma, WA 98406, USA
*
Author to whom correspondence should be addressed.
Challenges 2024, 15(4), 46; https://doi.org/10.3390/challe15040046
Submission received: 26 October 2024 / Revised: 3 December 2024 / Accepted: 4 December 2024 / Published: 13 December 2024
(This article belongs to the Special Issue Nurturing Connected Consciousness in the Anthropocene: Addressing Calls for Cultural and Spiritual Transformation as a Path to Personal, Collective, and Planetary Health)
Browse Figures
Figure 1
<p>Locating ourselves and our more-than-human community partners.</p> "> Figure 2
<p>Am I welcome here? 30 January 2024. Photo by Jessica.</p> "> Figure 3
<p>Collective concern: beauty, hope, and dread. 4 January 2024. Photo by Jessica.</p> "> Figure 4
<p>Invocation, 30 January 2024. Photo by Robin.</p> "> Figure 5
<p>LeHave Sunset Park, NS, Canada, Sacred <span class="html-italic">Pijinuiskaq</span> up close and personal, 1 February 2024. Photo by De-Ann.</p> "> Figure 6
<p>LeHave River, NS, Canada, Calm before the storm, 9 October 2024. Photo by De-Ann.</p> "> Figure 7
<p>LeHave Sunset Park, NS, Canada, A broader perspective, 9 October 2024. Photo by De-Ann.</p> "> Figure 8
<p>Model for Wholistic peacemaking.</p> ">
Review Reports Versions Notes

Abstract

:
Humans and more-than-humans experience injustices related to the triple planetary crisis of climate change, pollution, and biodiversity loss. Nurses hold the power and shared Responsibility (Note on Capitalization: Indigenous Scholars resist colonial grammatical structures and recognize ancestral knowledge by capitalizing references to Indigenous Ways of Knowing (Respect, Relations, and Responsibilities are capitalized to acknowledge Indigenous Mi’kmaw Teachings of our collective Responsibilities to m’sit no’ko’maq (All our Relations). Respect for Land, Nature, Knowledge Keepers, Elders, and the names of Tribes, including the Salmon People and sacred spaces, such as the Longhouse, are also denoted with capitals)) to support the health and well-being of each other and Mother Earth. The heart of the Planetary Health movement to address these impacts centers on an understanding of humanity’s interconnection within Nature. As nurses, we seek partnerships with more-than-human communities to promote personal and collective wellness, Planetary Health, and multispecies justice. This article introduces a longitudinal, collaborative autoethnography of our initial engagement with more-than-human communities. In this research, we utilize reflexive photovoice and shared journals to describe our early conversation about this interconnection with three waterways across diverse geographies. This work acknowledges the importance of relational and embodied Ways of Knowing and Being. We invite nurses to embrace the heart of the Planetary Health movement and share these stories with their more-than-human community partners.

1. Introduction

Humanity’s three greatest interlinked public health threats are climate change, pollution, and biodiversity loss—known as the “triple planetary crisis” [1]. Through trauma from conditions such as wildfires, floods, and drought, the triple planetary crisis can cause the loss of a sense of place and belonging, contributing to a broad range of health outcomes, including adverse mental and spiritual health impacts [2]. Many non-human beings also experience injustice in the form of habitat loss and extinction [3]. Multispecies justice is a term that expands the idea and practice of justice to encompass and respond to the destruction of multispecies ways of life and rejects the notion of human exceptionalism [4]. The focus of multispecies justice is on the interconnected Relations (Respect, Relations, and Responsibilities are capitalized to acknowledge Indigenous Mi’kmaw Teachings of our collective Responsibilities to m’sit no’ko’maq (All our Relations). Respect for Land, Nature, Knowledge Keepers, Elders, and the names of Tribes, including the Salmon People and sacred spaces, such as the Longhouse, are also denoted with capitals. For more, see Table 1 [5]) between animals, plants, microbes, rivers, forests, humans, and natural ecosystems [6]. We adopt an Indigenous Wholistic theoretical stance that assumes we are all part and parcel of the whole [7].
The transdisciplinary science and movement of Planetary Health focuses on understanding and addressing the impacts of the triple planetary crisis on human health and all life [8]. The heart of the Planetary Health movement is understanding our mutual interconnection within Nature [9]. Nurses often partner with communities to promote health equity [10]. These nurse–community partnerships hold untapped potential to address the health impacts of the triple planetary crisis and promote Planetary Health. The nursing literature is beginning to explore nurses’ sense of place and belonging within Nature and how to co-create authentic relationships with more-than-humans in these community partnerships [11,12,13,14,15,16]. The term “more-than-human” refers to the multiple worlds of all beings within Nature and their interconnection with humanity [17]. Here, we share our stories of learning to embody these concepts within local ecosystems.

Our Story

Our story of arriving at this place and space of writing provides evidence of the Spirit of Nursing at work [18] and the wise life force that has beckoned us to listen. A chance meeting of nursing scholars from the Atlantic to Pacific Coasts, in two countries, illustrates how interconnected we all are to our Earth Mother, her waters, her atmosphere, and all beings (what is now referred to across disciplines as Planetary Health and Well-being). We recognized in each other a Soul Wound [19]:
Culture is part of the soul. As human beings, we are all part of a culture and not separate from it. When the soul or culture of some persons are oppressed, we are all oppressed and wounded in ways that require healing if we are to become liberated from such oppression
(p. 588).
As nurses, we shared grief and scars from having worked within colonial systems. We cared deeply for Mother Earth and were interested in resisting hegemonic nursing discourses by recentering Indigenous Knowledge Systems. We were no longer willing to be confined to limiting oppressive constructs, cultures, or identities, including being human, that silo us from Nature. Instead, we recognized ourselves as part of a living, evolving, and emerging ecosystem.
We began this journey already breathless from a race with others to summarize a Global Nurse Agenda for Climate Justice [12] and to outline how nurses might ethically encounter Planetary Health. Our initial bonding was centered around academic writing and listening deeply to Elders. Thank you, Elder Dr. Albert Marshall, for teaching us about Etuaptmumk (Two-Eyed Seeing) [20] and encouraging us as nurses to write things down (personal communications 2021–2022). Thank you to the late Elder Dr. Murdena Marshall for your gifts in integrative science and lessons on the sacred nature of Medicine [21]. Thank you, Dr. Julio Quan, for identifying the five landscape regions that we must navigate for regenerative thinking: political, ecological, economic, social, and ideological (personal communication 7 May 2024). We considered the Mi’kmaw Teachings of Etuqptmumk and Ksaltultinej (Love in Action) [22]. We leaned into the collective work of “Gesturing Towards Decolonial Futures”, which invited us to examine our denial and entanglement in the violence of modernity and colonialism [23]. We acknowledge and extend gratitude to nursing colleagues and co-writers who helped us along this journey. As we worked together, considering these Teachings, our consciousness became more flexible and fluid. We published our invitation to others for Planetary Health [18], our Climate Justice Agenda [12], together with a definition of climate justice [24], and the lesson of the Salmon for other nurses who are just beginning their journey towards Planetary Health [25]. We also knew that taking a step back to consider everything we had learned/unlearned was a radical act.
In Andreotti et al.’s germinal 2015 article, Mapping interpretations of decolonization in the context of higher education, they provide a map that they call a social cartography [26]. The authors illustrate “a social cartography of general responses to modernity’s violence” (Figure 1, p. 25). In this visual, we are moved on a continuum from a soft reform space that mirrors the status quo (and the limitations of all forms of technological and political responses to Planetary Health) to a beyond-radical reform space where modernity is dying and unfixable. As readers, we are encouraged to read and reread the diagram, considering our role as nurses in hospicing these dying systems and gesturing towards futures free of colonial entrapment. We are encouraged to move out of linear thinking and perhaps even occupy all the spaces simultaneously. This work continues to inspire our writing and theorizing. We are aware of both the systemic violence of modernity and, at the same time, intentionally leaning into finding spaces to breathe, pause, and reflect.
We recognized that relational and embodied Ways of Knowing and Being were embedded in our processes that were not thoroughly permeating our writing. The race was hard on our bodies and our Relations with more-than-human communities. We were tired of rushing our words to be understood and being out of breath. We started to stumble amongst ourselves and our stories. Things seemed out of step with our good intentions. We began to realize that what we were missing was indeed time to breathe the air that is the beginning and ending of our interconnections within more-than-human communities. As we missed our breath, we made missteps in sharing our hearts. Sometimes, the words we spoke and wrote became untethered from our conscious embrace. We realized that, unless we committed to earnest work to form agreements with each other that would stand the test of time, our social ways of sharing our Medicine would be at risk.
When we began sharing our conversations and lived experiences, we recognized at once that our hearts were being opened further to the pain and destruction of Mother Earth and that, somehow, simultaneously, we were hearing that our healing was deeply intertwined with planetary healing. While we do not yet know what this all means, we do know that this feels important, and we desire to share our process with nurses.
“All my Relations”, means all. Everyone…also means everything that relies on air, water, sunlight and the power of the Earth and the universe itself for sustenance and perpetuation. It’s recognition of the fact that we are all one body moving through time and space together…if we could all glean the power of this one short statement, we could change the world”
[27].
M’sit No’Ko’maq loosely translates from Mi’kmaw to All my Relations. The wise words of Richard Wagamese above describe Cree understandings of this term in his language and Worldview while suggesting the potential this concept holds. Imagine the interconnected relationship that would allow nurses to nurture patients and communities while Mother Earth and all of Nature simultaneously nurture us. Yet, this is often not in our conscious awareness. Questions that arose during our previous work of introducing Planetary Health to nursing began to re-emerge [18]:
  • What would happen if nurses entered into dialogue with Mother Earth and leaned into her wisdom?
  • Would nurses show up differently if their practice was guided by Mother Earth Wisdom?
  • If nurses committed to a practice of connecting with the planet, would she heal us?
  • If we really became accountable for understanding All my Relations, what would have to change?
Inspired by these questions, we join in space (Figure 1). I, Jessica, have four hundred years of unwelcome settler colonial ancestry in Turtle Island and live in Teejop (pronounced de-jope), named by the Hocąk (Ho-Chunk) Nation who stewarded this land for at least 12,000 years. The English translation of Teejop is “Four Lakes”, reflecting the connected chain of lakes across this land. Below, I share a story of being with, listening, and learning from the second largest of these lakes, Čihabokihaketera (Tchee-ho-bo-kee-xa-te-la), translated as “Great Tipi Lake”. I, Robin, join as an immigrant from Wales, the son of botanists and biologists who worked to conserve natural habitats for forests, bogs, and mountains. We arrived as uninvited guests on the lands of the Puyallup and the Lushootseed-speaking peoples in the Pacific Northwest. I live in Tacoma, home to the fourth largest port in the Western US. Here, I talk with an Inlet that feeds Qʷiqʷəlut (Little Marsh), repaired and reclaimed from the poisoned site of the Rhône Poulenc fertilizer factory in the middle of port industrial tideflat lands. I, De-Ann, identify as Mi’kmaw and Irish and live in my home Territory of Mi’ma’ki on the shore of Pijinuiskaq (Mi’kmaw name which loosely translates to the river with long joints), also known as LeHave River, Nova Scotia, Canada. This river is 98 kilometers (60 miles) long and empties into the Atlantic Ocean. It is a tidal river, and depending on the tide, the river can appear to flow north or south. Yet, we know the freshwater stays at the surface while the saltwater moves upstream, creating an estuary. Estuaries provide unique opportunities for biodiversity and are home to many communities of plants and animals. I chose a space that has a small causeway to an island. From this location, I can always see the flow and where I am in relation to the water.
We know nurses hold the power and shared Responsibility to advance the health and well-being of each other and Mother Earth. This longitudinal study describes our process of partnering with more-than-human water communities to grow personal and collective wellness, multispecies justice, and Planetary Health.

2. Materials and Methods

Our first step was to stop doing and start noticing and listening. Here, we describe the beginnings of the methods that we will use throughout this longitudinal study to create a circular path around our consciousness of each other. These methods help us braid our ideas, dreams, and understandings of our purpose into co-learning our purpose together. This is simply a beginning, an opening into deepening our Respect for Mother Earth and ourselves. As a reader, you are welcome to read and understand, but know that writing these things down is just that, a past action from which we lift into the present only that which we can carry with us for the journey.
Collaborative critical autoethnography is a methodological approach to qualitative inquiry and empowerment that facilitates solidarity and resilience in justice work [28]. This evocative form of autoethnography allows us to incorporate dialogue and experiences and, most importantly, tell our stories in our contextual realities [29]. We utilized critical praxis, participatory inquiry, and relationship-building with local Earth beings (i.e., multispecies). Reflexive photovoice was our primary method for reflection and deepening a sense of place in the context of anthropogenic change and Indigenous survival [30,31]. Following this method, photos were taken to center Nature, and reflective journaling helped deepen Relations and describe our understanding of interconnection within Nature. The University of Wisconsin-Madison Minimal Risk Research Institutional Review Board determined that this research did not involve human subjects as defined by United States DHHS and FDA regulations.
We set an intention to contemplate our own experience of rupture from ourselves and reflect on the good work of repair and recovery during the Winter Solstice of 2023. Interestingly enough, we all had established relationships with bodies of water and were aware of water protection work. When we embarked on this project, Jessica noticed that lakes in her area were not freezing as early as in previous years. This inquiry led us all to reflect on our shared interconnection with water ecosystems and partnerships with more-than-human communities within (previously described) local geographies.
During our first month of invoking relationships with each other and the waters, we listened to the questions that formed and let our reflections guide this study. We sat with the land and water and wrote down what came forth. We listened to discern our just rights and Responsibilities for caring for these relationships. We set no further intention for the full 21 days from 21 December 2023 to 11 January 2024, except to watch, wait, and record our thoughts. We formed a WhatsApp group called Water Whisperers and shared photographs and reflections almost daily. We started to heal our understanding of our brokenness and disconnection from Mother Earth. When we gathered on the 25th of January, we resolved to continue our work together and to gesture towards a future where we might share with nurses as nurses. We suggested this was a way of “keeping a spoon in the soup”. We set an intention to write in a good way about our efforts to generate an understanding of interconnection within Nature, noticing that our work together would be an “opening/resonance/invocation”. Two weeks later, we started our conversations with water, each of us finding a place and a way to encounter a body of water. We considered this a way to start listening for questions, “watching the thaw”. We expect our research questions and reflexive photovoice narrative to evolve over this longitudinal project of approximately ten years and support ongoing, intentional praxis to further Planetary Health embodiment and reciprocity [32].
This project is an ongoing collaboration and intentional practice among three nurse researchers conducting autoethnographic work simultaneously, with biweekly sharing, interaction, and the intention to distill common themes and narratives [33]. Our physical distance from each other is across the continent of Turtle Island (North America, see Figure 1). We talk regularly over Zoom for about 90 min every two weeks. Our ways are to always begin with a warm-hearted welcome to how Mother Earth speaks to us from the corners of the seasons, the light, and the whispers of the wind. Our talk Respects all of our Relations and is concerned with following the ways of stories with the land, or, as others have described, “worlding the world” (Carl Mika, as cited in de Oliveira) [34]. Some of these stories are sacred, some are personal, some are to be shared socially amongst others we know, and perhaps amongst other nurses, some are already traveling through time and have a physical presence for us to learn from.
We agreed that we would “sit with the land” and “invoke/reflect/listen and discern our just Rights and Responsibilities for caring for this relationship” to “let our reflections guide us”. We knowingly set aside other thought structures and frameworks because of the “troubled identities of text and Western thought structures”. But, we did suggest questions from which to begin this conversation (Table 1). These consider our physical, personal, and relational knowledges of nursing and our emerging explorations of what it means to be actively engaged in Planetary Health.

3. Results

Here, we share results using exemplary photos and narratives from our initial engagement with local waters.

3.1. Am I Welcome Here?

An ongoing question I have as a white settler with a long ancestral history of settler colonialism is, “Am I welcome here?” I think the short answer is “No”. “Am I welcome in Nature?” What does that even mean? What kind of question is that? I think about Cultural Safety and consensual relationships within Nature. Can Nature consent to be in a relationship with me? I believe the fundamental question presupposes a paradigm of separateness between myself and Nature. Whereas, in reality, are we not already interconnected? Are we already in a relationship? So the question I received back from Čihabokihaketera is, “Are we in Right Relationship? Because we are already in a relationship—that’s reality. Are we in Right Relationship?” What does that mean for me? What does that mean for my ancestors? What healing can occur there between myself and throughout the spiral of time?
Figure 2.
How did I begin my conversation with Čihabokihaketera?
Listening: It is Winter Solstice, 2023, and we meet on Zoom to celebrate. We discuss our reflections on the literature. We share our thoughts on climate change and its impacts on local lands—the rivers, mountains, and floods. Listening to the stories and teachings, we realize that we are all connected through rivers and tributaries—waters that flow into the ocean. My imagination begins to stretch into new ways of being, composting old ways, and midwifing the new. What is dying? What is emerging?
Noticing: It is 4 January 2024, and I am walking with a dear friend. As usual, we stop to give reverence for the beauty. And suddenly, my breath is caught. The lake is not frozen—or anywhere near it. I say, “Isn’t it usually frozen by now?” “Yes”, my friend sighs, “it should be…it’s been warmer than normal this Winter”. Later that day, I reflected on how the average freeze date for this lake used to be the Winter Solstice. Now, it is January. It still has not frozen. I take a photo representing the juxtaposition of this beautiful sunrise, a symbol of hope and the dread I feel for all life on Earth (Figure 3). I share this image and sentiments on social media, knowing that I have many connections in this watershed, testing the waters for reactions. A mix of emotions is shared back. One friend writes, “I hear you. I was just thinking similarly on my walk this morning”. Another public health nurse friend shares, “[Son’s name] and I walked across Wingra Bay in February the first year we moved to [neighborhood]. Now, there’s not even any ice on it. It feels strange. I have much worry, too”. Other locals wrote, “If the human race were removed, the Earth would heal. We have been poor guardians of Mother Earth”. “I’ve shared this view and these thoughts for the past week (and more!)”. “Right there with you”, Friends outside of the watershed said, “I hear you”. “Such a beauty”. “Yes”. I realized that I wasn’t alone in noticing this change. I connected with a collective concern. I begin an online photojournal to share this experience with De-Ann and Robin.
Learning, Unlearning, and Reflecting: A few days later, I walk among the effigy mounds along Čihabokihaketera. These mounds, created about 1500 years ago, resemble bears, canines, birds, and water spirits [36]. I do not yet know that Čihabokihaketera is the Hocąk name for the lake, but I reflect on how the Hocąk Nation has called these lands Teejop since time immemorial. Later, at home, I begin researching the original names of the waters. I learned the name for the river that connects two of our lakes is Mąą’ii yahara, which translates to “Catfish River”. I am pleasantly surprised that it retained (most) of its name (Yahara River). White colonial men renamed these waters to replace the Hocąk names. I learned that the original name for this lake is Čihabokihaketera, which translates to “Great Tipi Lake”. This was the first time Čihabokihaketera and I had been properly introduced. I reflect on the whiteness and coloniality of my ancestors. They arrived in what is now called the United States as early as the 1600s. It feels like a long time until I compare it to the 12,000 years the Hocąk have lived here. This leaves me with a conflicted sense of place. I feel connected with the land and waters, but to what extent? Is there a more profound, ancestral level of interconnection within Nature that I will never know? That I cannot know. This thought saddens me. I reflect on this in my photojournal, including pictures of the mounds and monuments along Čihabokihaketera. In mid-January, there is a blizzard, and Čihabokihaketera freezes amid extreme snow and cold. Soon after, Čihabokihaketera begins to thaw again, unable to fully rest, recover, and regenerate.
We continue to meet, share, and reflect on our journeys. We discover that we had followed a similar process of learning the original names of these waters and unlearning the settler names. We commit to developing a shared practice of inquiry with the land and waters, sitting with these places, and letting our reflections guide our processes.

3.2. My Path to Talking with Inlet/Qʷiqʷəlut/Rhône Poulenc

Invocation: I, two sticks from cottonwoods, to you the inlet behind where I am standing: Thank you for your persistence where there is so much doubt; thank you for the water you continue to bring to the roots, the air, and brother moss. These two sticks found me in the cottonwoods beyond the fence, behind your shores. One rose up out of the marsh as I walked wet footed, one broken off hanging from the thicket where spring promises growth. As I cast these two sticks into you, I ask for connection, for Etuaptmumk, for the inspiration to move with you in Kesultulinej. I am listening, I am looking, I have the memory of the bark of wood in my fingers, and I am hearing the song of chickadee, the call of merganser, inside the furnaces of humankind that surround us. I will wait here for your voice.
Figure 4.
What is my method to begin talking with Inlet, in the place of the Rhône Poulenc site now called “Qwiqwəlut”, which in Lushootseed means Little Marsh?
I remember the day that I found Inlet/Qwiqwəlut/Rhône Poulenc, a restored salt marsh sandwiched between an oil refinery and a container shipping yard. I had dedicated my sabbatical year to explore the vast tideflats of Commencement Bay inside Tacoma, the city where I live and teach, and the largest port in Puget Sound, lands of the Coast Salish peoples, thriving since time immemorial. These waters have supported the lives of Puyallup. Lands were seized through force and exclusionary policies from the mid-19th century treaties of Isaac Stevens at Medicine Creek, Point no Point, and Point Elliot to the hideous General Allotment Act of 1877 to the present day and the prevailing power of white supremacy.
I had come intentionally looking for Inlet/Qwiqwəlut/Rhône Poulenc, noticing that it was listed as a city park and a place of public access. I could not find it on my first drive down the barrel of the Port of Tacoma road because the parking spot was minuscule. I passed through miles-long walls of container-cargo yards at the sprawling Washington United Terminals—stacked to the maximum height of seven containers during that time of the pandemic and the collapse of the extraction supply chain. And then, there was nothing. I made a U-turn just past a grove of cottonwoods that would later become my beacon to Inlet’s location and drove back, looking. I pulled up alongside the shipping yard and asked the guard, but they had never heard of it. I drove past again, and, then, I saw it… right behind where the guard was sitting, there was a small pile of mulch, a chain link gate, and fence amongst other chain link fences.
There is a narrow path heading northeast toward the water between two of these chain link fences for about 100 yards. Looking back to where you park (Figure 4), on the left, there is a bustle of workers in the parking lot of the container terminal: trucks heading in and out depositing and fetching containers from the deep water dock and massive container ships that populate Commencement Bay. On the right is the US Oil tanker farm (one of several on the tideflats) stretches out empty of people across emergency drainage ponds, towering tanks, and snaking pipelines. A truck or two sits without people by some sheds next to the dock where tankers, such as the “Florida”, come once a month to fill up on their way to Hawaii. You walk between these two industries on an asphalt path where Bradley Thompson, a nurse and volunteer with the climate justice group 350Tacoma, has been working to establish plants that can survive the heat of the summer and the drenchings of the Pacific storm winters [37]. 350Tacoma has adopted this park [38]. The park itself is reclaimed from the former site of the Rhône Poulenc fertilizer factory and is part of the many superfund cleanup sites in this area.
The path twists slightly left and right in the narrow strip between fences, like it was designed for people to linger and look at the industry to the north and south. But the surprise awaits just around the last bend, and, past some surviving cottonwood trees, there is a deck that looks out over the salt marsh and Inlet/Qwiqwəlut/Rhône Poulenc. There are ripples of green and brown salt marsh grasses, scrub pines along the side, mud exposed down to the edge of the (Dredged) deepwater Blair Waterway. The Inlet itself is the tongue of water that fills and empties the salt marsh twice a day. The water is always in motion with the tide, and there is an intimacy in this tiny space wrested back from the oil tanks and shipping containers that surround me. The view northeast across the waterway is of the Koch Brothers’ Georgia-Pacific Gypsum factory, always grinding, with white dust and steam, and, looking to the right, you can see rows of cars, blinking, imported, awaiting delivery. And then, you can see the steep hills that form the banks of the bay, tree-clad, with houses and homes downwind of the breezes that blow from here.
So, this is where I come. I have found places flat enough to sit on both sides of Inlet/Qwiqwəlut/Rhône Poulenc. I bring my cell phone to keep a visual and textual record. Following the suggestions of Kurio and Reason [35] and their Voicing River project, I always begin with some sort of a spoken invocation (Figure 4, Table 1). I thank the water and Inlet/Qwiqwəlut/Rhône Poulenc. Sometimes I bring an offering: fresh water that I have been drinking, a frond of cedar, a twig of willow. And I always begin with a question. I must be accountable to my own agreements with my colleagues in this project, and I must begin a conversation.
This conversation, of course, I now realize is already there, following its own course of storying and re-storying in my head in the time I am away from Inlet/Qwiqwəlut/Rhône Poulenc. With enough intentional “noticing” of this conversation, I can develop new questions to ask. My noticing of the world on my way to Inlet/Qwiqwəlut/Rhône Poulenc is a way to begin to key into the conversation again, almost like a welcoming and an opening.
And then I sit. And I try to notice my own senses participating in the conversation, letting go of my unified sense of myself a little in the process. Practicing Etuaptmumk (Table 1), I notice the various parts of my body that are in contact with the ground, the smell of the marsh grasses and the roughness of the rocks I am sitting on. I notice that my ears are hearing different noises on either side of my head—the rush of the Gypsum Mill, the incessant alarms of reversing container trucks—but these come through into one experience, and, by listening closely, I can also hear the lapping of water, the dribble of freshwater seeps, spilling down their self-dug channels in the exposed mud, and the silver rustle of the cottonwood above my head. The two nostrils in my head also participate, sensing acrid vapors from the oil refinery, dust from the asphalt of the container yard, and the deeper flavors of salt mud, pine sap, and water. Unifying what I am seeing, my eyes see the physical world in front, below, and above: the broken ground, the steel fences and asphalt, the cranes and ships, the water, the mud, the snail on a pebble on the mud by the water. A seal breaks the surface from below, and an osprey now in my range of vision swoops from high overhead to a nest of sticks in the light tower in the container yard. I am thankful that my eyes and all my senses can talk to each other. Especially now that I am aware of how they are deciding what I should see, smell, hear. I know that this is only the beginning practice of Etuaptmumk and that there are levels of vision that I have not yet begun to encounter in my sitting, that this is just the beginning stages of a deeper conversation with Inlet/Qwiqwəlut/Rhône Poulenc.
As I sit and listen now in this state of being aware of how my sensing “selves” are communicating with each other, I take notes on what I am experiencing. In a way, I am collecting and annotating what I am hearing Inlet/Qwiqwəlut/Rhône Poulenc say. I let go of caring that I am writing these things down, that my subjectivity is influencing what I am thinking. I think the work of Etuaptmumk (Table 1) permits me to be ok with the various conversations that my senses are having about my experiences of the ways of Inlet/Qwiqwəlut/Rhône Poulenc talking to me. If I have an insight into the question I asked Inlet/Qwiqwəlut/Rhône Poulenc out aloud at the beginning of this conversation, I write it down. I notice opportunities to inquire further with what I am writing, entering into a deeper conversation with the forces around me. It turns out to be easy to look and sit and listen to water. It is calming, of course, and the urgency to adhere to a time limit dissolves. I find myself leaning into the practice suggested by David Abram [17] (Table 1) to “keep myself from falling completely into the civilized oblivion of linear time” (p. 202), summoning up the body of memories I have of Inlet/Qwiqwəlut/Rhône Poulenc through my feet and my connections to the ground, all the harm of 150 years of extraction, all the bounty of a millennium as water/mud/clam-bed/lahar-flow/bed of the great ice sheet, and all the times I have traveled past here, talking and acting with others about nursing, breathing, healing, and community. Holding this body, I “call into awareness” the vast possibilities of my future. Then, holding these two as if, as Abram suggests, “they are two balloons”, I allow them to flow into this present moment.
I find that words from the past and future become the substance of what I hear in my conversation. I take a photo or two of something that moves me. I write in the notes application of a cell phone. The next day, I will return to select one of these photos, edit my text, and post something on the running record that I have been keeping and sharing with my Water Whisperer nursing friends. When we first began this project, we set loose parameters (previously described) for beginning these conversations with water. I return to these whenever I am at a loss of how to move inside this conversation and my Responsibilities in this relationship with Inlet.
A note on my naming of this land: In my conversations with this more- than-than human being, the suggestion arose to name her in a fluid way that resists colonial forms of knowing, recognizing (1) the enduring importance of Inlet as a source of shelter and food, (2) acknowledging the renaming reclaiming work of the Puyallup and 350 Tacoma (Qwiqwəlut “little marsh”), and (3) holding for healing the historical trauma still burdening this land from the poisoning caused by the Rhône Poulenc company from fertilizer chemical pollution that this land is reclaimed from.

3.3. Flowing with Pijinuiskaq (River of Long Joints)

I offer Tobacco and give prayers of gratitude for Pijinuiskaq (Piji I decide in the moment to call her) and ask permission to talk to her. I already sense the answer and don’t want to assume and honor protocol by demonstrating Respect. I quickly hear yes. Now as I sit at your feet I feel your quiet power and steadfastness. I am overcome with humility and I start to feel smaller yet more connected. I am at once both full of curiosity and not sure what I have to bring to this conversation. She keeps flowing and I breathe in her ether and my fears begin to ease. I can feel my nervous system regulating and attuning to her vibration. I begin to feel my senses open up one by one to appreciate all that is being offered. I close my eyes and ground my being into the earth. I thank Mother Earth, holder of all Knowledge, for holding me and Father Sky for securing me safely as I merge with the essence of the river. With my eyes closed I am more aware of her song. It’s actually quite obvious and sleepy parts of my brain begin to listen differently. I feel the cold air on my face and smell the aromas at the water’s edge. I open my eyes and take a deep breath and a long luxurious 180 degree gaze at the moving water. An eagle flies overhead, geese are feeding near the shore and the white pine and hemlock are majestical in the way they guard this place. A red squirrel clucks disapprovingly as I have interrupted a cone gathering in progress. I realized when I get back to my car that I hadn’t spoken or thought of any words or questions. I think this came as a surprise as I was so sure communication had happened.
Figure 5.
As I continue(d) to grow my relationship with Piji and my practice of intentional dialogue, I very quickly began to feel like a soldier who took off her armor. These conversations with Piji and our collective were opening portals in my thought, felt, spiritual, and somatic bodies. It felt like everywhere I looked I saw injustice. My everyday lived experiences left me raw and overwhelmed. I realized that I had already set up a playbook in my head about how this was supposed to look, and I was already getting this wrong. It was not enough. I think a lifetime of disconnection and dislocation had patterned an internalized violence that I had not been aware of before. I brought this to Piji. She listened deeply and said nothing. As I sat and listened to her with my whole being, I felt a huge weight lift off my shoulders as she gave me permission to be ‘not fine.’ This sense of allowing began a compassionate turn in my own healing. This turn was unexpected.
Hurricane Milton is hours away from striking the West coast of Florida. I have been watching news updates all day, sending prayers to all my kin in harm’s way and I just can’t settle myself down. I feel the urgency to do something and the frustration of knowing there’s nothing to be done. I am angry when I read conspiracy theories about the hurricane and climate. I decide to go visit Piji. Figure 6. The tide is out and I’ve never seen her this still. I can’t even perceive flow. I sit in this paradox of the peace of Piji and the chaos of Milton and two airborne ducks I hadn’t noticed plop into the water unceremoniously. I walk to the water’s edge and offer Tobacco. It lands in the rock and seaweed. My heart feels heavy yet I also sense my Spirit is beginning to feel soothed. I am thinking about this and recognize my dis-ease is guilt. I shouldn’t be sitting in peace if Floridians were waiting in fear. Piji has done it again and turned my attention. She invites me to consider a broader perspective. My world got bigger and for a few moments I could hold the stillness and the chaos. I didn’t need to have all the answers. She reminded me again that I am part of something bigger than I can comprehend. Figure 7. I have learned to trust her and trust myself. I surrender to the liminal space and take a deep breath and let out a sigh of relief. I leave once again changed. I am relearning/unlearning/learning how/who/what to engage community as partner, broadening my perspectives and allowing myself to feel and heal.
As I leave Piji I pray for a dream. We have noticed collectively that our stories have been coming into each other’s dreams.
Our initial engagement with local waterways are as diverse as our ancestry and geography, yet shared lessons surface the truth like ancient canoes recently discovered in Teejop [39]. Simply put, when we open ourselves to communicate with more-than-human communities, we find ourselves in a place to experience communication with countless other beings and life forms [40,41]. With this early sacred work as guidance, we begin to set a way of working together that will last through the next ten years of our commitment to whisper with water for collective wellness, multispecies justice, and Planetary Health.

4. Discussion

Here is what we know so far in this work. Elders Albert and Murdena Marshall taught us to practice Etuaptmumk and Ksaltultinej, above all else, in our practices to integrate our Medicines or gifts with each other and with other nurses. We are to be mindful of our attention to our consciousness, employ our stories to develop pattern-based knowledge, and Respect how these stories are exchanged. We recognize that we must hold ourselves accountable in seeking, attaining, and sustaining the seven Sacred Gifts necessary for our work together: Love, Honesty, Humility, Respect, Truth, Patience, and Wisdom [42].
We realized, as our methods evolved, that the deep listening and dialogue during our Zoom meetings evoked other Knowings: something we forgot to share, a memory of something related, or new inspired questions. As we listened and responded to each other, it seemed that many synchronicities, such as professional conversations, academic journals, and webinars related to our conversations, were occurring. We considered the writing of Bohm to understand what was emerging in our dialogical process [43]. This relational work also activated dreams for all three of us. At the time of this writing, we have not added a dream journal to our method, but dreams with our more-than-human kin and each other are coming forward in our photojournals and during our meetings. Shawanda advocates for the Knowledge gained in dreams as data and eligible knowledge for academic writing [44]. Questions that we might consider adding: How do we understand dreams in our data collection and messages from our more-than-human kin? How do we share and interpret our Dream Knowledges [44]? Can/should we share them?
We learned from teacher Dr. Julio Quan to seek Wholistic peace-making within our group. He warned us that, in his experience in peace work for the United Nations and Guatemala, group dynamics can become a structural element for maintaining and advancing hegemonic actions and oppression. He explained the urgency for regenerating methodologies of group work that can transform these structures into a Wholistic practice of critical consciousness and the advancement of human rights: moving in a continuous cycle of preparing, building, maintaining, and recuperating our group. He taught us the importance of finding “satisfiers” [45] to meet needs in our nursing practice within our group. He showed us how these needs can be understood within his “Modelo”, a systematic way to consider the tensions between two dialectic axes: gnoseological and axiological, system and existential. In the first axis, a group’s application of the gnoseological (or techniques) is balanced with the group’s commitments to the axiological (or value) components necessary for group work. In the second axis, systems for group dynamics are balanced with the existential categories of being (Figure 8). It is only by applying ourselves to the choosing of ways to meet our needs that this system will become concrete. Our move towards Wholism in our co-learning together marries our intentions for working well together [46], performing autoethnographic analysis [47], and recognizing the importance of cultural and land-based practices for health [48].
We recognize that we are just beginning to reworld ourselves inside this story of partnering with more-than-human waters, so we are in the “preparing for peace stage”. Each category or concept within the Modelo for this stage will be reflected on as we begin our preparation. We must decide for ourselves what our Rights and Responsibilities are (to the group, for the group), knowing that we hold the value of freedom and employing our ability to choose. In this early work, we must reflect on how respect informs our relations with ourselves and our more-than-human partners, with dignity as a fundamental element. We will consider techniques for improving our quality of life, maintaining diversity and balance within Relations of unity and considering ways to sustain our group in the years ahead. Last, in the stage of preparing for group work, we will consider how to employ the techniques of defending ourselves and our work socially; our value will be security. We will agree on what should and should not be written down. More important, perhaps, than considering what others say we should be defending, such as Internal Review Board approval, we need to decide for ourselves how to control what is shared outside of our group, who to include, and how to maintain our autonomy within equitable Relations. This ten-year project, with expected opportunities to publish specific insights along the way, must necessarily consider just dissemination strategies as we navigate our own academic, practice, and advocacy interests. We must be vigilant in confronting epistemological dominance [26] and avoid becoming a part of local and global capitalist political economies of knowledge production with environmental and epistemic implications.
The forces of epistemological dominance will always threaten this project of relating and kinbuilding with the more-than-human because they encourage the instrumentalization of human work for human purposes. Our project challenges this dominance through actions necessary to “worlding” more just and equitable futures for water. Our experiences completing and disseminating the principles of the Global Nurse Agenda for Climate Justice (CJ Agenda) taught us some of these lessons. We had to answer questions from our audience about the importance of these words and quickly found that readers were drawn to actions that impacted human communities rather than the climate justice considerations for multispecies lifeways and the rights of Nature to exist, persist, maintain, and regenerate its vital cycles [49]. We realized that, when we spoke about community, others thought we were only thinking about the human community.
We responded to nursing’s inclination to instrumentalize the human over the more-than-human in our climate justice work in various ways. We included a final principle that encouraged nurses to “grow environmental consciousness through transformative experiences in embodied land-based, art-based, storytelling, drumming, and dancing” (Principle #36 [12]). With permission from Salish Storyteller Roger Fernandez, we began our textbook chapter on climate justice with the Story of Salmon Boy [25]. Our 10-year journey was inspired by a principle in the CJ Agenda, which called on nurses to “develop deep practices in meaningfully engaging the self and others with the environment to advance ecological respect, healing, environmental and Planetary Health, environmental stewardship, and justice” (Principle #9, [12]).
We are on a collective journey to reconsider community from anthropocentric to kincentric [14,50], thereby extending our understanding of communities of practice and committing to personal and Planetary Health and well-being. Our experiences to date have provided significant personal and professional insights, and we feel an urgency to share this (a fractal of what we have learned) with our nursing colleagues. There is still so much to learn. There has never been a time when we have so many competing demands for our attention or when we are rewarded for checking out. This relational practice with more-than-human community partners is an invitation to be embodied in the present. We theorize that this will heal individuals, communities, and Mother Earth. Research, education, advocacy, and practice by nurses embodied and connected to the places they live, work, and play will be a radical departure from the status quo.

Worlding Futurities with More-than-Human Communities

Many Indigenous communities globally regard Mother Earth as sentient, meaning an animate being [51]. The Magpie River in Canada and other rivers worldwide have been given the legal designation of personhood, which recognizes inherent Rights. Elder Jean-Charles Piétacho, chief of the Innu of Ekuanitshit, speaking of the sacred Magpie River says… “I Am the Magpie River” [52]. When we know multispecies communities as worlds of kin, we can be in Relations with them that foster and sustain life, engage in less harmful practices, and co-create pathways to futures where all life can thrive. We experience the healing and connection of this relational praxis, research methodology, and place-based experiential dialogue and extend the invitation. Through practices such as attentiveness and deep listening, we learn about place-specific histories and shared networks informing our nursing and re-worlding with more-than-humans for Planetary Health. Leaning into the ontological difference in “wording” and “worlding”, we hesitate to draw conclusions, suggest next steps, or prescribe methods [53]. As a balm in these times, we offer this collaborative autoethnography of our stories and experiences immersed in the power and life force of our more-than-human kin.

Author Contributions

Conceptualization, J.L., D.-A.S. and R.E.-A.; methodology, J.L., D.-A.S. and R.E.-A.; writing—original draft preparation, J.L., D.-A.S. and R.E.-A.; writing, review, and editing—J.L., D.-A.S. and R.E.-A.; visualization, J.L., D.-A.S. and R.E.-A.; project administration, J.L. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Data Availability Statement

Data is unavailable.

Acknowledgments

We are grateful for our more-than-human partners, Elder Albert Marshall, the Late Elder Murdena Marshall, Julio Quan, and our colleagues with the Alliance of Nurses for Healthy Environments, Canadian Association of Nurses for the Environment, and Nursing for Planetary Health.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. Locating ourselves and our more-than-human community partners.
Figure 1. Locating ourselves and our more-than-human community partners.
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Figure 2. Am I welcome here? 30 January 2024. Photo by Jessica.
Figure 2. Am I welcome here? 30 January 2024. Photo by Jessica.
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Figure 3. Collective concern: beauty, hope, and dread. 4 January 2024. Photo by Jessica.
Figure 3. Collective concern: beauty, hope, and dread. 4 January 2024. Photo by Jessica.
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Figure 4. Invocation, 30 January 2024. Photo by Robin.
Figure 4. Invocation, 30 January 2024. Photo by Robin.
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Figure 5. LeHave Sunset Park, NS, Canada, Sacred Pijinuiskaq up close and personal, 1 February 2024. Photo by De-Ann.
Figure 5. LeHave Sunset Park, NS, Canada, Sacred Pijinuiskaq up close and personal, 1 February 2024. Photo by De-Ann.
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Figure 6. LeHave River, NS, Canada, Calm before the storm, 9 October 2024. Photo by De-Ann.
Figure 6. LeHave River, NS, Canada, Calm before the storm, 9 October 2024. Photo by De-Ann.
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Figure 7. LeHave Sunset Park, NS, Canada, A broader perspective, 9 October 2024. Photo by De-Ann.
Figure 7. LeHave Sunset Park, NS, Canada, A broader perspective, 9 October 2024. Photo by De-Ann.
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Figure 8. Model for Wholistic peacemaking.
Figure 8. Model for Wholistic peacemaking.
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Table 1. Guiding Questions and Practices.
Table 1. Guiding Questions and Practices.
Guiding Questions and Practices
Kurio and Reason (2021) [35]What would it be like to live in a panpsychic world?
How could we relate to the rivers as beings, subjects or other-than-human persons in their own right?
How might we engage with the rivers through a personal relationship, ceremony, and invocation?
What were the possibilities for reciprocal communication?
Bartlett, Marshall, and Marshall (2012) [20]Lessons Learned
Acknowledge that we need each other and must engage in a co-learning journey;
Be guided by Etuaptmumk Two-Eyed Seeing;
View “science” in an inclusive way;
Do things (rather than “just talk”) in a creative, grow-forward way;
Become able to put our values, actions, and knowledges in front of us, like an object, for examination and discussion;
Use visuals;
Weave back and forth between our worldviews.
Abram (1997) [17]Locate yourself in an outdoor space;
Breathe, relax, and close your eyes;
Feel the whole bulk of your past;
Call into awareness your future;
Imagine them as two bulbs of time in an hourglass of which you are at the neck;
Allow them to leak their substance into this minute moment between them;
Let the past and future dissolve entirely;
Open your eyes.
25 January 2024 IntentionWhat should we share with nurses? As Nurses?
How do we teach wellness through these experiences—these conversations with Pijinuiskaq, Čihabokihaketera, and Inlet/Qʷiqʷəlut/Rhône Poulenc?
How do we teach wellness through the conversations with this writing team of friends?
How do we stay connected to the work for Planetary Health?
How do we steward these Relations?
How do we keep a spoon in the soup?
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MDPI and ACS Style

LeClair, J.; Sheppard, D.-A.; Evans-Agnew, R. Getting to the Heart of the Planetary Health Movement: Nursing Research Through Collaborative Critical Autoethnography. Challenges 2024, 15, 46. https://doi.org/10.3390/challe15040046

AMA Style

LeClair J, Sheppard D-A, Evans-Agnew R. Getting to the Heart of the Planetary Health Movement: Nursing Research Through Collaborative Critical Autoethnography. Challenges. 2024; 15(4):46. https://doi.org/10.3390/challe15040046

Chicago/Turabian Style

LeClair, Jessica, De-Ann Sheppard, and Robin Evans-Agnew. 2024. "Getting to the Heart of the Planetary Health Movement: Nursing Research Through Collaborative Critical Autoethnography" Challenges 15, no. 4: 46. https://doi.org/10.3390/challe15040046

APA Style

LeClair, J., Sheppard, D. -A., & Evans-Agnew, R. (2024). Getting to the Heart of the Planetary Health Movement: Nursing Research Through Collaborative Critical Autoethnography. Challenges, 15(4), 46. https://doi.org/10.3390/challe15040046

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