I Dare You to Drink the Vinegar

In this third article of Seeing Beyond the Stigma: Nursing Practice at the Margins, the story no longer begins with “What is stigma?” or “Who are Alex and Sharna?” We have already explored those questions (if you haven’t, go read articles 1 and 2 of this series). Their missed doses, late arrivals, and visible distress are now understood as part of lives shaped by poverty, trauma, and structural inequity, not as simple “noncompliance.” The work at this stage is different: it is about what nurses do with that knowledge in the flow of everyday practice, especially in the moments when documentation, policy, and split‑second judgments either deepen exclusion or open the door to more just and inclusive care. From Recognition to Responsibility  In the earlier posts, stigma was named as more than a personal attitude: it was framed as a social process in which people are labelled, stereotyped, separated, and pushed into lower status in ways reinforced by power. Link and Phelan’s description...

In every nurse’s career, there are people whose stories challenge us to look beyond the surface, to see the complex intersections of health, identity, and circumstance. Consider Alex and Sharna, a couple who have navigated many years of living in relationship with opioids, including stretches of reduced use and times when they were not using at all. Their histories hold layers of trauma, loss, resilience, and care, as well as repeated efforts to adapt, survive, and move toward safety and stability. Yet, for many clinicians, the ways their lives show up in care, the missed appointments, periods of renewed use, or struggles with mental health, can still trigger frustration before compassion. Stigma is not just an attitude; it is a social process that shapes care .  Link and Phelan (2001) describe stigma as a relationship between labeling, stereotyping, separation, status loss, and discrimination ,   all operating within unequal power dynamics. In the healthcare setting, these ...

Language is extemely powerful. The language that is used to describe mental health is important. I think that sometimes people forget that. I recently participated in an online discussion about whether stigma attached to mental health issues is more damaging than mental health diagnosis. One particpant, another mental health professional suggested that labels themselves do not do the damage, it is the meanings that we attach to these labels that causes damage. My question is, do words function independently of meaning? For example, is the term addict or personality disorder simply a neutral word? While I understand the author's notion that positive meaning could be attached to these terms just as much as negative ones this ignores the fact that there are meanings already attached to these words. Further, this ignores that fact that in medicine a client is often identified by their label, their mental health diagnosis. Since the beginning of my nursing career I have worked with ma...