These are my personal reflections on health care and social justice from my perspective as a nurse practitioner.
The medical part of the title is obvious. By margins I refer to different nuances of the meaning of the word, and of its spin-offs of “marginalize,” “marginal,” etc, loosely transposed from the Oxford English and Merriam-Webster dictionaries:
Margin: a limit below or beyond which something ceases to be feasible; an area, or state, or condition excluded from or existing outside the mainstream (and an old, obsolete meaning still pertinent here is to take notes or jot things down in the margin).
Marginalize: to treat a person, group, or concept as insignificant or peripheral.
“The center of a representational system is always dependent on the margins, despite its attempt to establish hegemony over it.”–Arthur W. Frank
Josephine Ensign was born in Richmond, Virginia in 1960. She received her BA (Biology and Religion) from Oberlin College in 1981, her masters in primary care nursing from the Medical College of Virginia in 1986, and her doctorate in public health from the Johns Hopkins University in 1996. She has done postgraduate work in medical ethics at Harvard University and in narrative medicine at Columbia University. Currently she is Associate Professor of Community Health at the University of Washington School of Nursing in Seattle, Washington where she teaches health policy and narrative medicine. She has worked as a family nurse practitioner for the past three decades, providing primary health care to homeless adolescents and adults in large urban areas on both coasts of the U.S. Through a Fulbright Fellowship, she expanded her research and advocacy internationally with work in Thailand and Venezuela. The focus of her career has been to increase an understanding of the lives of marginalized populations, and to develop ways to increase their access to effective health care programs.
As a university faculty member she has published numerous journal articles and book chapters on homelessness, health and human rights. Her literary non-fiction essays have appeared in the The Sun, Oberlin Alumni Magazine, Silk Road, University of Iowa’s Examined Life, and Johns Hopkins Public Health Magazine. She received the Zola Prize in the 2010 Pacific Northwest Writer’s Association Literary Contest for an essay entitled “Gone South,” published in Silk Road (Winter/Spring, 2011). An excerpt/reprint of “Gone South” was published in the University of Iowa‘s The Daily Palette. She currently is working on a book entitled Catching Homelessness, a narrative nonfiction account of her work as a nurse practitioner providing health care for homeless people while navigating her own passage through homelessness. An essay “Next of Kin” based on a chapter from Catching Homelessness will appear in Creative Nonfiction’s anthology I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse (Lee Gutkind editor; In Truth Press, 2013).
- Note on my personal blogging ethical code: I blog as if my mother were reading every word I write. If you knew my mother, you would understand that this is a much higher ethical code than any existing blogger’s code of ethics (cyberjournalist.net has a good one).
- University Big Brother and Big Sister would like me to state the following: “This is a personal website, produced in my own time, on my own computer, and solely reflecting my personal opinions. Statements on this site do not represent any past, current or future employer, or any other organization with which I may be affiliated. All content is copyrighted.
- You can contact me either by leaving a comment (links to my personal e-mail and I will respond).

Hello Josephine!
I took your homeless youth class several years ago while I was in nursing school. I am starting the Community Health Nursing program at UW this fall. I stumbled upon your blog through someone who posted it on Facebook. I can’t wait to read more. I have always admired and respected what you do.
Julie Myers
Hi Julie,
Thanks for the note and update on what you are up to now–congratulations and lucky us to have you starting in community health! Hope to see you around.
Josephine
Hello!
My name is Sam and I work with Jacksonville University’s School of Nursing. Because of the quality information you are providing to the online world about nursing, we would like to award your blog one of the “20 Best Blogs for Nurses.” To mark this achievement, I am including code information with this email. When the code is added to your blog, a badge will be produced which announces that Jacksonville University considers your blog one of the 20 Best Blogs for Nurses. You can see what the badge looks like here: http://schoolofnursingonline.wordpress.com/ on the right hand side toward the bottom.
I wish to congratulate you on your success, and am happy to offer you help in successfully publishing this badge to your site. In the right hand column, you will be able to add this code and on every page your visitors come to, they will see that you have been recognized as a top blog in the niche of nursing.
CODE for Your Award Badge:
RN to BSN
Please email or call me if you have any questions. Keep up the great work, and I look forward to reading future posts on your blog.
Thanks so much!