RE-FORM: INSIDE AND OUTSIDE PERSPECTIVES ON HEALTH CARE

In late August 2011, just before this issue of Advances in Nursing Science went to production, Steve Jobs resigned from his post as chief executive officer of Apple. This event, even though anticipated for a while, created a flurry of tributes to Mr Jobs for the astounding accomplishments that he has overseen not only in the field of technology but also in the entire world of media and publishing. As one of those devoted "Apple" fans, I read many of these tributes and was impressed with some of the changes that Steve Jobs created that we now simply take for granted; many of which I had not realized carried a "Steve Jobs" imprint. What happened during the "Jobs" era, both in film (Pixar) and in digital technology (Apple) could be seen as a massive re-formation. Not only did he set in motion the development of the tools that made the changes possible, he charted a course for an entire shift in the way things are done.

As a reader you may be wondering what this has to do with a professional journal like Advances in Nursing Science; you may even be one of the rare individuals who is actually reading this editorial in print form! In more likelihood, you are reading this on a computer or on a mobile device. It may not be an Apple product, but the fact that by far most people now access information like this editorial online can be attributed in part to the shift that started with iPod and iTunes (Apple Inc., Cupertino, CA). When the product (iPod) and the process (iTunes) for getting stuff on it first appeared, many music fans were already using some form of mobile device to listen to music (MP3 players and even the old "Walkman" players). And a good number of those fans were downloading music, song by song, using illegal channels available on the web. Then along came a way to have lots of music of all genres, song by song, for a small 99-cent fee. As one of the articles on Jobs noted, many people wanted the convenience of mobile music, but did not want to "become mouse-enabled criminals taking the music we wanted." So we jumped on the opportunity to pay a small fee to have exactly what we wanted to hear, when we wanted to hear it.1 The same kind of re-form in the world of print media is evolving, influenced in large part by the appearance of the iPad, and other tablet devices that have quickly followed.

Those of us involved in the production and distribution of professional literature have realized, as these shifts have taken place in the world of popular media, that our world is beginning to shift in mammoth proportions. The biggest challenge, which the Steve Jobs story makes abundantly clear, is that of seeing the world through a different lens. Jobs was working and living in a world of computers, which, from inside the other world of music, magazine, and book production, seemed to have little to do with how people purchase and listen to music, or how people read books and magazines. Certainly, computers were essential to the process of production and distribution, but from that inside world, it was not so apparent how "computers" could play a role on the other end-the world of those who actually listen and read.

Many ideas from both outside and inside the world of health care have been put forward as to how this endeavor of health care should and could be re-formed. Indeed, at the time of publication of this issue of Advances in Nursing Science, the United States and many other countries are experiencing a crisis in health care that is without precedent. I suspect that we have not yet encountered a "Steve Jobs" equivalent-a single force that comes along and quietly puts on the table a possibility that makes real re-formation possible. This does not need to come in the form of a single person with a vision. But it will need to embrace possibilities that somehow elude what most of us can imagine so far. I believe that nurses can contribute to the vision that is needed, and many have been working on promising possibilities for a long time. If you read further in this issue, you will find some of these possibilities. Let us all move beyond what is, and crack through the barriers that expand our vision! Once that happens, I believe true re-form is indeed possible!

-Peggy L. Chinn, PhD, RN, FAAN

Editor

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