One of my earliest lessons as a new hospice nurse was the realization that my work was largely focused on one central theme-relationships. Becoming immersed in the new field of hospice care in 1980, I began to understand that my role was to bear witness to the intimate relationships of seriously ill patients and their grieving family members. In each case, "my patient" was more than a patient; he was a son, a friend, a spouse or partner, a sibling, a treasured employee, and a person in a deep relationship with his God. My own becoming a hospice nurse was to grow in my ability to witness, nurture, support, and learn from these relationships. The work of palliative nursing is born of the knowledge of family systems theory, communication skill, and bereavement theories, as well as expert assessment and patient/family teaching. It is also made manifest in a delicate dance of unspoken communication between the nurse and the relationships served; the intuitive knowing of nurses as relationships change dramatically, as death approaches, and ultimately in the basic tenet of palliative nursing that our care is family centered and if done well is relationship centered.

This issue of the journal features reflections on this concept of relationship. The authors have addressed topics of end-of-life discussions in assisted living, family communication, and choices regarding hospice care. The article by Jablonski and Clymin introduces a very delicate issue of relationship-that of patient and nurse when request for assisted death is considered. Authors Beth White and Patricia Beach write of "In the Shadows for Family-Centered Care" and raise our awareness of the unique issues of relationships when parents become caregivers of adult children. At the opposite spectrum is the article by Haut et al on family caregiving in the pediatric ICU, where parents care for a child amidt serious illness or impending death. The article by Thrane and Jones reminds us that nurses continue in relationships with parents after the death of a child. Each of these articles also reminds us of how privileged we are as nurses to be a part of these relationships occurring in the most sacred days of our patients' lives.

Each of these authors is to be commended for capturing the delicate dance as well as the scientific foundation of the relationships examined in their articles. Well done!

This first issue of JHPN for 2012 begins our expansion from six issues per year to eight issues. This expansion is a result of our growing body of knowledge to be shared and the generous contributions of nurses and other professionals who give of themselves through their publications so that we all can provide better care for patients and families.

My hope is that the articles in this issue will inspire your practice in such as way that you too will seek to write for publication. Authors and readers are also in an important relationship, sharing their wisdom and advancing our practice.

Betty Ferrell, PhD, MA, FAAN, FPCN, CHPN

Editor-in-Chief

[email protected]