It is hard to believe that the American Association of Critical-Care Nurses (AACN) is celebrating 25 years of AACN Advanced Critical Care! The journal has undergone many significant transformations throughout its illustrious history, not the least of which have been 2 name changes from its original AACN Clinical Issues in Critical Care Nursing to AACN Clinical Issues: Advanced Practice in Acute and Critical Care and then to the current title of AACN Advanced Critical Care (Figure 1). I have been fortunate to follow a series of distinguished editors:
* John Clochesy, RN, PhD, editor from 1989 to 1994
* Mary Lou Sole, RN, PhD, CNS, FAAN, editor from 1994 to 1999
* Patricia Gonce Morton, RN, PhD, ACNP-BC, FAAN, editor from 1999 to 2005
* Marianne Chulay, RN, PhD, FAAN, editor from 2005 to 2008
* Marla De Jong, RN, PhD, CCNS, FAAN, editor from 2006 to 2007
In recognition of the journal's 25th anniversary, now is a fitting time to hear from these editors about the changes they put into place through the years. The interviews provide reflections on their experiences as editors as well as an opportunity to hear from Ramon Lavandero, RN, MA, MSN, FAAN, senior director at AACN and an integral partner in launching and advancing the publication.
The Beginning
What was AACN's goal in creating this journal, and how was the title determined?
Clochesy: We wanted the words clinical and critical care in the title. I suggested that we start the name with AACN to let potential subscribers know who was sponsoring the journal, and a secondary benefit would be that a journal title beginning with AA would be shelved first in the library, making it easy to locate.
Lavandero: The goal of the publication was to provide acute and critical care nurses with advanced periodical content focused on specific clinical conditions. The second title-AACN Clinical Issues: Advanced Practice in Acute and Critical Care-was constructed to describe the intent of the publication:
* AACN differentiated it from existing or future publications with a similar name.
* Clinical Issues differentiated it from a research-based or -focused publication.
* Advanced Practice signaled it was not basic content.
* Acute and Critical Care indicated the clinical focus.
* Recognizing that other professions could use the content, "Nursing" was intentionally not included in this title.
How was the format determined?
Lavandero: The WB Saunders (now Elsevier) Clinics periodical series of topic-specific quarterly print seminars was well established and respected in the medical community and included Nursing Clinics of North America. Saunders was interested in developing Critical Care Nursing Clinics. However, the Clinics model uses invited manuscripts without peer review, and the model could not be changed. Also, the model did not allow AACN to hold the copyright for the content.
JB Lippincott (now Wolters Kluwer Health|Lippincott Williams & Wilkins) was willing to launch an AACN-branded quarterly with the same characteristics. However, it would include peer-reviewed content, and AACN would hold the copyright for the content.
Clochesy: The quarterly nature of the publication and the length of each issue were determined by the AACN Publications Committee and staff. Designing the actual format of the journal was an interesting, iterative process. I traveled to Lippincott's headquarters in Philadelphia and spent a day working intensely with their design team. They told me that no editor had ever been that involved in the design of any of their other journals. We talked about page look and fonts; they would print a mock-up, I'd critique it, and we would modify it. These cycles of design went on for a good part of the day. I knew that my reputation and that of AACN's were at stake.
Why did you want to become the first editor, and what was the most satisfying part of launching the journal?
Clochesy: My interest in serving as a journal editor was inspired by my interactions with Drs Kathleen Dracup and Marguerite Kinney as well as Suzanne Hall Johnson and Jay Lippincott. I had experience as a reviewer and editorial board member for several critical care nursing journals. When I heard that AACN was considering a quarterly, clinically focused journal, I decided to apply.
The single most satisfying part of launching the journal was having the first issue ready for the NTI in May 1990. Colleagues at other journals and the publisher's team said we couldn't be ready in less than 18 months. I took up the challenge since our membership needed to see the journal live at our largest gathering of the year, and we made it!
The Evolution
What drew you to becoming an editor?
Sole: I believed that being an editor-in-chief would be both fun and challenging. I had served as an article reviewer for many years and edited a textbook; therefore, being a journal editor was something new to pursue. At the same time I was somewhat naive about the workload associated with being an editor and learned that quite quickly!
Morton: I enjoy writing and publishing. I reached a point in my career where my greatest satisfaction was helping others successfully publish their ideas. Serving as an editor was an ideal way for me to assist others to learn the publishing process and to develop publishable papers.
Chulay: Being an editor was never on my "to do" goals list. In fact, I hate writing and figured that being an editor was a lot about writing! AACN asked me to temporarily take on the role when the editor at the time, Patricia Morton, was elected to the AACN Board of Directors and needed to give up the editor position. At that time, AACN thought it would take them less than a year to find a permanent editor, so I willingly "stepped up to the plate" on the editor position. That year stretched into 3 years as we embarked on the journey to find a new editor.
De Jong: Prior to becoming the editor, I was privileged to serve in numerous volunteer roles with AACN at the local, regional, and national levels. Thanks to superb mentorship from Patricia Morton, Suzanne Hall Johnson, and Margaret Zuccarini, I developed interest and skill in publishing and served as an editorial board member and manuscript reviewer for several journals, including AACN Clinical Issues. I was attracted to the role because it enabled me to support AACN, shape dissemination of high-quality and relevant clinical information to readers, promote scholarship, and maintain the integrity of a valued journal. Another appealing factor was that the journal is intended to provide experienced critical care and acute care clinicians, advanced practice nurses, and educators with relevant information that can be directly applied to practice.
What did you find most challenging about being an editor?
Clochesy: While I thought the toughest part of the role of an editor would be managing the peer review process, I found out that recruiting potential authors to write quality manuscripts for a journal is always the priority.
Sole: When I first took over around October or November, I was told I needed to have an issue out for February. Authors had been identified but nothing else had been done. I was able to get the articles in with a quick peer review, and we published the issue in March. After that, we met all publishing deadlines.
Another challenge was working with more seasoned authors who were overcommitted and did not always put 100% into their writing. Both guest editors and I had to assist many of these individuals in meeting publishing goals.
Morton: The first challenge was to find time in my busy life to be an editor and put the time into the job that was needed. Another great challenge was working with authors. Often authors saw the request for a revision as a failure on their part. It was sometimes difficult to help authors realize that the request for a revision is a very positive step in the publishing process. Some authors were angry or insulted by the request for review. It took a lot of time to help them understand that peer review is the normal process for publishing papers and that the process is intended to improve their work.
Chulay: For me, there were really only 2 challenges. The first challenge was that each editor of AACN's publications always had an editorial in each issue. So, in considering whether to take on the "temporary" job as an editor, I knew that for me writing an editorial for each issue would be a major challenge-remember, I don't like to write! In fact, I decided that I didn't really want that type of responsibility hanging over my head every few months, so I turned down the editor position initially because of that component of the position. Since my editor role was only going to be temporary, AACN agreed to allow the publication to go without an editorial column during my tenure.
The second challenge proved more daunting-getting enough manuscripts to fill the pages of the journal. Most journals are constantly looking for well-written manuscripts, and AACN Advanced Critical Care was no different. We were especially challenged in the early days of publication change, because people were not aware that the journal would take unsolicited manuscripts.
De Jong: The most challenging aspect of the editor role was to publish high-quality articles about diverse topics of interest to readers. Often, authors were most eager to write about topics such as sepsis, electrocardiograms, or hemodynamic monitoring. More difficult was my goal to publish papers about conflict resolution, mentoring and coaching, pediatrics, and effective decision making in the critical care and acute care environments.
What significant changes occurred during your tenure as an editor?
Sole: We went from hardcover issues to paperbound copies in an effort to reduce costs. The hardcover issues were true library quality. We also strengthened the peer-review process and developed the reviewer database. We expanded reviewers and developed an indexing for their expertise. We developed clear policies and expectations for the peer reviewers. I remember hiring a student to help me implement the peer-review process. My years as the editor were long before online submission of manuscripts. We spent a lot of our budget on Fedex for expedited delivery of manuscripts to reviewers, return of reviews to the guest editors, and dissemination and review of page proofs!
Lavandero: After a peak of more than 1000 in the early 2000s, the number of subscribers began to slowly decrease. Conversations with the editor had started to identify ways of differentiating the AACN quarterly from its Clinics competitor. The editor at that time, Patricia Morton, was elected to the AACN National Board of Directors, and continuing her editorial role would have prevented her from serving on the board. A transitional editor was engaged-Marianne Chulay-and plans for differentiation continued.
Chulay: As I was taking over the editor position, Ramon Lavandero suggested that it might be time to step back and determine if there were any improvements to the journal that could be done to increase readership. As discussions evolved about different changes that could be made to refresh the look of the publication, we began to realize that the title for the journal didn't really identify the target readership. The articles were about clinical issues, but the journal was specifically targeted to topics of interest for very experienced acute and critical care nurses. We felt it would be easier to market the journal to acute and critical care nurses if the title indicated that the content covered in the issues was meant for advanced clinicians.
The new format evolved from feedback and input from a variety of sources, including prior reader survey data, an AACN member survey, and various key stakeholders of the publication. From this information, the following occurred:
* Changed the publication title to AACN Advanced Critical Care.
* Continued to have a symposium topic in each issue but one that would account for no more than 50% of the issue pages. The remainder of the issue pages would then be devoted to articles on individual topics, solicited or unsolicited.
* Added standing department columns, such as pharmacology, ethics, and research, to improve the variety of topics covered in each issue. The goal was to increase the relevance of each individual issue of the publication to subscribers with a variety of clinical specialty foci.
What did you find to be most satisfying about your association with the journal?
Sole: One of the most satisfying things was developing new authors and guest editors. I worked with all to ensure that solicited articles would be acceptable following peer review. I often helped to rewrite articles to meet deadlines, but ultimately these authors got published. Likewise, I helped to develop the skills of those who wished to guest edit an issue, but lacked experience. These individuals usually had more time to devote to the work and were willing learners. Many are now very seasoned in the publishing world.
Morton: I am most proud of my ability to help authors write and revise their papers, so they were publishable. I spent a lot of time guiding and mentoring authors through the revision process so that they would see their ideas published in the journal. I tried my best to make the experience positive and rewarding so that the author would be proud of his or her work and desire to publish again in the future.
Lavandero: We had 2 major successes: The initial launch of a periodical modeled after the well-regarded Clinics format that also included formal peer review and was based on actual experience, and transitioning to a new editorial framework that retained what was successful, and incorporated editorial and subscription elements responsive to reader needs. This was confirmed by the increase and maintenance of individual subscriptions from fewer than 1000 to nearly 5000 currently.
Chulay: Certainly for me, the most satisfying part of being an editor was having the opportunity to make changes in the publication to better meet the educational needs of acute and critical care nurses. It was particularly gratifying when the new subscription rates jumped up after we made the changes in the journal-it seemed like we had achieved some of our early goals.
De Jong: I was honored to directly mentor new as well as experienced authors who had good ideas for articles but needed help to develop their slant, link concepts, synthesize and correctly cite literature, organize the papers, polish grammar, correct internal inconsistencies, and/or create meaningful tables and figures. Although some initially resisted feedback, they were delighted with the final paper and proud to see their paper in print.
Do you have any final reflections you'd like to offer?
Clochesy: It is exciting to see how my colleagues have nurtured the evolution and growth of this important journal since the early years.
Sole: It's been great to see the journal develop with a true focus on advanced practice. I like the column features as well as the ability to have both solicited and unsolicited manuscripts.
Morton: The journal continues to be a wonderful resource for experienced and advanced practice nurses in critical care. I am proud to be a part of the history of the journal.
De Jong:AACN Advanced Critical Care is a practical, high-quality, peer-reviewed journal that fills an important information need of critical care, acute care, and progressive care clinicians; advanced practice nurses; and educators. Congratulations on the 25th anniversary of the journal! Without a doubt, AACN Advanced Critical Care will continue to be a comprehensive, authoritative, and influential journal with far reach and high impact.
The Next 25 Years
AACN Advanced Critical Care continues to evolve. In the past 5 years, we have transitioned to an entirely online manuscript submission process, have expanded content and reader features on the journal's website (http://www.aacnadvancedcriticalcare.com), and have launched an iPad app. The world of publishing is progressing at an exponential rate, with changes related to technological advances, open access, and the needs of readers. There is no doubt AACN Advanced Critical Care will continue to face challenges similar to ones that have been confronted in the past, such as working with authors to ensure a steady stream of quality manuscripts, as well as new challenges not yet envisioned. However, the journal has a strong foundation built by talented and visionary leaders, ensuring that it is up to the challenge of providing our readers with timely, clinically relevant information available at their fingertips.
Mary Fran Tracy, RN, PhD, CCNS
Mary Fran Tracy is Editor, AACN Advanced Critical Care, and Critical Care Clinical Nurse Specialist, University of Minnesota Medical Center, Fairview, 500 Harvard St SE, Minneapolis, MN 55455 ([email protected]).
Acknowledgments
It is with sincere gratitude that I thank AACN Publications staff Ellen French, Michael Muscat, and Melissa Jones, as well as current staff Kathleen Phelan, Amy Myers, and Christen Melcher at our publishing partner Wolters Kluwer Health|Lippincott Williams & Wilkins, for their dedication to publishing a quality journal for our readers.
Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Defense or the Departments of the Air Force, Navy, Army, or Public Health.