The first edition of Nursing Administration Quarterly (NAQ) (volume 1, number 1) was published in 1976. That was 2 years after Peter Allen released a song he cowrote with Carole Bayer Sager, titled, "Everything Old Is New Again." I found myself humming that tune, which I didn't know I remembered. It came to mind because I was preparing to celebrate 40 years of NAQ by reviewing our past editions. The lyrics kept repeating in my head: "No need to remember when ...'cause everything old is new again ... let's go backwards when forward fails...."
As I read the words of nurse authors from the past, I was struck by the number of long-standing topics and challenges our profession continues to address. I was also impressed by the nurse leaders who were pushing for coordinated care systems long before health care reform and its associated next-era emphasis on wellness, community health, and prevention of disease and disability. In other words, we've been advocating for, and trying to develop, systems of health and prevention longer than many of our colleagues who are relatively recent converts to the idea that there is more to health than sick care.
In addition to providing care in hospitals, nursing has historically worked to maintain health of communities and to prevent illness and injury to individuals. A formal program for "Visiting Nursing" started in 19th-century England, where nurses provided care to the sick in their own homes while also teaching hygiene and sanitation to prevent disease.1 More than 100 years ago, the recognized founder of American public health nursing, Lillian Wald, encouraged nurses to go "far beyond the care of the sick and prevention of disease to rectifying causes responsible for poverty and misery itself."1(p346) Her nursing care for populations included improvement of communities through establishment of playgrounds, advocacy for better working conditions, and founding of public school nurse programs. She recognized that caring for the total well-being of people is more than hands-on physical ministrations to individual bodies.
Another early pioneer in providing health care to prevent sick care was Mary Breckinridge, who organized nurse midwives to deliver prenatal and delivery care to rural women. She founded "Frontier Nursing" in 1925 and ensured that the outcomes of the nursing care were studied. Her results showed that the first 1000 women cared for by these traveling nurse midwives had less complications during pregnancy and delivery than the general population.1(pp348-352) On another front, Lavinia Dock was concerned about the suffering caused by venereal disease, which was rampant largely because it was not "mentionable." She shocked society by publishing a 1910 book (Hygiene and Morality) to educate individuals about how to prevent it.1(p357)
These women were a few (of many) nurse leaders who dedicated their lives to making the world a healthier place for others. I believe they would have been pleased to see the pages of NAQ I've been perusing. I hope they would see the articles as evidence that they have been followed by other nurses who have worked in their communities to provide quality care both inside and outside of the hospital. I believe they would applaud our continual quest to improve health and to study (and share) which of our efforts result in better health outcomes. One example of this is "Instrument Development: Measuring Quality Outcomes in Ambulatory Maternal-Child Nursing," written by Eunice Blair, Barbara Hauf, Catherine Loveridge, et al2 for the NAQ Research edition in the summer of 1978. Of course, over 40 years, there are more than a thousand others, many of which are relevant today, although they preceded the current era.
NAQ authors are not new at sharing information on the continuum of care. Volume 8, issue 2 (1984), included an article on home health by Susan Gleeson, John Yuncza, and Edward Klane.3 The fall 1997 journal was themed Leading Beyond Traditional Boundaries. One article in the Spring edition of 1998 was "Community Health Collaboration Models for the 21st Century," by Linda Burnes Bolton, C. Alicia Georges, and Virginia Hunter, et al.4 A second was "Building Partnerships With Physicians: Moving Outside the Walls of the Hospital," by Steven Dziabis and Thomas Lant.5 A third, by Jodie Alphin,6 was also about "Looking Beyond the Walls."
In volume 14, issue 2 (1990), Margo Zink and Anna Bissonnette7 wrote about "A Unique Multidisciplinary Approach for Urban Geriatric Home Care," whereas Timma8 addressed "Innovative Community-Based Health Care for the Elderly: A University-Community Partnership. Lillian DeYoung, Kathy Sifferlin, and Annette Mitzel9 also explored leadership in the outpatient world when they wrote the winter 1983 article, "The Family Health Nurse in a Leadership Role."
Addressing the need for clinically integrated networks isn't new to nursing. The spring edition of 1980 included Katherine Meyer's10 article on "The Hospice Concept Integrated With Existing Community Health Care." In 1996, the winter edition included "Patient Care Leadership Within an Emerging Integrated Delivery Network," by Barbara Moore, Sharon Smith, and Larry Schumacher.11 In the spring edition of that same year, article titles, such as "Policy Imperatives for Nursing in an Era of Health Care Restructuring," by David Keepnews and Geri Marullo,12 are evidence that extensive change is a familiar phenomenon for nurse leaders. Our profession's history of seeking best practices to manage that change is indicated in the winter 1981 article, "Using Theory to Promote Change," by Joan Gygax Spicer and Ellen Lewis.13
Managed Care isn't foreign to us, either, as Marita Schifalacqua, Mary Hook, and Paula O'Hearn, et al14 shared in their work on "Coordinating the Care of the Chronically Ill in a World of Managed Care (spring 2000). This was 7 years after volume 17, issue 3, which was a collection of articles on managed care.
Some of NAQ's earlier authors might be amused about things that are touted as new thinking. For example, "matrix "(and its offshoot "dyad") leadership is thought by some to be a new way of managing. That's despite the fact that Ruth Barney Fine's15 article, "New Responsibilities Call for New Relationships," appeared in the 1979 (volume 3, issue 2) NAQ, which was all about reorganizations and matrix management. Ellen Lewis16 might smile over the push for calling patients consumers and encouraging their input into our services, since she wrote "Consumers as Members of Nursing Committees" in the spring of 1980. Roxanne Spitzer's17 take on this was published in spring 1988, in "Meeting Consumer Expectations."
One of the expectations that consumers have today is that those who call themselves health care providers will be as concerned about keeping people well as they are about helping them get well. Nursing and NAQ are proponents of health from the beginning. Editor Barbara Brown wrote in 1987 (volume 11, issue 3) that "Nursing has been in a pivotal position to redirect energies, resources, and revenues to increasing promotion of wellness."18 That was in the edition about how Nursing Leads Wellness Promotion, which included "Health Promotion and Disease Prevention for the Hospitalized Patient's Family" by Donna Hathaway, Bonnie Boswell, Debra Stanford, et al19; "Health Promotion Within the Nursing Work Environment" by Susan Moch and Carol Diemert;20 "The Role of the Nurse Practitioner in Developing Wellness Promotion Programs for Employees in Acute Care Hospital Settings" by Farideh Khoiny21; and 3 on-the-scene reports of nurse-led wellness initiatives.
Looking at these wonderful articles from NAQ's past was a great trip down memory lane for me. I knew many of the authors. I remembered many of the topics, and the times we were going through when they were top of mind. I realized that some (if I covered up the dates) could be published as valuable "new" information today. That's partly because of the strange dichotomy that, while we have experienced much change over time, many of our issues have not changed. It's also because nurse leaders have often been ahead of others in their thinking, work, and research. We have not just envisioned a healthier, better world, we've worked (and continue to strive) to make it that way. If you have library access, or have saved your journals, you might want to go back and read some of the 4 decades of nursing leadership thought recorded there. There are gems in the pages of past NAQs. I think Peter Allen was right when he sang:
Don't throw the past away
You may need it some rainy day.
Dreams can come true again
When everything old is new again.
-Kathleen D. Sanford, DBA, RN, FACHE, FAAN
Editor-in-Chief
Nursing Administration Quarterly
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