A Tribute to Us
As we reflect upon the impact of 2001, one cannot help but look beyond what was before and what is after. Before, we were complacent, secure, and optimistic. Now, we are anxious and vulnerable. Our vocabulary has even changed. There are new words in our vocabulary such as ground zero, jailed corporate CEO, recession, belly-up pension plans, markets crashing, and airport insecurity. We witnessed 9/11 with disbelief and maybe for a short time refused to accept the fact that, in an instant, thousands of civilians were killed. They were not distant figures, but our fathers, mothers, brothers, wives, husbands, and friends. We have seen corporate America at its worst and saw Americans at their finest hour. Out of diversity and pain came strength and a new respect for each other. We will never be the same, yet we may be stronger, more innovative, and somehow determined to achieve. Substantial leaders did emerge out of this most difficult time.
A Tribute to Barbara
Yes, indeed, so much change occurred in 2001. Nursing Administration Quarterly has also seen turbulent times. The journal is changing publishers and is in transition. We, as contributing board members, await the decisions of Lippincott Wilkins & Wilkins, Inc. (the new publisher), to determine the direction of future issues.
The success of NAQ can be attributed to Dr. Barbara Brown, Editor. Barbara has been the visionary leader and the glue that has bound us together. Barbara is the synergy and has made it all happen. Her foresight and persistence facilitated the development of each journal issue.
Through her direction and that of the Board of Directors, a simple idea, a trend, a thought became a focus for an issue. Barbara yearly has conducted Board of Director meetings, contacted authors, edited articles, plagued authors, and encouraged them to write their story. Leaders wrote their thoughts, their framework, and their successes because of Barbaras requests. These too-many-to-count published articles have supported research and breathed life into faculty, students, practitioners, new nurses, and undergraduate and graduate education. Barbara has been relentless in her quest to provide the profession with the finest, most up-to-date published articles. The journals have a unique feature. Issues 28 years old have a timeless quality and today continue to give a message.
Barbara has persistence, vision, and enduring energy. Thank you, Barbara, for your driving enthusiasm, your hard work, and for creating Nursing Administration Quarterly. This journal, for more than two decades, has provided the nursing profession with consistent, constructive, and progressive articles. It has been a pleasure working with you, and I believe that each reader is grateful for all of your contributions.
A Virtual Reality Environment
Virtual means essential, practical, pragmatic, effective. Reality means actual, valid, fact, and truth. This issue discusses information, which enhances learning and knowledge within nursing practice, education, and research. There are many initiatives in technology within the nursing profession that are expanding learning and communication within the nursing profession. Virtual reality can be attained through the Internet, through computer software simulations, and through innovative clinical information systems. There are many programs, from Web-based clinical information systems to clinical simulations, which enhance advances in technology.
This journal is modest in its impact when we compare it to the effect of 9/11, yet this issue captures within the nursing profession the birthing of systems that attempt to streamline data, enhance communication systems, affect processes, and create practices and new educational opportunities for learners.
Each article replicates a change in thought, an alteration of practice, and a remodeling of behaviors. New words are entering our vocabulary. They are expanding our horizons. Virtual reality, dashboards, e-learning, electronic mail, long-distance learning, modems, and real-time simulation are just a beginning thread of our future.
Enjoy the visions of our authors. The philosophy of Dr. JoEllen Goertz Koerner establishes for us a philosophy for practice and gives the readers a framework for innovation. This issue spans from the Veterans Administration Systems sharing of innovative practices to the dashboards at Hartford Hospital, to Emory's descriptions of systems that support patient care and care givers.
This issue also focuses on initiatives relating to communication of patient data, innovative computer networks, clinical simulations, and long-distance online learning opportunities. Providing professional nurses with current scientific and clinical technological advances through computer simulations can provide practitioners with opportunities for reality-based experiences. The Internet can also provide professional nurses with instant expert consultation. The ability to talk with an expert regarding patient data via the Internet exists within these environments. Sharing clinical practice and outcomes with an expert on the Internet can only benefit patients and families. The ability to attend classes online opens many avenues for learning. Long-distance learning now can provide participants with opportunities for graduate and undergraduate completion.
This issue is most pertinent for individuals who are interested or who support innovative technology-people who are not complacent and who accept change and thrive on challenges. In the beginning of this editorial, I spoke of the turbulent times in 2001. We also have coped with tumultuous times within health care. Our lives suddenly changed with the disaster of 9/11, and during the past 10 years our lives have changed within health care. The survival of our profession is dependent upon those individuals who confront technology and direct and harness their energies toward improving systems, which enhance our productivity, our knowledge, our leadership, and our practice. Let us open our minds and our hearts to innovation and accept the challenge of making it real.
Virtual Reality
Ever want to experience something new and dangerous in a safe environment? Many of you have already donned a virtual reality helmet and experienced the excitement of skiing down a dangerous mountain sloop. Have you sailed in a championship race, felt your heart racing, breathing hard, only to take the helmet off and know that you have been in a computer stimulation? Students are donning virtual reality helmets to learn surgical techniques. The possibilities for creating new learning techniques are almost limitless. Nursing has been using stimulation techniques for decades. Many of us remember "Mary Chase" and practiced on pretend patients. It is a long way from "Mary Chase" to a virtual reality helmet. Innovative technologies are providing nurses a way to experience something new and dangerous in a safe environment. Computer-based learning programs, Web-based clinical information systems, artificial intelligence enhanced systems, instant consultation over the Internet, clinical chat rooms, and long-distance learning of formal education programs are now available to the nurse.
Within Emory Hospitals, we are using computer programs that reduce the time required to plan and document patient care. Need a nursing procedure? Look it up on the computer; no need to worry if you have the latest paper copy. The computer nursing procedures are the latest version. Need a drug? The pharmacy robot will have picked the patient drugs for the unit-dose system with great accuracy. Need to order a supply, lab test, X-ray? Go to the computer and order them. Want to find out if the patient had a similar lab result when he was in the outpatient clinic? Find it quickly in the electronic medical record; no need to find his paper record.
There are many computer systems that support managers. Some systems automatically enter employee's time and generate payroll reports. The manager checks and then signs off on these reports. Need an employee schedule? The staffing system can generate the draft for the manager to adjust and approve. Staffing a patient care unit is especially challenging with the current nursing shortage and financial constraints. The staffing system compares the available staffing and patient nursing care needs. These programs support a flexible budget concept. There is no need to get your calculator out just print the report. These are only a few of the programs that are used every day by our staff to enhance the decision-making process of our managers. Without these programs and without this innovative technology, staff would spend their time with "things," not with patients.
Virtual reality is developing at a fast pace in our hospital world, and we have many, many opportunities ahead of us. This issue will endeavor to provide an overview of the current status of clinical simulations, and to provide stimulus to further develop the concept of virtual reality as a teaching learning modality. The quality of care is improved because nurses are having their first experiences in the safety of clinical simulations. We have not even dreamed of the impact that will come in the next decade. Virtual reality is imminent!