The litmus test for any science, ultimately, lies in impact. High-impact sciences raise clinical standards, influence health policy, inform citizens, and improve the health and well being of the public. The American public, rightly, has high expectations of benefit from the nation's research enterprise, although expectations focus narrowly on medicine and public health. Known for rapid translation from bench to bedside, these two disciplines are widely credited with disease prevention, health promotion, and resulting unprecedented longevity.

A glance at National Institutes of Health (NIH) funding levels to academic health sciences institutions quickly shows that impact and price tag go hand-in-glove. Medicine and public health garner the largest share of NIH dollars. For example, data from 2000 regarding NIH awards to schools of medicine, public health, nursing, pharmacy, dentistry, and allied health show the extreme disproportion of funding levels. Schools of medicine that year received over 50 times the research dollars per institution than schools of nursing, and schools of public health exceeded nursing schools by a factor of 14-to-one. Schools of dentistry and pharmacy received over twice the NIH dollars of nursing. Only allied health received fewer dollars than nursing on average per school. These data are humbling on two counts: (a) the great need for federal research dollars for nursing science, and (b) the reality that nursing is not yet producing enough research to qualify as a high-impact science. In fact, the public has extremely low expectations of nursing science. Indeed, the majority of the American public simply is not aware that nurses do research or that nursing is a scientific discipline. Dissemination and translation of nursing research is agonizingly slow, and there is low accountability for infusing discoveries into practice and teaching.

Passing the litmus test of impact will require us to change more drastically than we have been willing to consider so far. We hold on to time-honored traditions, for example, the length of training time to the nurse scientist role, and the sacred "triple threat" that requires faculty to juggle all roles rather than to specialize in one. Our segregation since the 1960s of academe and practice also contributes to slow translation of evidence to practice. In its Strategic Plan for the 21st Century, the National Institute of Nursing Research enjoined us to reduce the lag time between publication of findings and implementation of discoveries. We add to that the following refrain: For nursing science to impact health and healthcare, every nurse investigator must commit to time-efficient research and to productivity standards that equal high impact disciplines. We need timely transitions from bench or field to (a) publication, (b) media coverage and other dissemination, and (c) translation and utilization. Only such a trajectory will meet the litmus test.