Over the course of the past year, we have heard many politicians make proclamations about reforming the healthcare system, and by the time this article goes to print, Americans will have elected a new president to lead us through these tumultuous times. In the past 40 years alone, we have seen a dramatic change in the operation of the healthcare system in the form of governmental programs such as Medicare and Medicaid as well as the reorganization of the healthcare industry by third-party payers and managed-care companies. In addition, many scientific, technological, and pharmacological advances have aided in increasing the life expectancy of the average American. Despite these advances, we are still faced with the long-term management of chronic illnesses, which stress the healthcare system further. Additional future challenges include the aging population, war-injured veterans with long-lasting disabilities, economic instability, new diseases, and ethical dilemmas associated with stem-cell and genetic research.
One constant during this time has been nurses' ability to maintain resiliency in upholding the art and science of our profession by maintaining our caring nature and promoting science through research and evidence-based practice (EBP). In an effort to remain vibrant, nursing has established multiple subspecialty areas such as neuroscience nursing; the American Association of Neuroscience Nurses (AANN) was founded to advance this subspecialty. Four decades later, AANN is thriving as neuroscience continues on a path of discovery with major advances in the management of neurological disease states in the acute and chronic arena. The Journal of Neuroscience Nursing (JNN) has contributed to the growth of AANN membership through publication of cutting-edge research and articles of current practices. JNN continues to influence, not only neuroscience nursing, but also the nursing discipline as a whole by attaining a Thomson Scientific (formerly Institute for Scientific Information) Impact Factor that recognizes our contributions to the nursing profession.
In order to keep up with the changing times, nurses must continue to collaborate with a variety of disciplines to provide maximum healthcare services to an aging and ailing population. Since the days of Florence Nightingale, nurses have been actively involved in researching nursing practice and care modalities, though the results have been underutilized by our colleagues. EBP has come to the forefront of the nursing profession over the past decade, using current research to enhance patient outcomes. Now, and in the future, JNN will continue to promote EBP with the publication of work highlighting neuroscience research and practice change recommendations.
Promoting optimal health outcomes has become top priority of many institutions, leading groups like The Joint Commission, in collaboration with the American Stroke Association, to establish such programs as the Primary Stroke Center Certification. Neuroscience nurses have been instrumental in implementing interventions and evaluation of stroke outcomes to aid their centers in achieving and maintaining the certification. Through educational meetings and JNN, AANN provides up-to-date information regarding stroke care and optimizing health outcomes. In other aspects of neuroscience nursing, JNN has published numerous articles regarding the care of patients with a wide variety of neurological illness, including multiple sclerosis, Parkinson disease, epilepsy, and the dementias. In addition, the journal has tackled everyday issues in the nursing realm such as ethics, EBP, the role of the advanced practice nurse in neuroscience, and problems in the workplace. As the healthcare system and nursing are faced with inevitable changes, JNN will continue to meet the needs of AANN members and our fellow colleagues with publications that focus on the issues at hand.
Among the issues the nursing profession will tackle over time is serving war-injured veterans. On a daily basis, neuroscience nurses deal first-hand with soldiers who are returning to civilian life with traumatic brain injuries (TBIs) and associated complications, such as seizures, cognitive deficits, and physical deficits. Therefore, we are committed to using our best evidence in caring for these individuals, whether war-injured or other, to maximize their outcomes. I would challenge my colleagues to share their experiences with the JNN audience.
As the United States continues on the course of an economic slowdown, associated costs make health care inaccessible for many average Americans, including the elderly. The patients we care for in acute and outpatient settings have more complex healthcare needs. Patients with neurological illness often require multiple therapies to adequately treat the condition (e.g., neurodegenerative and neuroimmunological illnesses). The neuroscience nurse's role in managing these individuals is crucial in minimizing costs and improving outcomes with our best evidence. JNN will continue to seek authors who strengthen the core of neuroscience nursing in regard to EBP and clinical interventions.
In reality, there are many problems within the healthcare system, and we are in a position to make our voices heard. As neuroscience nurses, we need to continue to support our nursing organizations, including AANN. As individuals, we must commit to stay abreast of treatment modalities and therapeutic interventions that improve patient outcomes. To do this, we must get past the intimidating factors surrounding EBP and participate in research through all steps, including disseminating the findings. JNN will continue to strive to publish cutting-edge research and articles on current practices within neuroscience nursing, and, with your help, we will continue on our positive course for another 40 years.