In 1998 Jay Lippincott, the great-great-grandson of the founder of J. B. Lippincott and Company, AJN's first publisher, asked me why I wanted to be AJN's editor-in-chief. I told him that I wasn't interested in leading the journal as it was; rather, I wanted to transform it by promoting excellence in clinical practice, advancing debates on important professional issues, and adhering to high standards in journalism and biomedical publishing. I wanted the public to see reports of what AJN published on the nightly news and in leading newspapers. And for the past decade I've had the privilege of trying to live up to that vision, one that has been refined along the way by a fine editorial team.
And now I've moved on. At the end of May I left my position as editor-in-chief of AJN and assumed the position of editor-in-chief emeritus. As of September I'll hold an endowed chair at the Hunter-Bellevue School of Nursing, at the City University of New York, where I'll work to launch a center for health media and policy.
Of course I have mixed feelings about leaving. I'm exceedingly proud of AJN's accomplishments. In April, for example, we learned that AJN was selected by the Biomedical and Life Sciences Division of the Special Libraries Association as one of the 100 most influential journals of the century in biology and medicine-the only nursing journal chosen. This 110-year-old journal is the nursing profession's journal of record in this country. That legacy and its current high standards are respected by health care journalists, and AJN is the nursing journal most frequently cited in the mainstream media. I know that many journalists have come to value nurses' perspectives in their reporting.
AJN has influenced thinking and practice in health care. For example, we have published three articles on family presence (the practice of allowing family members to witness resuscitation and invasive procedures). The media pickup on this work was huge, and the authors said that once their articles were published, the issue finally appeared on health care's radar screen. We've published two articles on abusive behavior among physicians and nurses that were cited by the Joint Commission, which this year began requiring accredited facilities to have policies and procedures in place to reduce such behavior in the workplace. I'm grateful to several foundations for funding series on palliative care, assessment and care of older adults, and chronic kidney disease. And our 2008 report Professional Partners Supporting Family Caregivers, produced in collaboration with AARP, is shaping how our country thinks about supporting family members who are the primary caregivers for loved ones.
This journal is a place to provoke thinking and debate. Sometimes readers thought I went too far, like when we published the poem "Learning the Bones" (Art of Nursing, January 2004), which brought more than 200 letters of complaint, including some demanding my resignation and that of other editors involved in publishing it. I've heard from many readers, in both agreement and outrage. But I've learned that many nurses are so angry that they can't mount a reasoned, dispassionate argument. I think it's crucial for nurses to engage in debate without resorting to attack, especially as we discuss the health care issues confronting our profession and our nation.
AJN's editorial staff has been committed to raising the bar for nursing publishing. Over the years, we've written policies on plagiarism and, more recently, sourcing (both available at http://ajn.edmgr.com). And although we're peer reviewed, we know the flaws in that system and work hard to ensure the accuracy, balance, and clarity of what we publish. Some authors have railed against our "heavy edit," but there is no doubt that it has resulted in more clearly written, evidence-based, interesting articles. My own editorials undergo our heavy edit, in fact, usually the job of our managing editor, Joy Jacobson. She is a gifted editor and always makes my editorials better. When I've suggested that she be listed as coauthor, she has always refused, saying that she is just doing what editors do.
One of the hardest parts of leaving is saying goodbye to the superb team of editors I've worked with so closely. I'm deeply grateful to them. They are smart, funny, challenging, and caring. When we started to ramp up our work online, I knew that all I had to do was turn loose this fabulous group. In addition to our redesigned Web site (http://ajnonline.com), we've now got a great blog (http://ajnoffthecharts.wordpress.com), Facebook page (http://facebook.com/pages/American-Journal-of-Nursing/45449079203), and Twitter presence (http://twitter.com/AmJNurs). I often get credit for AJN's successes, but I can tell you that it has taken a village: editors, editorial board members and contributing editors, peer reviewers, a series of supportive publishers at Lippincott Williams and Wilkins, and a journal oversight committee that has taken seriously its role as the journal's watchdog. AJN is the only nursing journal to have such a committee, although several leading medical journals have them. I hope other nursing journals will follow suit.
All across the country, I've met people who love AJN and others who don't subscribe because they get other publications for free. But there is no such thing as "free." Free often means compromised by the influence of advertisers. My experience here has raised my awareness of how seriously compromised the nursing literature is. I recently had conversations with two authors whose works were discovered to have been plagiarized or written by a ghostwriter paid by a company whose product the article discussed. During editing we often find inaccurate referencing, inaccurate representation of sources, plagiarism, and bias. I urge all nurses to pay closer attention to the quality of what they're writing and publishing.
That said, I've often been very impressed by what nurses have written. I loved the timeliness and relevance of the family presence papers by Theresa Meyers (and colleagues), who risked her own job to take parents in to see their son while a code was in progress. Elizabeth Pitorak's piece on care at the time of death was one of the best papers I've seen on the topic. We published two excellent papers by Jeannette Crenshaw and colleagues: a study on preoperative fasting (unfortunately, we still have miles to go before people are no longer told to be "NPO after midnight") and one on breastfeeding in nonmaternity settings. These are just a few of the many important papers I'm proud of having published.
One of the biggest disappointments of my tenure was being unable to convince the American Nurses Association that AJN was more than a convenient "member benefit." I remain dumbfounded that the association couldn't see this historic, influential publication as the strategic tool it is, known throughout the world as the "leading voice of nursing since 1900" and so highly visible in mainstream media. But those in publishing know that it's hard to be a society journal and maintain editorial independence and integrity, and these standards must be maintained.
I'm committed to helping to find a new editor-in-chief who will enable AJN to continue to be the leader in nursing publishing. I'm grateful to Maureen Shawn Kennedy, the current editorial director, who will lead the journal through this transition. A non-drug-addicted, non-adulterous version of Edie Falco's new TV character Nurse Jackie, she's tough, supportive, and hardworking.
During my interview with Jay Lippincott, he said, "I can think of no better job opportunity in nursing right now." He was right. And while I thank my employers and AJN's staff, I also thank all of you, our readers and contributors. You have shared our vision for nursing publishing. Thank you for being part of the village that restored AJN to its rightful place in nursing journalism. I look forward to continuing to work with nurses and other health care professionals to harness the proliferating media tools to promote the public's health. The new center for health media and policy will aim to develop health care providers' skills in using media to change public thinking and policies on health. I have a vision for this work now, but it, too, will take a village.