Shawn Kennedy, MA, RN, FAAN
Editor in Chief, American Journal of Nursing

ANA’s theme for this year’s Nurses Week – “Inspire. Innovate. Influence.” – is perfect, I think. It’s what we’ve always done, from our earliest beginnings and in every setting. Here are some of my favorite examples (and the articles from the AJN archives will be free to read for Nurses Week! Click on the pdf version for the best reading experience.)

Florence Nightingale was the first to organize nursing and implement unheard of care measures (the most important being cleanliness and fresh air– how radical!). Simplistic and common sense, but until she and her cadre of nurses marched into Scutari Hospital and instituted these measures, no one had thought to do them in a consistent way. And when the Army wouldn’t agree to her proposed changes, she used her contacts and influence to make her case and win over public sentiment.

Lillian Wald was a visionary leader and is considered the founder of public health. Her community health model is an example of how we’ve come full circle – community health centers are now considered the ideal way to develop healthy communities and deliver preventive care. Wald was newly out of nursing school when she and friend Mary Brewster founded the Henry Street Settlement visiting nurses in 1893, after they saw the dire need for health care among immigrants. They began with nine nurses; by 1916, there were 250 nurses. Visiting homes and providing care to the sick, teaching mothers about infant and child care, and promoting general hygiene was the hallmark of their practice. They added a clinic, a children’s playground and camp. Later, the Visiting Nurse Service of New York became independent, but Henry Street, now in its 125^th year, still offers a full array of social services to over 60,000 people annually.

Wald also began school nursing, after she convinced the New York City School Board that nurses in school could reduce absenteeism. She placed Lina Rogers, a Henry Street nurse, in a school to teach basic hygiene and treat minor ailments. At the end of the trial, the school board hired 12 more nurses.

Mary Breckenridge founded the Frontier Nursing Service in 1925, when maternal and infant mortality in the Appalachian region was dismal. She and two other nurse midwives on horseback visited 800 families each, providing care and teaching health. The overall maternal death rate from 1925-1954 averaged 34 per 10,000; in her area, it was 9.1 per 10,000 births.

But you don’t have to go back in history to find innovators.  The American Academy of Nursing recognizes the key roles nurses play in improving care and so has created a program – Edge Runners - to highlight nurses who’ve been creative in addressing challenges. From creating independent birthing centers to reducing pneumonia in ventilated patients or creating a clinic for racetrack workers, nurses have been at the forefront of care improvements. A recent addition to this group has been Sarah Szanton, whose innovative program (the home health team consists of a nurse, occupational therapist and a handyman) has enabled older people to remain safely in their homes.

Today’s health care system is being disrupted by many changes, from telehealth, digital documentation, to a changing patient population requiring changing models of care – just the right time for innovative thinking. Look around – what’s in your setting that needs nursing ingenuity? What innovations have you or your colleagues implemented or thought about implementing? Maybe it’s your turn to join the ranks of nursing innovators. There’s no better time than now.