Abstract
This Editorial marks the first in 2024. There are five papers and their associated commentaries in this edition and the first in a series of Perspectives we will publish this year.
The first two papers focus on the economic burden when clinical staff seek to establish peripheral venous access in difficult circumstances and how to systematically assess difficult venous access (DIVA) using a valid and reliable measurement tool. These two papers take Ann back to her days as a clinical nurse specialist at the Christie Hospital in Manchester where she was one of the first two specialist nurses to establish peripheral intravenous access lines to administer intravenous cytotoxic drugs. This ‘specialist’ practice has become mainstream in nursing and in cancer nursing, in particular. Nursing never stands still.
It is always instructive to reflect over our careers and marvel at some of the technological and indeed societal developments that have occurred and consider how nursing roles have adapted and developed in response. Some of these changes and their impact on nurses and nursing will be a theme that will feature in our Perspectives throughout this year.
Three of the papers in this edition are about the development and refinement of measurement tools to systematically inform clinical care and decision-making. The DIVA scale can be used prospectively to identify patients with perceived DIVA offering the potential to mitigate the circumstances and reduce patient distress, professional stress and the economic burden to the healthcare system. The Hospital Quality of Life (HQL) scale is designed to measure children’s experiences of hospitalised care in Turkey. The authors’ argue that the use of the scale can both inform policy and help to mitigate risk in clinical practice. We anticipate its development and use might also serve to prompt nurses, in the moment, to take action to improve the experiences of children in their care. The cross-cultural validation of a Patient Reported Outcome Measurement Scale (PROMS) empowers Portuguese patients to actively participate in their care and enable nurses to tailor the care of end-stage renal disease patients undergoing haemodialysis. Together, these three papers illustrate the ever-increasing codification of nursing assessments, the direct involvement of nurses in this multidisciplinary international research arena and the potential to actively involve patients in their care through the use of PROMS in practice.
The generation of all these research-informed valid and reliable measurement tools require nurses with the capacity and capability to generate, appraise and use evidence in their practice. It is fitting therefore that the final peer-reviewed paper in this edition describes an initiative to embed clinical research in an undergraduate nursing programme through the development of learning resources and evaluates student nurses’ experiences of using them. The authors assert that their data indicates that this approach helps nurses and midwives overcome barriers to research engagement.
Ann has said for many years that nurses are the mothers of invention. We conclude this edition with a Perspective that brings this assertion to life with a vivid account from a tenacious nurse who had an idea, built a team and navigated her way through a tortuous process to develop and then evaluate the usability of a product designed to reduce the incidence of catheter-acquired infections. Prepare to be inspired!
So, what else do we have in store for you this year?
In addition to five more editions comprising peer-reviewed papers and commentaries, we have two guest-edited editions. The first of these has neared completion and is guest-edited by our latest Editorial Board Member, Camille Cronin: this edition focusses on Digital Health. Later in the year, we will publish the other – guest-edited by Elaine Maxwell and Mark Radford on Theories, Models and Nursing. And as indicated above, it is our intention to publish a series of Perspectives this year. This will include a retrospective analysis of the papers JRN has published since its inception, and others reflecting on how nursing roles have adapted and developed during this time. We anticipate generating learning from these reflections, which will enable nursing to continue adapting and developing in response to the ever-changing circumstances in which we find ourselves.
The Royal College of Nursing of the United Kingdom (RCN) launched a new definition of nursing last year to publicly acknowledge how nursing had evolved over the last 2 decades. This new definition aims to reflect the complexity, range of skills and huge responsibility of contemporary registered nurses (Royal College of Nursing, 2023). This is a welcome and timely publication. It acknowledges, for example, the ongoing development of advanced practitioners and increasing numbers of nurse specialists. It also highlights registered nurses’ responsibilities in relation to the introduction and development of a range of support roles, some of which offer new routes onto the nursing register.
These developments have arisen in response to myriad forces – internal and external to nursing, including dominant political ideologies or the perceived needs of other healthcare disciplines. We are not suggesting that such reactive developments are, by definition, inappropriate, but we firmly believe that it is time to critically reflect and clearly articulate a cohesive and coherent vision for the future of nursing. Without this, our profession will continue to be pulled in many directions and arguably it will become increasing more difficult to articulate the essence and the value of nursing, and to develop and implement innovative ‘person-centred’ nursing services. We remember The Department of Health (1993) – a four country, UK-wide nursing initiative established to make sense of the changes nursing faced at the turn of the century. The similarities with what we see happening around us now are clear. But what arguably is missing from the current debate – is debate! And that surely should focus around what was described 30 years ago as the nursing constant: then it was
The work of the nurse, whatever the setting draws upon a tradition of caring, based around both skills and values, and includes: ● A coordinating function ● A teaching function, for carers, patients and professionals ● Developing and maintaining programmes of care ● Technical expertise, exercised personally and through others ● Concern not only for the ill but also for those currently well ● A special responsibility for the frail and vulnerable
(The Heathrow Debate 1993 – Figure 14 page 21)
But what is it now?
Without this clarity – a goal to achieve and set standards for nursing may continue to evolve reactively, rather than proactively, will struggle to clearly articulate its contribution to care in novel circumstances or shape change and development in service provision. For example, in 2022, the RCN issued a press release that called upon the UK government to invest in nurse-led services and research to support the growing number of people living with long COVID and struggling to access specialist care https://www.rcn.org.uk/magazines/News/UK-RCN-Congress-2022-long-COVID-postcode-lottery-070622. This echoes our open call for papers in this field. However, there seems to be a dearth of evidence supporting nursing development in this space, and if nursing still has a special responsibility for the frail and vulnerable, then why is this so? We propose this may, in part, be a consequence of nursing’s contemporary lack of clarity around the ‘nursing constant’ and indeed the theories and models which underpin that. We look forward to furthering this conversation throughout the rest of this year.
During 2024, we will continue to support international nursing research conferences celebrating nurses and their research, and will, as usual, be identifying and celebrating the 2024 Veronica Bishop paper-of-the-year prize winner. We are just starting the process of translating our 2023 winning paper into a graphic paper to add to our library https://journals.sagepub.com/page/jrn/collections/virtual-special-issues/jrn-veronica-bishop-award.
We plan this year to further increase our social media presence, and we will publish a number of podcasts to complement the Perspectives we publish. Please follow us across our social media channels: on X (formerly Twitter), Instagram and YouTube at @JRN_latest, and on Facebook by searching Journal of Research in Nursing.