AJN's Annual Year in Review: 2009 Editor's note: Each January AJN examines the major stories affecting nurses and health care during the previous year. The main issues of 2009 mirrored those of 2008: the failing economy, the financial impact of impending health care reform and its ripple effect on the nursing shortage, and concerns over pandemic flu and war. Public health officials were right in predicting the onset of a 2009 pandemic influenza, but it was H1N1 swine flu and not bird flu. The war focus was on Afghanistan and not Iraq, but the effects of limb loss, traumatic brain injuries, and posttraumatic stress disorder were just as devastating. And nurses' unions agreed that passing health care insurance reform was more important than organizational differences and agreed to join together to create a "super union" of nurses.