McNeil, Paula A.; Lindeman, Carol A.

In April 2017, members and friends of the Western Institute of Nursing (WIN) celebrated the 50th Communicating Nursing Research Conference and the 60th anniversary of the organization that made the research conferences possible. The story of the Western Council on Higher Education for Nursing (WCHEN) and its successor, the WIN, is an inspiring story of leadership, vision, commitment, and a conviction that the people of the Western region of the United States needed nursing services of excellent quality and that nursing education must prepare nurses capable of providing that care. It is a story of commitment by Western educational and clinical institutions “to work together in developing graduate education and research in nursing, taking into account the needs of the region as a whole” (^{Dunlap, 1992}, p. 78). The Western region refers to the 13 states holding membership in the original Western Interstate Commission for Higher Education (WICHE) organization and comprises nearly half the U.S. geography. The region includes Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. Historically, the region was sparsely populated and faced problems in healthcare delivery, resources, and education. Of necessity, the region, in general, and nursing, in particular, forged practices based on collaboration, resource sharing, adaptability, and adjustment in an ever-changing environment. It is a proud heritage that endures to this day. It is the Western way.

THE BEGINNING

Following the end of World War II, hundreds of thousands of men and women took advantage of the assistance provided by the Servicemen’s Readjustment Act of 1944 (known commonly as the “GI Bill”) to attend college. Institutions of higher education were stretched to accommodate undergraduate students and experienced great difficulty in meeting the demand for graduate and professional programs. It was this situation that prompted governors of the Western states to create a commission to oversee interstate collaboration in higher education. Thus, the WICHE was established in 1951 (^{Abbott, 2004}).

In 1955, the executive director of WICHE—Harold Enarson—was authorized to study nursing education in the West and to propose an appropriate course of action for interstate collaboration. By the end of 1955, Enarson was working closely with nurse leaders from the West comprising “The Committee of Seven,” including Lulu Wolf Hassenplug (Chair), Pearl Parvin Coulter, James Enochs, Katherine Hoffman, Amelia Leino, Annette Lefkowitz, and Kathryn Smith (Table 1). The Committee defined a program that would move nursing education from hospitals to universities and colleges and would strengthen programs of graduate study and research (^{Abbott, 2004}). At its annual meeting on August 1956, the WICHE commission adopted nursing as a program and directed staff to identify sources of outside funding (^{Abbott, 2004}). Thus, WCHEN was born. The original areas of emphasis of WCHEN are listed in Table 2 and included function, need (linking education, practice, and research), and research priorities. The original core value of WCHEN—the interrelatedness of education, practice, and research—have endured throughout the organization’s history.

Table 1

Table 2

In the mid-1950s in all of the West, there were only a half dozen programs preparing nurses for leadership positions (in nursing education), essentially no body of nursing research,

In the mid-1950s in all of the West, there were only a half dozen programs preparing nurses for leadership positions (in nursing education).

and around 10 nurses with doctoral degrees, most of whom held degrees in disciplines other than nursing (^{Elliott, 1968}). WCHEN members recommended that the first order of business was to develop the research infrastructure of member schools. Therefore, the foundation for WCHEN’s/WIN’s effort to communicate nursing research and contribute to a body of knowledge actually began well before the current Communicating Nursing Research series of conferences, which marked 50 years in 2017 (^{Batey, 1992}).

Between 1957 and 1962, three regional research conferences were held. The University of Colorado School of Nursing conducted a series of seminars for faculty teaching research. Then the University of California, Berkley, organized a conference to help nurses design and conduct research in patient care settings. The third conference was offered by the University of Washington School of Nursing and focused on reviewing current research programs and identifying areas needing study. Members attending the University of Washington conference requested that WCHEN distribute a report on newly initiated and completed research in Western states. The ^{WCHEN (1963)} report, Report of Current Research in the Field of Nursing by Faculty of WCHEN Schools of Nursing, listed 66 studies either in process or being designed. Most of these studies (n = 38, 57.6%), had a direct relationship to patient care: 17 (25.8%) focused on nursing students, 10 (15.2%) addressed curriculum and teaching methods, and 1 (1.5%) had an organizational development topic. Thirteen of 60 WCHEN member schools reported research activities. The list of principal investigators reads like an early “who’s who in nursing” in the West (^{WCHEN, 1963}).

THE FIRST 25 YEARS: 1968–1992

The number of doctorally prepared nurses and the number of graduate level nursing education programs had significantly increased from 6 in the mid-1950s to 11 in the mid-1960s. The number of doctorally prepared nurses increased from 10 to 50, or 10% of the total number in the United States (^{Elliott, 1968}) during this same time frame. Deans and directors of graduate programs believed that it was time to implement a series of conferences to communicate completed research and to provide a forum for further development of research skills. Funds were obtained from the Division of Nursing, Department of Health, Education and Welfare—now the Department of Health and Human Services—to support the first three annual research conferences. The planning committee was charged with creating a new environment for nursing research while still living in the current one. Committee members had to make decisions for which there were few precedents. They decided that each conference would have a theme focused on one central component of the research process. There would be a keynote address followed by presentations of completed research, each with an accompanying formal critique. The research critique was considered a component of the research process, that is, the research was not complete until it had a formal critique. As the characteristics of a research critique were not well understood, that became the theme for the first research conference.

The First Communicating Nursing Research Conference

It was in the mid-1960s that Dr. Katherine Hoffman, Dr. Maureen Maxwell, and myself (Dr. Madeline Leininger) came together as the Planning Committee for WCHEN’s first Nursing Research Conference. Marjorie Batey, Jo Eleanor Elliott, and WCHEN staff were also present to facilitate the goals and plans for this premier event. The stimulating discussion, creative opportunity, and the freedom to plan anew to develop scholarly nursing research conferences in the West were clearly evident. It was especially exciting to consider different methodological strategies for critical thinking and appraisals of nursing research to ensure discipline knowledge to guide nursing practice. (^{Leininger, 1992})

The theme for the first conference held in 1968 in Salt Lake City, UT, was, “Communicating Nursing Research: The Research Critique.” It was selected to convey the position that evaluation of research was a necessary component of the research process. Forty-four people attended the conference. Most were nurse researchers from universities and hospitals in the West. Representatives from the American Nurses Foundation and the U.S. Public Health Service were also in attendance.

The planning committee selected papers and preselected the individuals to critique the research studies. A total of 22 papers were submitted for consideration, and five were selected for presentation at the conference. Conference expenses were paid by the grant and included funding of scholars to develop presentations, either research or critique. Dr. Madeleine Leininger gave the keynote paper on “The Research Critique: Nature, Function, and Art” (^{Leininger, 1968}). It has long been rumored within the organization that, after hearing Dr. Leininger’s paper, the scholars selected to critique research presentations hurried to their hotel rooms to rewrite parts of their critiques! Following the keynote address, the five papers and related critiques were presented in sequence. There were some “growing pains” at that first conference. A major one was learning that ideas, not individuals, were being critiqued (^{Murphy, 1992}). At the end of the day, those in attendance believed that a giant step had been taken for nursing.

The conference proceedings were published as Communicating Nursing Research, as they have been over the past 50 years. Marjorie Batey edited the publication and served as editor for the first six proceedings.

Conferences 2 Through 6

The format for Conferences 2 and 3 was similar to that of the first conference. The one modification was allowing the researcher to respond to the critique. The number of papers submitted for consideration, the number selected for presentation, and the number of participants remained essentially the same.

Once again, funds were obtained for Conferences 4, 5, and 6 from the Division of Nursing to continue the annual communicating nursing research conferences. Changes were made to the format. Participants wanted more research related to patient care, and they wanted more presentations. In the first conference, two of the five presentations concerned direct patient care, two concerned social constraints on nursing performance, and one evaluated teaching strategies. The Table of Contents for the sixth conference shows that 12 papers were presented and 10 focused on patient care. The “research clinic” was introduced as a means of providing feedback for research in the planning stage. Research briefs that did not include formal critique were introduced. From its inception, the Communicating Nursing Research conference has shown concern for diverse and vulnerable populations. An early innovation was to have responses to research involving a minority population by those from that population or with special insight into that population. By the sixth conference in 1973, there were 12 presentations selected from some 50 submissions. Attendance had grown to over 100.

In 1971, WCHEN was awarded funding from the Division of Nursing for a “Regional Program for Nursing Research Development.” The project focused on nursing research development and utilization. The outcomes influenced the discipline throughout the region and the entire United States. Among outcomes were “46 interinstitutional, non-targeted projects, 50 projects in which research findings were utilized in clinical settings, 23 research grant proposals and 41 publications” (^{Dunlap, 1992}). Of perhaps greatest significance, the project showed that research was an integral role in professional nursing. The work was of such importance that it influenced the reorganization of WCHEN in the mid-1970s and reaffirmed the commitment of the organization to the annual Communicating Nursing Research conferences.

The Move to Self-Funded Research Conferences

WCHEN hoped for additional federal funding from the Division of Nursing to continue the highly successful conferences in the same way the first six research conferences had been funded. However, it was made clear by representatives of the Division of Nursing that there would be no further conference funding.

What happened next is described by Dr. Ellamae ^{Branstetter (1992)}, chair of the WCHEN Executive Committee:

The Executive Committee, a risk-taking group, continued to favor a self-supported plan and said “Let’s go for it!” The motion was made and approved that WCHEN would sponsor a self-supporting research conference program, pending approval of the General Assembly. Marylou McAthie then suggested that the new research program be called the “Western Society for Research in Nursing (WSRN).”

Jo Eleanor Elliott reminded the enthusiastic group that there were no funds available for staff to plan the research conference for Spring, 1974. Marylou McAthie suggested that we offer “Founding” memberships at $25.00 each and present the plan to the membership the following morning. Everyone present found this to be an exciting idea, and there was great clamor among the group, as each tried to produce the first check in order to be Founding member number one.

By the time the proposal was submitted to the General Assembly the next morning, the news had spread by word of mouth, and a total of 27 Founding members had already submitted their support in the form of a $25.00 initial membership check. The proposal was met by the general membership with such enthusiasm and excitement that hats were actually passed up and down the rows for collection of checks from those wishing to be founding members.

The implicit purposes were the same then as they are now: 1. To support nursing research efforts in the West; 2. To provide a network for nurse researchers in the West; and 3. To sponsor the annual Communicating Nursing Research conferences. (^{Branstetter, 1992}, p. 70–71)

The Research Steering Committee responsible for planning the first conference under a self-supporting framework had to make decisions without history to use as a guide (^{Mitsunaga, 1992}). The first major decision was to market the conference to all nurses with an interest in research. The previous conferences were open to a select group comprised mostly of educators. They also decided that anyone who wished to submit an abstract for consideration could do so. It was agreed that the formal research critique was no longer needed and the format was changed to a symposium-like structure, which included discussants. She then commented on the outcomes of the decisions:

When 177 participants registered, which was 78 more than the preceding year, the commitment of nurses to research and its dissemination at an annual conference was clear. In addition, the change in format was well-received, the only complaint being inability to attend every session of interest to the participant because of simultaneous scheduling. Furthermore, the revenue generated, together with WSRN funds, was ample to meet conference costs including publication of the proceedings. (^{Mitsunaga, 1992}, pp. 83–84)

Growth and Change

Growth and change not only marked the first 25 years of WCHEN/WSRN/WIN’s research conferences but its entire history. Success never meant maintaining the status quo. As the conferences grew in number and diversity of attendees, the Steering Committee also experienced a growth in number and nature of abstracts submitted for consideration.

From a conference in which five papers were presented to an invited audience of 44 deans and directors of graduate programs in western schools of nursing, the annual conferences grew over 25 years to a format in which over 125 papers were presented to an open attendance of between 300 and 350 people from all parts of the United States and other countries, such as Canada, Sweden, Samoa, and China. This time period culminated in a silver anniversary celebration.

THE SECOND 25 YEARS: 1993–2017

Today’s Communicating Nursing Research Conference

The Communicating Nursing Research conference, in its second 25 years, continued to grow and change as the needs of nursing changed, but constant goals have been to promote an increase in nursing research and to address ways to implement research findings in patient care settings. Whereas the content of the first conferences was largely focused on the research process, problem identification and research design, and the research critique, subsequent conferences showed that nurse researchers had clearly built on the experiences of the early projects and were addressing research about healthcare needs, not only of the Western region but also of the United States and the world.

In addition, significant technology changes drove the evolution of the Communicating Nursing Research conference and of WIN itself. For example, a number of schools of nursing in the West embraced distance education modalities, resulting in doctoral level enrollments from around the country and the world. Abstracts were once submitted mostly from researchers residing in the Western region; however, a review of the affiliations of student and faculty presenters over just the past 4 years (2013–2016) shows they came from 43 of the 50 states, Washington, DC, and the following foreign countries: Australia, Canada, India, Israel, Japan, Lebanon, South Korea, Spain, Taiwan, Turkey, and Uganda. There has been an increasing diversity of ethnicity of presenters at WIN conference and a notable increase of research projects from men and from interprofessional colleagues.

True to its beginnings, WIN and its Communicating Nursing Research conferences have held to the belief that research, education, and practice are equal parts of the discipline of nursing and are essential to achieving the goal of improving the quality of patient care. In addition, this outcome is more likely to be realized with input from diverse perspectives and recognition of the diversity of the public we serve. These basic beliefs are reflected in a scan of the themes of research papers given between 1993 and 2016. The themes also reflect the advancement of nursing science and provide an impressively wide array of research topics. Broad themes included rural health issues; diverse and vulnerable populations; Latino/Latina health; women’s health from childbearing through the life spectrum; child health from prematurity through adolescence; family health and caregivers; gerontology from health promotion and illness through end of life; chronic health conditions including diabetes and cardiopulmonary conditions; mental health issues over the lifespan; sleep disturbances; the nursing role, including nurses’ health; improving the quality of patient care; building the science of nursing education; and symptom management and response to illness. There is a consistent thread related to methodology, including experimental design, phenomenology in clinical research, dichotomous outcomes, feminist empiricism, animal research, magnitude estimation, mixed methods, and community-based participatory action research.

The advancement of science and technology has resulted in nursing research on a wide variety of topics, such as biomarkers; cytokines; and microvascular, cellular, and genetic assays. Physiological research findings have been presented on genomic markers and measures, closed crush muscle injury, biomarkers in sleep disturbance, and irritable bowel syndrome.

Nursing research has addressed contemporary healthcare and sociopolitical issues, reflecting social consciousness and global perspective. Examples from the past several decades include research on HIV/AIDS, the Ebola epidemic, homelessness, and the impact of the environment on health. Studies on military nursing practice, including resuscitation and aeromedical evacuation, impact on families, and caring for active duty personnel followed the U.S. involvement in the Middle East war. Nurses have studied global populations, including Asians, African refugees, and Asian Pacific Islanders.

Conference participation has continued to grow over the last 25 years. In 1993, there were 85 research papers given in 27 concurrent sessions and 78 papers given in 18 symposia, for a total of 163 papers. There were 21 poster exhibits and one poster symposium, and 64 posters in the Research Information Exchange, for a total of 90 posters. By 2016, there were 130 papers presented in 28 concurrent sessions and 64 papers presented in symposium sessions, for a total of 194 papers. A total of 465 posters were presented in four poster sessions, of which 226 were presented in the Research and Information Exchange. Attendance at the 2016 conference was 926.

The early conferences focused on research methods, always with a goal of improving patient care. This goal is evidence throughout the history of the conferences and the evolving themes. A systematic study of the trends and themes from the WIN conferences over the years would constitute an important and interesting research project.

The WIN leadership has always believed that one of its important functions is the mentoring of students and new graduates. Examples of mentoring activities include interactions between matriculated students and senior researchers and/or clinical researchers and practitioners offered via the conference; the opportunity for those who have never reviewed abstracts to be paired with experienced reviewers for their first review; and the opportunity for graduate students to work with poster judges to learn the process and, hopefully, become posters judges after degree completion.

The innovations in conference programming in the first and second 25 years are listed in Table 3. The innovations in the first 25 years have been retained, whereas the conference has led innovations addressing contemporary needs in the second 25 years.

Table 3

ONGOING ENACTMENT OF ORGANIZATIONAL PURPOSE

Today some people may primarily associate WIN with its very successful annual research conference. However, starting with its inception and consistent with a commitment to education, practice, and research, WIN has implemented numerous cutting edge programs that link education, research, and practice. Projects, grants, or surveys in the 1950s included continuing education for leadership, reports on research conducted by faculty, identifying nursing supply for the West, and defining clinical content in graduate nursing programs. In the 1960s, projects included regional conferences on research in nursing, staff development workshop for nursing directors, improving instruction through the use of selected tools and technologies, identification of essential content in baccalaureate programs, curriculum improvement project, and continuing education in psychiatric mental health for faculty in associate degree programs.

Projects in the 1970s included the aforementioned research development project, educational programs for nurses to improve patient education, faculty development to meet minority group needs, models for introducing clinical diversity into nursing curricula, feasibility study for leadership preparation for complex organizations, a compilation of nursing research instruments, and analysis and planning for improved distribution of nursing personnel and services. In the 1980s, the organization focused on continuing education to improve mental healthcare, changing nurses’ participation in health planning, preparation and utilization of new nursing graduates, information on the impact of diagnosis-related groups on the reimbursement of hospitals, on clinical nursing care in hospitals and community settings, and a Western project to improve education in geriatric nursing.

The 1990s found a focus on a continuing education program regarding special needs of racial/ethnic minority populations who abuse alcohol and other drugs and dissemination of information to strengthen nursing education and practice and to set future directions. A continuing education project for nursing faculty in preparation for teaching nursing informatics was undertaken through a Cooperative Agreement with the Division of Nursing.

The 2000s provided a highly innovative, ongoing project, The Nursing Education Xchange (NEXus; www.winnexus.org). Through NEXus, students in schools of nursing that belong to the consortium can take distance education doctoral courses from other members of the consortium. NEXus was first funded by the Fund for the Improvement of Postsecondary Education (FIPSE), U.S. Department of Education (FIPSE #P116B040822), for 4 years and then by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA; D09HP09070). In the first 4 years, the NEXus consortium structure, bylaws, policies and procedures, and membership were developed and implemented. Initially, the consortium members were from the Western region, but the focus of the HRSA grant was to expand the consortium across the United States. A full list of consortium members can be found at www.winnexus.org. A subsequent collaborative agreement was reached with the John A. Hartford Foundation to enhance access to courses in geriatric content. When HRSA changed its focus and NEXus no longer fit the funding criteria, its members instituted membership dues and the consortium, now in its 12th year, is self-supporting.

The project makes available to students matriculated in the member institutions an array of course offerings, including highly specialized content taught by experts in their fields. NEXus alleviates the need for schools of nursing to provide all courses. A student-friendly benefit of NEXus is that these courses count as credits in the student’s home institutions, rather than transfer courses. Each program continues to grant its own degrees. Student evaluations over the 12 years of this project indicate that the students’ progress in their courses of study, and even graduations, would have been delayed were it not for the project.

NEXus is a prime example of what can be accomplished by cooperation and collaboration among schools/colleges of nursing. A recent article on integrating omics content in PhD programs pointed to NEXus as a model for delivering scientific and theoretical content across institutions to optimize faculty knowledge and skills across institutions (^{Conley et al., 2015}). Although WIN separated from its relationship with WICHE many years ago, WIN and the Western Cooperative on Educational Technology (WCET/WICHE) partnered to write the NEXus grants after the need was realized during a WCET project. Both WIN and WICHE continue to view collaboration and resource-sharing as productive. It is, indeed, the Western way.

RESPONSES TO CHANGES AND CHALLENGES

The 1980s found the organization faced with some important decisions. The leaders were notified by WICHE that it would no longer be able to financially support the organization and there were differences in public policy issues, including WCHEN’s support of the Equal Rights Amendment. Another Committee of Seven was named and included Jean Lum (1984–1985 Chair of WCHEN), Carol Lindeman (Chair-Elect), Ellamae Branstetter, Gerry Hansen, Frankie Manning, Patricia Schmidt, and Anna Shannon (^{WCHEN Report, 1985}). The Committee was later expanded to include Clair Martin (1985–1986 Chair-Elect) and Myra Warnick (Table 1). The Committee outlined to WCHEN members several options: (a) create an autonomous, self-supporting new western regional organization; (b) maintain WCHEN within WICHE on a self-supporting basis; or (c) provide for the continuation of the research conference if neither Option 1 nor Option 2 was approved. The Council members met on October 30 and 31 and November 1, 1985 and voted 52 to 1 that WCHEN become an autonomous, self-supporting organization. The Council also promptly reaffirmed its support of the Equal Rights Amendment to the U.S. Constitution (^{WCHEN Minutes, 1985}). The name of the organization was changed on October 29, 1986, to the WIN. There was discussion about relocating to a member agency and incorporating as a nonprofit, but WIN continued to be housed with WICHE in Boulder, CO. The Board of Governors decided in 1995 that the organization should fully separate from WICHE and issued a Request for Proposal from among its member organizations and others to house the organization. The WIN Board selected the proposal from the Oregon Health & Science University (OHSU) School of Nursing, Portland, OR. WIN opened its doors in Portland on July 1, 1996, and has administered the Communicating Nursing Research conferences beginning in April 1997. The organization was incorporated as a nonprofit according to the laws of the State of Oregon in November 1998.

Another proposal for restructuring was presented to the membership in 1996. After a robust debate, the membership reaffirmed the tripartite (research, practice, and education) mission of the organization and subsumed the responsibilities of WSRN into the core functions of WIN. The action reaffirmed that, from the inception WCHEN in 1957, the promotion of research in nursing in the Western region has been a manifest function decreed through the organizational structure (^{Dunlap, 1992}). The conference has continued its growth with abstracts on nursing research, evidence-based practice, and clinical or educational projects or research, reflecting the tripartite mission of WIN. The number of presentations and growth of the conferences have prompted attendees to continue to express concern about the number of papers and activities and insufficient time to attend more sessions.

WIN arrived at OHSU with limited resources, and the membership structure, which included a number of delegates allotted to each members institution, made membership recruitment difficult. Decreases in external funding sources resulted in a situation where writing grants was not a logical way to support staffing. Therefore, a proposal for a structural change was presented to the Governing Assembly in 2001. The proposal changed the basic form of membership to individuals, including students and retired members. Organizational members were each allotted an individual member through whom membership benefits would flow, along with additional benefits. These changes were successful in restoring fiscal health to the organization, which now follows a policy for a reserve fund to ensure operations during downturns.

SPECIAL RECOGNITION

It is important to note that the growth and development of research and of WCHEN itself is due in large part to generous funding from the U.S. Public Health Service; the W. K. Kellogg Foundation; the Division of Nursing, Bureau of Health Manpower, Department of Health, Education and Welfare/Department of Health and Human Services; and the FIPSE, U.S. Department of Education. The Anniversary Book is an invaluable resource for historical information about the Communicating Nursing Research conferences. Jeanne Kearns and Patricia Uris identified the content and edited the publication, and their work is gratefully acknowledged. The organization gratefully acknowledges the OHSU School of Nursing for its support and housing over the past 20 years, which has allowed WIN to grow and thrive.

ORGANIZATIONAL IMPACT

The effect of the organization and its research conferences can be portrayed in several ways. The first is a summary of its programs, found in Table 4, which highlights the organizational impact over its 60-year history. The second is through individual testimony. The latter is probably the most descriptive:

Table 4

For many of us, these conferences were the settings in which we gained experience in presenting research, met people whose work we admired, sought counsel from the “feds,” talked with journal editors about how to get published, participated in networks with people having similar interests, and offered guidance to others.

Originally conceived as meetings to foster the research skills of nurses, the conferences have become major arenas for the creative activities of a large cadre of nurse investigators and for the socialization of newcomers to research and scholarship. Across these years, the nursing community has lost many of the early pioneers whose dreams made these conferences a reality. In a singular way the conferences are a living memorial to the vision and commitment of those far-sighted nurses. (^{Benoliel, 1992})

It is also equally important to acknowledge the vision, courage, and commitment to collaboration of the WCHEN staff and nurse leaders in the West. Jo Eleanor Elliott is widely acknowledged for her vision and leadership in the development of the organization. It is somewhat amazing that the organization has only had four Executive Directors in its history: Jo Eleanor Elliott, Sally Ruybal, Jeanne Kearns, and Paula McNeil. Each has provided leadership in their own way through the challenges and issues of the times.

None of the accomplishments of the past 60 years, including the planning of the Annual Communicating Nursing Research Conference, would have been possible without the support, commitment, and involvement of WIN members. The vision and leadership of the organization’s Board of Governors, numerous committees, and dedicated members have been translated into successful events and projects. Too numerous to name individually, WIN is indebted to each and every one.

THE FUTURE

“Somewhere in the West, a brisk breeze is always blowing – a current which may unpredictably become a whirlwind, sweeping before it outgrown traditions and practices and creating space for innovation, experimentation, and progress. The West is changing—on the move—and nursing is changing and moving with it.” (^{Coulter, 1963}, p. 1)

Thus begins the progress report, The Winds of Change: A Progress Report of Regional Cooperation in Collegiate Nursing Education in the West From 1956–1961. The ongoing story of WCHEN continues to inspire the organization today with its emphasis on leadership, vision, commitment, and a conviction that the people of the West needed nursing services of excellent quality and that nursing education must prepare nurses capable of providing that service. It is a success story “relating the dreams, the hard work, the cooperation through which higher education for nursing in the West achieved a distinct identity and is finding its way into the system of higher education” (^{Coulter, 1963}). It is also a story of adaptability and adjustment to the brisk breeze blowing in the Western region.

The companion article to this historical perspective in this issue of Nursing Research is “Nursing Practice, Research, and Education in the West: The Best Is Yet to Come” (^{Young, Bakewell-Sachs, & Sarna, 2017}). The authors provide some actions that WIN and its members could take in creating a preferred future and improving health in the Western region. The suggested actions include serving as a clearinghouse for best practices on health and policy; engaging in policy and advocacy efforts; and organizing to identify problems and set top priorities on nursing practice, education, research, and policy to improve health and healthcare outcomes in the region. As they note, WIN is well positioned to marshal its members for these actions.

Westerly winds can be gentle and soothing, or they can be tumultuous. As surely as the winds will blow, WIN and its members will face these challenges as great opportunities in the future just as will the nursing profession. WIN will respond to the challenges and opportunities in accordance with the abiding core values handed down from the founders and enacted through its research conferences and projects: the interaction of individuals from nursing education, practice, and research; attention to quality; attending to underserved population health needs; mentoring of new researchers in academic and clinical settings; and improving the quality of patient care. WCHEN/WIN has always relied on regional cooperation and collaboration to achieve past goals. These core values and our belief in cooperation and collaboration will stand the organization in good stead as we address the future. It is the Western way.

REFERENCES