As a former Editor-in-Chief, I am honored to be invited to write one of the guest editorials celebrating the 20th anniversary of Advances in Neonatal Care (ANC). The importance of publishing a journal was not lost on the National Association of Neonatal Nurses (NANN) board of directors 20 years ago. It was clear that the association needed a vehicle to share information, knowledge, and research that impacted neonatal nursing. Indeed, that is one of the functions of a professional association—to advance the education and practice of the professionals that the organization serves.1 We have been privileged over the last 20 years to have talented authors, reviewers, editorial board members, and editors who have made ANC a trusted vehicle to share knowledge and discovery with our colleagues in neonatal care.
We live in an age where we are inundated with “information,” some of it good and much of it not very good at all. One only needs to spend a few minutes on social media to find realms of misinformation. Consequently, it is more important than ever that we keep up with what is new and can sort out what is reliable information and what is not. Lack of discernment leads to proliferation of misinformation, sometimes leading to tragic consequences, such as the spread of communicable diseases that are easily prevented with vaccinations. As nurses, we cannot engage in this. A reputable, peer-reviewed journal such as ANC is important to make sure neonatal nurses have scientific, up-to-date information. In fact, the very mission of ANC includes the words “publication of scientifically sound and clinically relevant articles that enhance intradisciplinary care.” So why is this so important? The following are only a few of the reasons why nurses must stay engaged and informed.
RAPIDLY CHANGING NEONATAL CARE
A colleague and I were recently asked to give a talk on “Dangerous Things We Used to Do in Neonatology.” I wish I could say that it was difficult to find examples. Unfortunately, there were many examples of things we used to do that have since been found to be dangerous, useless, or unsubstantiated. In the scheme of things, neonatology is a relatively young field. Neonatal intensive care units were virtually nonexistent 60 years ago.2 Much has changed in neonatal medicine and nursing. Significant advances in respiratory care, nutrition, and surgical care have been made. Thanks to the hard work and diligence of nursing scholars, the nursing care provided in the 1970s and 1980s has vastly improved. Much of what we have learned in neonatal care, including, but not limited to, nutrition, feeding practices, family-centered care, developmental care, and care of the substance-exposed newborn, comes from the nursing research. An association journal provides an avenue to publish new discoveries and to review solid information that is available.
Improvement in care comes not only from rigorous research but also from the practice of nurses who stay informed and translate the research into practice. As evidence-based practice has become the accepted standard, our clinical practice must be guided by the best possible evidence. Nurses have a responsibility to maintain knowledge and competency.3,4 The American Nurses Association Standards of Practice include integrating evidence and research findings into practice.4 This includes conducting research, using research findings, employing critical thinking skills to connect research and practice, and integrating research into quality improvement.4 It is not okay to just show up for your shift and complete the assigned patient tasks. Nurses must be knowledgeable, up-to-date, and engaged in practice.
We spend a lot of time in education talking about critical thinking. However, to engage in critical thinking or the creation of new knowledge, we must have a rich body of knowledge to begin with. This requires reading and learning what others have already discovered.5 A foundation of basic knowledge is essential, and because neonatal care is always advancing and the need to know continues to advance along with it.
PUBLIC POLICY ENGAGEMENT
Nursing has long been considered the most trusted profession.6 This requires practicing according to accepted standards and current, relevant knowledge. It also means partnering in a community engagement. It also calls for safeguarding nursing practice in the face of public and business policies that fail to put patient care front and center. Staffing issues, access to care, and healthcare quality are important topics that nurses must address. This requires knowledge. Providing evidence regarding healthcare outcomes is imperative to be credible when working to enact change.7 This requires keeping abreast of what is new and where problems exist.
Nurses also have the responsibility to inform the public. This includes educating our patients and being a source of reliable information. Being reliable means being educated and up-to-date on information. It means having a solid foundation of science and medicine. One cannot, for instance, educate others on vaccinations without a solid foundation on how the immune system actually works. To be educated, we need to be proactive in reading, attending conferences, and remaining engaged as lifelong learners.
Nurses may be intimidated at the idea of political involvement. However, involvement may include simple steps such as voting, writing letters to representatives, and participating in education about political issues.8 One author noted that fewer nurses voted in 2018 than in 2016 and less than half knew the names of their representatives.8 Increased knowledge of issues facing our patients, the public, and our colleagues increases confidence in the ability to influence change.
A recent study found that nurses had increased job satisfaction when they were learning and increasing knowledge on a regular basis.9 This should not be a surprise. Increased knowledge leads to increased confidence and sense of well-being. In addition, the perception of being able to solve problems, which is a natural outcome of increased knowledge, was shown to increase nurses' sense of control and power in the workplace.9 Knowledge is power.
Neonatal nursing is complex. To provide quality care, and to move the profession forward, requires engagement at all levels. We must not only master knowledge but also generate knowledge. We must then translate that knowledge to practice. If we do not generate, report, and absorb knowledge and then apply it to practice, we will not continue to improve neonatal care. Ultimately, this is the purpose of a specialty nursing organization and the associated journal. So, join your professional association (NANN). Don't merely join, become involved. Most of all, when the journal comes, read it! Then take what you read and put it into practice.
—Catherine Witt, PhD, APRN, NNP-BC
Dean and Associate Professor
Loretto Heights School of Nursing
1. Matthews JH. Role of professional organizations in advocating for the nursing profession. Online J Issues Nurs. 2010;17(1):3. doi:10.3912/OJIN.Vol17No01Man03.
2. Paneth N, Thompson T. Neonatal and perinatal epidemiology. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018, pp. 1–10.
3. Bourgault AM. Bridging evidence-based practice and research. Crit Care Nurse. 2018;38(6):10–12. doi:10.4037/ccn2018278.
4. American Nurses Association. Nursing Scope and Standards of Practice. 3rd ed. Silver Springs, MD: American Nurses Association; 2015.
5. Lang JM. Small Teaching. San Francisco, CA: Jossey Bass; 2016.
6. Milton CL. Will nursing continue as the most trusted profession? An ethical overview. Nurs Sci Q. 2018;31(1):25–16. doi:10.1177/0894318417741099.
7. Groenwald SL, Eldridge C. Politics, power and the predictability of nursing care. Nurs Forum. 2020;55(1):16–32. doi:10.1111/nuf.12377.
8. Vandewaa EA, Turnipseed DL, Lawrence S. A leadership opportunity: nurse's political astuteness and participation. J Nurs Adm. 2019;49(12):628–630. doi:10.1097/NNA.0000000000000827.
9. Ahlstedt C, Eriksson Lindall C, Holmstrom IK, Muntlin Athlin A. What makes registered nurses remain in work? An ethonographic study. Int J Nurs Stud. 2019;89(1):32–38. doi:10.1016/j.ijnurstu.2018.09.008.