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  1. Section Editor(s): Sanford, Kathleen D. DBA, RN, FACHE, FAAN

Article Content

As editor in chief, one of the fun things I get to do occasionally is interview nurses. I always learn something new, and I never leave the dialogue without a renewed conviction that our profession is filled with brilliant, compassionate, and dedicated men and women. Some of these are using their hands, heads, and hearts to deliver direct care to both sick and well individuals. Others, such as those in executive practice, strive to improve their organizations, communities, and world through work that is less visible to those who are served. Regardless of his or her role, each nurse I talk to is involved in activities to improve the lives of others. In addition, whether they've been nursing for a year or decades, they have all experienced major or minor disruptions in the work they do.

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The major disruptors in health care have usually involved money or technology and scientific advances. Providers have faced and continue to face changes in payment systems, shifts in local populations from fee-for-service-insured patients to government paid programs, increases in costs for everything from meeting regulatory requirements to installing business and clinical IT systems, and acquiring new technology, equipment, and medications. Nurses have adapted with disruptive activities of their own by figuring out new models of care (at least partly in response to hospital finances) and changing their processes and workflows to accommodate use of new technology.


Authors in this edition offer a variety of articles on positive disruptions that nurses have implemented in response to the wider societal and industry disruptions. Schuelke describes a pilot study that changes inpatient care with the addition of a virtual nurse; Waxman et al share their thoughts on simulation as a nursing education disruptor; Tanioka and coauthors describe the disruptions caused by use of robotics; Shaffer and Preziosi contribute thoughts on the ramifications of the rapidly growing retail health market and the emergence of digital health; and Lee and Park share how smartphones can be used to improve OR communications.


Others discuss changes needed to ensure that leaders are supporting staff as they experience disruption: Porta, Disch, and Grumdahl share that disruption is part of achieving sustainable goals; Shaffer advocates for disrupting current policies and practice related to refugees, particularly refugee nurses; and Kawar et al share thoughts on the compassion fatigue that nurses can experience in response to the work we do in chaotic, changing environments. Sullivan and Yoder-Wise share ideas about the process nurse leaders should follow to help their teams deal with disruption. In addition, Bleich offers a model for humanizing disruptive innovation, while Snow talks about the need for creativity and innovation.


I was privileged to interview 3 nurses whose innovation has resulted in new patient care products. They recognized specific obstacles to safety and quality and came up with solutions to these challenges. I hope you'll be inspired by their stories, especially if you've got innovative ideas you haven't yet fully taken from concept to reality.


Finally, some of the distinguished nurse leaders who serve on the Nursing Administration Quarterly advisory board offer their thoughts on disruption. Please read and learn from their wisdom, as you face your own need to either disrupt or respond to disruption in this challenging, exciting, and rewarding specialty of nursing management.


Thank you for choosing to lead,


-Kathleen D. Sanford, DBA, RN, FACHE, FAAN




Nursing Administration Quarterly