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  1. Bolton, Linda Burnes DrPH, RN, FAAN
  2. Simpson, Roy L. RN, C, CMAC, FNAP, FAAN

Article Content

In October 1991, meteorologist Bob Case coined the term "perfect storm" to describe the unprecedented set of conditions that foretold a monstrous storm, a storm that exploded in the northern Atlantic Ocean creating waves 10 stories high and imperiling the New England fleet.1 Today, nursing also stands on the shore of a turbulent sea of change. As the extraordinary set of conditions converging in healthcare threaten to imperil our profession, we would do well to take heed of predictions from the meteorologists of our profession. To that end, we have invited scholars and leaders in healthcare, business, education, and service to share their views on the evolving swells of change as insight for your contemplation.

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In Perspectives on a Perfect Storm, experts from different areas of healthcare offer their unique outlooks on the conditions and advice on how to deal with them. The Perfect Storm: Managed Care, Patient Safety, Aging Adults and a Shortage of Nurses examines the convergence of financial and clinical pressures. Key Forecasts Shaping Nursing's Perfect Storm also focuses on forces that contribute to creating perfect storms of the future, while Confronting the Perfect Storm: A Challenge to Nurse Leaders suggests key strategies for confronting the tempest.


What emerges from all these predictions is that to weather the storm, we must begin focusing on 3 critical areas-education, the workplace, and the state of the profession.


Education is ground zero. Evidence and Root Causes of an Inadequate Pipeline for Nursing Faculty examines the growing shortfall in the pipeline of RNs educationally prepared to take faculty roles. HIT Plants SEEDS in Healthcare Education shows how information technology incorporated in the education curriculum equips nurses to enter the workplace armed with the efficiencies that IT-savvy produces.


And, given the nature of the workplace, they will need all the help they can get. Burdensome Situations in Everyday Nursing: An Explorative Qualitative Action Research on a Medical Ward is a study of the effects of a stressful workplace on individuals and teams. A literature review of sleep deprivation in nurses, Sleepy Nurses: Are We Willing to Accept the Challenge Today?, examines a well-known but inadequately examined workplace danger. Assessing the Quality of Nursing Work Life explains how quality of nursing work life assessments identify opportunities for nurses to improve their work and work environment, while achieving the organization's goals.


Like the storm, the solution's strength rests in convergence-and the place where education and workplace improvement converge is practice. What we do to improve the 2 former will greatly determine the fate of the latter. Beyond Caring explores the dilemma of caring-specifically, the seeming subjugation of nursing science to nursing compassion, while A Conceptual Model for Growing Evidence-based Practice presents a model for resolving this dilemma. Finally, The Coaching Process: An Effective Tool for Professional Development shows the importance of applying our greatest resource-nursing knowledge-to the monumental task.


Each article is an interesting discussion on the forces from a unique perspective. As you read these contributions, consider the following questions:


* Do we have a clear and compelling vision for the future?


* If so, what do we focus on now, where do we direct our activities, and how do we use our resources to make that vision a reality?


* How are we engaging nurses and other professionals in addressing the raging forces of the perfect storm?


* Do we support activities and causes in a tangible way to further the greater good? Have we collaborated with the public to celebrate the contributions of nurses? The American Academy of Nursing recently launched Raise the Voice, a campaign to highlight Edge Runners, nursing professionals that have developed and implemented science-based programs that are improving the lives of individuals and communities. Do you know an Edge Runner? What are you doing to support their activities and programs in a tangible way?


* What will it take to move nursing to the next step? These authors may well present recommendations you can use.



As we move toward the next decade, we must acknowledge that despite a 5% increase in nursing school enrollments across the country, the lack of faculty, and a commitment to advance the profession compromises our ability to meet the increasing demand for nurses and healthcare services.


As a nation, we still relegate nursing to a primary care role, rather than a workforce we must assist to ensure a thriving healthcare environment.


Ours is a service profession committed to using its collective knowledge to benefit others. At the same time, we are a science-based profession that must mainstream our science to


* draw potential teachers and professors;


* develop practitioners to deliver effective, efficient healthcare that is healing and culturally relevant;


* reach out to national and community leaders who would embrace nurses and their work to improve the health of society;


* encourage government officials who would invest in nursing-led programs led to promote health and well-being and while discovering new ways to respond to disease and illness; and


* attract foundations that will help us explore possibilities through their generous funding.



Americans see nurses as angels of mercy. And we are-just ask the grateful patients who have benefited from our science and service across the continuum. This issue of Nursing Administration Quarterly raises the question, "Can we avert a sure catastrophe without new answers to our continuing problems?" Each author brings a fresh perspective. We hope you send us your comments and recommendations.


Linda Burnes Bolton, DrPH, RN, FAAN


Vice President, Nursing, Cedars-Sinai Medical Center, Los Angeles, Calif (Bolton)


Roy L. Simpson, RN, C, CMAC, FNAP, FAAN


Vice President, Nursing Informatics Cerner Corporation, Kansas City, Mo (Simpson)




1. National Oceanic & Atmospheric Administration. NOAA Meteorologist Bob Case, the man who named the perfect storm. NOAA News Online (Story 444). June 16, 2000. Available at: http://www.noaanews.noaa.gov/stories/s444.htm. Accessed January 22, 2007. [Context Link]