Publish or perish: The stature of nursing worldwide

“There are two ways of spreading light; be the candle or the mirror that reflects it.”—Edith WhartonThis past week, more than 60 editors gathered at the 2010 INANE (International Academy of Nursing Editors) conference held in Australia. Issues related to trends in publishing, technology and publishing, internationalization of the nursing literature, and how to rate the quality of journals were discussed. There has been a continued evolution in journal publishing—particularly related to the inevitable change in how the primary venue for dissemination has changed. Who would have ever thought that the phrase “print journal” would not be redundant? In fact, most experts expect a slow “fading away” of print versions of journals, as is fast happening with “print newspapers.” Shawn Kennedy, interim editor of the American Journal of Nursing (AJN), took us on a fascinating journey of that journal’s foray into the use of multiple platforms to disseminate knowledge in nursing, including an electronic newsletter, blog, Twitter, and Facebook. I could not, however, make a confident assessment of how the editors actually felt about the transformation of the print journal into more technologically, and in some cases more accessible, sophisticated venues. Even after a quite lively discussion of who does read the print journals, how do we know how many read them, and the ever looming question of whether the articles we print actually have any impact at all.

Two topics I found most interesting and very challenging during the conference were (1) choosing metrics to judge the quality of one’s journal and (2) improving access to knowledge for nurses globally. These topics are inextricably linked in some interesting ways of which leaders in nursing need to be aware. In some ways they serve as 2 of the biggest challenges nurses worldwide face as they try and build their presence as part of the healthcare team while being viewed as professionals in their own right. It is only when I am at international conferences and work in other countries that I am truly cognizant of the unique role nurses in a few select countries play as members of the healthcare team. In North America in particular, where we often decry our invisibility, our issues seem inconsequential compared with nurses in other parts of the world.

The first day of INANE was devoted to presentations related to the role journals play in access to knowledge for nurses around the world. Rosemary Bryant, RN, BA, Grad Dip. Health Admin, FRCNA, the current president of the International Council of Nurses (ICN) shared her perspectives on the criticality of access to knowledge by nurses around the world—many in places where the internet is unavailable. Kathleen Stone, PhD, RN, FAAN, editor of Heart and Lung, shared her wealth of experience working with international authors and her structured approach to most efficiently and effectively developing their important work into a quality contribution.

Lively discussions about working with international authors ensued, covering concepts such as: the appropriateness of imposing (my words) developed countries’ institutional review board regulations on authors who conduct research in countries where the term consent can mean many different things, to the need for ways to reach out to authors who have a need for rich knowledge about health problems and solutions in their own cultures. Many editors, most of whom have demanding day jobs outside their role as editor, talked about the hours they are willing to spend to help authors in all countries to bring their innovative ideas to fruition. But many questions remain. The audience was still largely editors from English-speaking countries in Australia, United States, Canada, and United Kingdom, with only a handful of editors who worked with nurses in Asia. This representation (which remains similar year to year) leaves a large gap between editors from India, South America, Eastern Europe, Africa, and the Middle East. Editors spend considerable time with international authors, largely from countries that require authors who are academicians seeking promotion and must submit their work to nursing journals with a high impact factors. There remains, however, a huge gap in access to knowledge by nurses who are actually providing the care to millions of people across the world, and whose access to cutting-edge research and knowledge on which to base that care is minimal.

Many questions arose in my mind as I thought about the presentations and discussions at INANE. What is the role of organizations such as the American Academy of Nursing (AAN), Council for the Advancement of Science (CANS), Sigma Theta Tau International (STTI), and ICN in not only promoting and encouraging scholarship and publication of nursing knowledge from nurses across the world, but in actually setting priorities and providing development opportunities for skill-building. This is not an esoteric question, but rather links explicitly to the issue of access to knowledge, as well as the very viability and stature of nursing across the globe. The harsh reality is that our colleagues in other health disciplines still, and will for a long time, view the “coin of the professional and academic realm” as publication in peer-reviewed journals, whether those are in print, online or in cyberspace. In my experience nurses in other countries do not appear to always be valued for their knowledge—and in fact sometimes have difficulty seeing their own value. I believe this to be, in part, a reflection of having knowledge that has not been made visible and thereby shared with others. The value of “publishing your work” goes way beyond the initial joy of seeing one’s name in print. The process itself improves one’s ability to think systematically about a phenomenon, to craft a persuasive argument, and defend one’s ideas. In short, to gain confidence in one’s ability to think, to act, and to change how someone thinks about something you believe in; whether it is a solution to a patient care problem, a new research study, or a new policy analysis of a health plan. Although editors surely play a major role in helping authors from around the world publish their work, we cannot do this alone. In fact, until “the work” gets to us, it is going to be the leaders in various countries and professional organizations who must explain the incredible value of learning to think, reflect on, critique, and share with others the work nurses do. Publishing is much more than an important exercise for promotion in academic circles. The written word whether in print or any other medium is a powerful vehicle for making visible what nurses know, who they are, and what they can do to make a difference.