Leading the American Academy of Nursing: A historical review of the Presidents' words and actions on "rationality," inclusivity, and health policy, 1973 to 2023.

BACKGROUND: Little has been written about the history of the American Academy of Nursing (Academy). An examination of the association's origins, purpose, early goals, and leaders' words and accomplishments can illuminate the organization's role within the profession today. PURPOSE: This paper begins the process of documenting the Academy's history. It focuses on the words and accomplishments of the Academy's Presidents, setting them within the social, political, economic, and health care context of the years between 1973 and 2023. METHODS: Traditional historical methods with a social history framework. DISCUSSION: Three themes emerged. These include the importance of "rationality" (later termed "scientific evidence") as the basis for practice; the critical need for cultural, racial, and ethnic inclusivity in the association; and the necessity of engaging all Academy Fellows and Expert Panels in the work of driving health care policy. CONCLUSION: Understanding the association's history, beginning with an analysis of the Presidents' words and accomplishments is a first step in documenting the Academy's history.

Nurses on the front line: The 1918 influenza and COVID-19 pandemics.

ABSTRACT: Due to advances in science and medicine, nursing is far different today than it was in 1918. During a pandemic, however, skilled nursing care remains critical to patient outcomes. This article identifies and describes the experiences of US nurses during the 1918 influenza pandemic and compares them to the experiences of nurses responding to the COVID-19 pandemic.

Nurses on the front line: The 1918 influenza pandemic and COVID-19.

ABSTRACT: This article identifies and describes the experiences of US nurses in the 1918 influenza pandemic and compares them to nurses' experiences today as they respond to the COVID-19 pandemic. The findings are based on traditional historical methods with a social history framework. Because of advances in nursing, medicine, and science, nurses' work is quite different today than it was in 1918. Yet two facts remain the same: In the setting of a pandemic of a dangerous virus for which there are few proven treatments and no vaccine, skilled nursing care is critical to patient outcomes; and support from federal, state, and local governments, community organizations, and volunteers is as important now as it was in 1918.

Babies at the Border: Reflections on Nursing on Ellis Island.

: Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.

Living in the epilepsy treatment gap in rural South India: A focused ethnography of women and problems associated with stigma.

In India, women with epilepsy face unique challenges. A focused ethnography of six women within the epilepsy treatment gap was conducted in rural South India. Women were asked to describe their day-to-day lives. Data were collected through open-ended, semistructured interview questions, participant observation, and field notes. Thematic analysis was done. The disease-related stigma contributed to the women's physical, psychological, and emotional struggles; the women and their family members made every effort to conceal the disease. Educational interventions to create awareness could help women seek effective treatments for their seizures, thereby reducing the stigma and improving the quality of their lives.

Using nursing history to inform decision-making: Infectious diseases at the turn of the 20th century.

BACKGROUND: This historical paper examines the impact of infectious diseases on the urban poor of Chicago and New York a century ago, before most vaccines were developed. PURPOSE: Working on the front lines of health promotion and health care, nurses and other providers are charged with informing the public about offered vaccines. The intent of this paper is to supplement providers' knowledge about vaccination with an appreciation of the devastation these diseases once caused. METHOD: Historical methodology guided this study in which archival and oral sources were used. DISCUSSION: The continued outbreaks of smallpox at the turn of the twentieth century, when a vaccine was available, may be compared with the re-emergence of measles today. Additionally, this paper shows the devastation caused by other, non-preventable, infections of the period. CONCLUSIONS: Awareness of the history related to the impact of infectious diseases, especially the role nurses played in decision-making related to care, is critical for today's health care providers.

Frontier nurse-midwives and antepartum emergencies, 1925 to 1939.

This article examines how the Frontier Nursing Service (FNS) utilized nurse-midwives to respond to antepartum emergencies such as preterm birth, eclampsia, malpresentation, and hemorrhage in the women of Appalachia in the years 1925 to 1939. Particular attention is given to the preparation that nurse-midwives received during their midwifery education to prevent and respond to emergencies. Using traditional historical research methods and primary source material from the FNS papers in the Special Collections, University of Kentucky Libraries, Lexington, Kentucky, this article describes the nurse-midwives' experiences and how they implemented skills they had learned during their training in Great Britain. Working in the isolated mountainous area of Leslie County, Kentucky-for the most part without direct assistance from physicians-FNS nurse-midwives decreased maternal and neonatal mortality rates. During their first 2000 births, they had only 2 maternal deaths, whereas the national average maternal mortality rate was approximately 7 deaths per 1000 births. The nurse-midwives performed external cephalic versions on a routine basis. For pregnancy and birth emergencies, they administered sedation, gave general anesthesia, and performed invasive lifesaving techniques in order to protect the lives of the women in their care. During these 14 years, their cross-cultural engagement, assessment skills, clinical judgment, and timely interventions improved maternal and child health throughout the region.

Historical Perspectives on an Expanded Role for Nursing.

The 2010 Institute of Medicine report, the Future of Nursing, recommended that nurses work to the "full extent of their training" to address the primary healthcare needs of United States citizens. This article identifies and describes historical antecedents, cornerstone documents, and legislative acts that served to set the stage for today, laying the groundwork for an expanded role for advanced practice nurses in the 21st century. Beginning with Lillian Wald's work in Henry Street Settlement in 1893, through Mary Breckenridge's founding of the Frontier Nursing Service in 1925, the discussion describes how nurses provided access to care for thousands of urban and rural citizens throughout the United States in the past. The article also discusses political forces at midcentury and the creation of the nurse practitioner role with the premise that nurses can learn from these early initiatives to create new models for nurses' roles in primary care today.

Marfan syndrome teaching algorithm: does it make a difference?

Marfan Syndrome (MFS) is an autosomal dominant, connective tissue disorder that is due to a deficiency in the structural protein, fibrillin. MFS patients are more likely to experience aortic aneurysms and dissections, dislocated lens, and/or severe musculoskeletal deformities than non-MFS patients. Attainment of a longer lifespan in MFS patients is directly dependent on vigilant blood pressure (BP) control, frequent cardiology surveillance, annual eye exams and frequent dental hygiene visits. This study evaluated the effect of a Marfan Syndrome Teaching algorithm (MFSTA) on 20 MFS patients, with regard to BP management, cardiovascular medication adherence; adherence to activity restrictions; and attendance at scheduled eye, cardiology and dental exams. This study demonstrated adherence improvement in the attendance at scheduled cardiology, ophthalmology, and dental exams from 50%, 55% and 70% prior to the study, respectively, to 95%, 90% and 100% post study. Furthermore, subject adherence with self-administration of ordered cardiovascular medications increased from 50% (pre-study) to 93.3% (93.3%), and subject adherence with activity restrictions escalated from 70% (pre-study) to 95% (post study). All subjects demonstrated proficiency in regular testing and recording of their blood pressure. There was no significant change in the mean systolic BP (SBP) for 13 of the subjects who had both pre- and post-intervention BP recording, although the post intervention SBP was slightly higher (p = 0.30). However all subjects in the intervention period demonstrated a mean SBP of 124.7 mm Hg, with standard deviation (SD) of 12.9 mm Hg. Limited pre-intervention BP readings of 7 subjects prevented a pre- and post-SBP comparison. The MFSTA model should be considered for other patient populations involving chronic cardiovascular healthcare conditions.