An Open Letter from Past Presidents of the American Nurses Association.

Eight former ANA presidents urge nurses to consider nursing's values when they vote.

Margretta Madden Styles.

In recognition of the Year of the Nurse and the Midwife initiative, AJN will periodically highlight the works of key nursing leaders. Sometimes it will be in the form of articles from our archives, at other times it will be excerpts from or summaries of nurses' work with related commentary. Here, courtesy of Margretta Madden Styles's daughter, we've reprinted Styles's "Declaration of Belief About the Nature and Purpose of Nursing," originally published in her book, On Nursing: Toward a New Endowment (C.V. Mosby Company, 1982). We hope it will inspire you.

Exemplars of Innovation in Practice: Implications of the AONE-CIT and CMS Innovation Advisors Projects Within the Massachusetts General Hospital.

Innovation in health care requires leaders to influence the development of positive environments that accelerate innovation and produce better outcomes for patients, the workforce, and organizations. Given the multifaceted changes in today's health care system, nursing leaders must utilize opportunities for innovation to focus on enhancing practice environments. In this article, nursing leaders who oversee personnel on direct care delivery units report on how they worked within existing organizational structures to influence improvement in practice environments while accelerating innovation.

The role of the nurse and the preoperative assessment in patient transitions.

Transitions in care in the perioperative environment are numerous and should be considered high-risk endeavors. The preoperative area is the first transition in care for a surgical patient and should be considered a critical dimension of care transition. The purposes of this study were to identify nursing's contributions to transitions in care in the perioperative environment and to identify the role of the preoperative assessment in this transition. Qualitative descriptive design was used. Focus groups were conducted with 24 nurses in a 975-bed medical center. The themes that arose in the focus groups were: (1) understanding patient vulnerabilities, (2) multidimensional communication, (3) managing patients' expectations, and (4) nursing's role in compensating for gaps. We conclude that the nurse's role in the preoperative assessment during the transition of preoperative care is that of advocate who identifies the patient's needs and risk factors that may be affected by the surgical experience. This study suggests that the nursing preoperative assessment can be useful in identifying and defining patients' risk factors not just for surgery, but for the entire perioperative care trajectory.

Nurse presence enhanced through Equus.

PURPOSE: The purpose of this study was for nurses to experience equine-assisted learning and for them to describe their being in the moment with their horse. The aims of the study were to assist clinicians in recognizing their ability and skill at being present--that is, calm and centered--as they engage with horses and to determine if interaction with horses is a valid representation in recognizing presence in the participants. DESIGN: Descriptive phenomenology was used to explore this lived experience. FINDINGS: Five themes emerged: The Experienced Novice, Present in the Moment, Discovery of Self, Team Building, and Leadership. CONCLUSIONS: Equine-assisted learning can be a meaningful venue for nurses to self-discover their ability to be present.

The national AgeWISE pilot.

AgeWISE is a 6-month nurse residency program designed to prepare hospital nurses to meet the needs of older adults, a population that comprises nearly 50% of all US hospital admissions. The goal of AgeWISE, now being piloted in 12 hospitals in the United States, is to produce a tested and refined national model for building geropalliative care capacity among hospital nurses.

Unhealthy states.

A groundbreaking report has spelled out the personal and economic effects of chronic disease in the US.