Thursday, 31 October 2013

Meet the Editors - Rita Pickler

Ten things about Rita:

1. Why did you become a nurse? 
I always thought I wanted to be a teacher, except I was not sure what I would teach. A family friend suggested I had a “nice voice for nursing” and since I had already had eight majors in my freshman year of college, I thought I may as well try it. Once I started my nursing classes, I knew I had made a good decision. I cannot imagine not being a nurse.

2. Why did you become an editor? 
I developed an interest in being an editor after years of editing papers for others as well as writing my own. I enjoy the actual “editing” process. I had some experience editing on a small scale for special issues in various journals and I have edited a column in a speciality journal for some time. When the announcement for the JAN editorship crossed my desk, I knew it was something I should pursue.

3. What is the best thing about being an editor? 
The best thing about editing is getting to read cutting edge, state of the art science before anyone else does!

4. What makes JAN unique? 
I think JAN is unique because of its broad topic and methods range. That sort of scope is pretty rare.

5. What is your favourite paper published in JAN this year and why? 
There were so many to choose from but my favourite paper this year is Lisbeth Uhrenfeldt, Hanne Aagaard, Elisabeth O.C. Hall, Liv Fegran, Mette Spliid Ludvigsen and Gabriele Meyer paper entitled, “A qualitative meta-synthesis of patients' experiences of intra- and inter-hospital transitions.” I like it because it is such an important topic for nurses and health care and its importance has only increased in recent years. This paper helps us to better understand the patient’s perspective.

6. What advice would you give to an author? 
I would advise choosing an important topic, studying it thoroughly, selecting a journal whose mission is a good fit for the topic, and then writing well.

7. What advice would you give to aspiring editors? 
I advise working your way into editing. Start by reviewing papers for journals in which you publish. Review as many papers as you can to get a feel for good (and poor) writing. Also look for opportunities to edit special issues of journals. These experiences will help you when you have an opportunity to apply for an editor position.

8. What annoys you most about poor manuscripts? 
As an editor, I read everything that comes into my inbox and so it annoys me greatly when I have to read a poorly written paper.

9.  What are the main challenges for nursing in the next decade? 
I think we will be challenged to gain or perhaps even to maintain the progress we have made as clinicians and scientists. I think this challenge will be made greater by the loss of nurses to retirement as well as the loss of potential nurse clinicians and scientists to other disciplines.

10. Who do you recommend to follow on Twitter? 
I am not an expert or frequent “tweeter.” However I do follow JAN and its editors, STTI, COPE, and other professional organizations.

Friday, 18 October 2013

‘Hospitalogenesis’ - you heard it here first

Roger Watson, Editor-in-Chief

Sleeping in hospital is always problematic but we usually assume that it is due to noise and bright lights from early hours until late with little control or choice over the lighting to which we are exposed.  When a paper by Bernhofer et al. (2013) from the USA entitled ‘Hospital lighting and its association withsleep, mood and pain in medical inpatients’ arrived in my inbox I assumed that this is what the authors would report.  I am always interested in potential papers on the effect of the hospital environment on patients but this one especially interested me because the results were not what I expected. 

It transpires that hospitals tend to have low light intensity and that prolonged exposure to this lowers our mood and upsets our normal sleep-wake cycles.  The effect is possibly twofold: our mood becomes suppressed in low light - like living in a dull environment for a long time - and our sleep pattern becomes disturbed.  The outcome is that patients become fatigued and also experience greater pain.

These are serious findings.  Hospitals are distressing and dangerous enough places already.  To a list that includes sensory deprivation, isolation, loneliness, malnutrition, pressure sores and cross-infection we can now add the adverse effects of poor lighting.

It was always Nightingale’s maxim that we ought to do the patient no harm.  We also know about iatrogenesis - the unintended adverse consequences of medical treatment - and I recall someone even coining the term ‘nursogenesis’ to mean the adverse effects of nursing care.  However, it is clear that, while iatrogenesis is used generally to describe the adverse effects of medical encounters, that there may well be a place for a science of ‘hospitalogenesis’ or something along those lines to describe, specifically, the adverse effects of simply being in a hospital environment, before the medical and nursing staff line up to inflict more damage.

Naturally, this will encourage the ‘something must be done’ brigade to swing into action: ‘what do we want? Bright lights’.  But this is not going to be an easy issue to solve.  The green lobby have been active in encouraging the widespread adoption of low energy light bulbs.  In Europe it is virtually impossible to purchase any other kind.  So much so, that in the UK where I live, streets and houses are markedly duller than before and entering any room in my house requires planning. First: turn on the light; second: wait for the low energy bulb to reach an acceptable level of illumination - one that prevents you walking into the furniture.

I digress, but there is a serious message here.  Hospitals tend to be huge buildings with hundreds of rooms requiring illumination; the expense of attending to the effects of poor illumination could take a significant slice of the gross national product of any country.

I will watch this line of research with interest.


Bernhofer I, Higgins PA, Daly B J, Burant CJ & Hornick TR (2013) Hospital lighting and its association with sleep, mood and pain in medical inpatients. Journal of Advanced Nursing doi: 10.1111/jan.12282