This issue marks the start of the second decade of the Advanced Emergency Nursing Journal (AENJ). Anniversaries encourage reminiscing and while it seems like only yesterday that we embarked on this journey, at the same time it seems like we've been doing it forever. As a Journal we have grown and matured, thanks to the efforts of our editorial board, reviewers, authors, and readers.
The past 10 years have been a time of relentless progress and change. In the world of scholarly publishing, there has been a migration to online platforms along with debates and new regulations concerning open access. Article retractions for scientific misconduct and the identification of predatory publishers have brought to light ethical concerns at a level not previously identified.
For AENJ, some things remain the same: We still have the same editors, cover, and regular columns. Some things are new. The Journal is MEDLINE indexed and is included in the new Emerging Sources Citation Index. We have an option that allows authors to pay to have their article be open access. We have a web-based manuscript submission platform, a web page, an online editor, and an iPad app. Ten years ago, iPads did not exist and the noun "app" would have drawn a blank stare from almost everyone. We have always emphasized information that could be used in daily practice and have published helpful Clinical Tips on the website every week for more than 3 years. This summer we added another website feature to help advanced practice registered nurses (APRNs) at the stretcherside. Evidence Based Guidelines for Emergency Care is a repository of guidelines from authoritative sources that have been abstracted to pull out the key points pertinent to emergency care.
Outside of publishing, many things that are now woven seamlessly into the fabric of our everyday lives did not exist or were in their infancy in 2006. In many cases, technology that originally seemed frivolous or only for entertainment has been leveraged for both personal and professional uses. Social media is no longer the exclusive realm of adolescents and young adults. We use it to share information (Facebook, Twitter), network (LinkedIn), and enhance education (YouTube). With the advent of smartphones, tablets, and WiFi, we are connected 24/7 and can communicate almost instantaneously with people around the world. Of course, this is both a blessing and a curse because now work can follow us to almost the ends of the earth.
In the clinical setting, the pace of technological advancement means that things that were previously cutting edge are now routine or even mandated. The same blessing/curse paradox exists here as evidenced by the groans of health care workers across the country when electronic health records or decision support is mentioned. However, the patient care benefits of some technologies are clear. Automated warnings remind us about patients' allergies when medications are prescribed. The widespread deployment of ultrasound outside of the radiology suite expedites patient assessment and improves the safety of invasive procedures. Telehealth brings specialty consultation to the stretcherside of patients in remote locations.
Societal changes have altered the health care environment inside and outside the emergency department. In 2006, public access defibrillation was a priority for education and equipment deployment. Now gun violence has resulted in a similar campaign, "Stop the Bleed." The goal is to empower laypeople to control life-threatening bleeding with education and equipment (Homeland Security, 2015), and public access bleeding kits are being deployed alongside automated external defibrillators (see Figure 1; Jacobs & Joint Committee to Create a National Policy to Enhance Survivability From Intentional Mass Casualty Shooting Events, 2015). Similarly, with the skyrocketing incidence of opiate overdose in the past 10 years, intranasal naloxone kits are being distributed to first responders, law enforcement officers, and laypeople.
Other advances and changes have specifically impacted APRNs in emergency care. Doctor of Nursing Practice programs have supplanted master's preparation for nurse practitioners and clinical nurse specialists. Awareness about the role of advanced practice nurses has increased among health care workers and the public. There is a new specialty organization, the American Academy of Emergency Nurse Practitioners, and the Emergency Nurses Association now has an Institute for Emergency Nurses in Advanced Practice. Nurse practitioners have helped create a new role in triage to perform rapid medical examinations. Credentialing as an emergency nurse practitioner is available via a portfolio process and will soon be available by examination.
Given the ever-accelerating rate of change, it's hard to imagine what advances we'll be writing about on our 20th anniversary. Perhaps we'll just beam the content into your brain where it will be stored for instant retrieval as needed. We look forward to continued growth and development of the Journal and our practices as APRNs in emergency care. Here's to AENJ's 10th anniversary!
-Jean A. Proehl, RN, MN, CEN, CPEN, FAEN
Emergency Clinical Nurse Specialist
Proehl PRN, LLC
Cornish, NH
-K. Sue Hoyt, PhD, RN, FNP-BC, CEN, FAEN, FAANP, FAAN
Emergency Nurse Practitioner
St. Mary Medical Center
Long Beach, CA
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