1. Spencer, Kathleen Walsh MSN, MA, RN, CS, CPSN

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"Where does nursing knowledge come from?" That was the first big question posed in the first class I took in graduate school back in 1979.

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"From books, of course," I thought. Glad I did not raise my hand on that one!!


"Nursing knowledge is the result of empirical nursing research," the professor proclaimed.


We might have a hunch at something, or a big idea about how to solve a problem, have some idea we think might work with our patients, but the prudent thing to do is to test it and gain evidence, before we put it into practice.


Florence Nightingale believed that unsanitary conditions were what caused infections in the hospital where she cared for patients. She would have been totally disregarded, but she made careful observations, took meticulous notes, and tested her hunches ("theories") to support her claims. For nurses to be taken seriously, to have credibility, to be treated like the educated people they (were) are, she was wise to have evidence to back herself up. It is the same today. Dr. Marilyn Oermann describes evidence-based practice on pages 37-39 in this issue.


I am excited about this issue of Plastic Surgical Nursing, because it contains several good examples of research. One study, done by Carol Benton, RN, is a terrific example of how nurses, like you, can make patient care better immediately in their practice (see pages 40-44). If nursing research can be deemed courageous, this is the study that exemplifies that. Imagine-starting tomorrow, you and your colleagues set out to provide evidence that hand-washing in your clinical setting is not up to par. You start surveillance on the hand-washing practices of the physicians. Not only do you record their compliance or noncompliance with hand-washing protocols, you approach (read: confront) them with the findings. Do you think some doctors might have a poor reaction to this kind of research? Or, think the nurses might find it intimidating? Would the patients benefit? Yes, yes, and yes.


Turn the calendar back to 18 XXXXX. Dr Summelweiss tried to improve the hand-washing practice of other doctors because he believed that their faulty hygiene was causing their patients infections and death. He was ridiculed and shunned for suggesting that the doctors were harming their patients, despite the evidence he provided.


Turn to pages 16-36 and read the research study conducted by Dr. Figueroa-Haas. Her article is a result of research that took 3 years to complete. It was her dissertation that was well over 149 pages long. Dr Haas could have said to herself, "glad that dissertation is over, think I'll just shelve my copy in the library (at Barry University in FL) and go on a graduation trip and never think about that research again." She didn't. Knowing that the knowledge she gained would benefit nurses and their cosmetic surgery patients, she labored again to make it a paper that could be shared with all of you. Original research not only helps patients, but it sets the platform for future research as well. In her dissertation, she listed countless suggestions for further research. The benefits to patients and nurses is even farther-reaching than her own research.


Dr Haas's research study, a meticulous process, had to be condensed to a format that would fit this journal. Granted, a lot of details are "lost in the translation." With all of the articles that appear in PSN journal, there is contact information for each author alongside his or her article. Our wish is that when you have questions or comments, you do go ahead and contact the author.


The nurse authors and researchers I have met are generous people. They are excited to exchange ideas, share findings, have you test out their ideas, and ultimately, contribute to nursing knowledge. Nursing knowledge is a result of nursing research. Nursing research findings come from nurse researchers, real people. Lucky for us, these nurses publish their findings in journals and books.


So, nursing knowledge comes from books after all!!