1. Ferrell, Betty PhD, MA, FAAN, FPCN, CHPN

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I recently attended a palliative care meeting focused on advanced care planning, which included a role-play scenario. The clinician participating in the role play did an impressive job of demonstrating expert communication, sensitive language, and nonverbal skills that collectively created a model conversation with the actor/patient in this very difficult area of palliative care practice. In the discussion that followed the role play, an observer remarked that the clinician's actions and communication were so superb that it was like he was "playing jazz." The term caught my attention-playing jazz?


I thought then about jazz musicians I have seen on screen or in live performance. From legends such as Duke Ellington, Louis Armstrong, Miles Davis, Ella Fitzgerald, or Nat King Cole, their music is masterful while at the same time seemingly effortless. Not long ago, I visited New Orleans and went to the historic jazz district where I watched a band of jazz musicians, all likely in their 80s, play soulful music in a way that seemed magical-no sheet music, no program, no clear start or end-just playing jazz.


Watching expert palliative nursing is also like observing playing jazz. Nurses orchestrate intense conversations, carefully titrate medications for complex symptoms, assess with precision the changes in patient status, and respond to the myriad emotions of family members with great intimacy. The observer may not realize that the expert palliative care nurse is not performing this care without expert knowledge, years to decades of clinical practice, and undoubtedly with extreme intention.


The articles in this issue of the journal reminded me of palliative care nurses playing jazz. They report on the everyday music of our work-supporting surrogates in decision making, offering bereavement support, transitioning very ill patients across settings of care, managing delirium, and providing so many other aspects of our care.


This notion of playing jazz also reminds me of watching Norah Jones sing with Ray Charles. I hope that in palliative nursing, we are similarly mentoring the next generation of nurses to play the music of our profession. An important contribution to this mentorship is in the JHPN supplement included with this issue, which recognizes the 25th anniversary of HNPA. The articles in this supplement chronicle our proud history and serve as a foundation for our future.


In this final edition of JHPN for 2011, I am very excited to share that the journal will be expanded from six to eight issues per year beginning in 2012. This is a result of the tremendous contributions of authors, the dedicated work of our reviewers, and commitment by the HPNA Board of Directors to increase the knowledge base of our field. Thanks to everyone, including our readers, for making this advance possible.


Betty Ferrell, PhD, MA, FAAN, FPCN, CHPN




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