As some of you may know, I am the senior editor of Core Curriculum for Neonatal Intensive Care Nursing. Over the past year, myself and 2 other editors have been working with our contributing authors to update the text for the sixth edition. The text contains figures, tables, and boxes in addition to the narrative to help the bedside nurse when in need of a reference, and as an aid for the neonatal nurse who is preparing to take the high-risk neonatal nursing certification examination. To update the book, we expect that the latest evidence will be used, although many of the reference figures, tables, and boxes do remain the same. I was astounded to receive an e-mail from the publisher asking whether a number of figures, tables, and boxes were necessary. My first thought was, of course, they are necessary or we wouldn't include them! As I continued down the e-mail it became apparent that the publisher's concern was the dramatic increase in the costs of permissions to use those materials and the limited budget. The costs continue to rise exorbitantly with each edition. Because the permissions are obtained one by one and chapter by chapter, the publisher and the editors don't know how much money will be spent on permissions until the permissions have been obtained for all figures, tables, and boxes in chapters 1 to 40.
For example, one agency wanted to charge "us" $2350.00 to publish a table presenting national patient safety goals. The information is available online at their website for anyone to access; however, when does a bedside perinatal/neonatal nurse have the time to go online to search for information that is not specifically related to direct patient care? According to the publisher, we are charged a fee for materials that are "public use" because the book is a product that is being sold. I do admit that we receive a small sum in royalties, but nothing to base a retirement on, and certainly not the motivation for being editors and contributors of this excellent reference text.
Professional organizations in all specialties have increased the fees for "borrowed" materials considerably. The fees paid grant the person making the request permission to use "1-time" only; thus, with each edition, the permissions need to go to the rightsholders again, which allows them to reap additional fees. Unfortunately for editors like us, it has become a common practice and a lucrative source of easy income for some organizations. If the content is in one of their journals, then the professional organization holds the copyright and can charge whatever it wants. One organization wanted a fee for a table that one contributor developed summarizing a research article!
My angst in the spreading use of spiraling fees for evidence that affects practice is that, without money, the likelihood of the science being used decreases. For example, many intermediate- and low-risk nurseries/mother-baby units plot the transcutaneous bilirubin readings on Bhutani's nomogram. I am curious as to what kind of a copyright fee was charged since we paid a substantial amount for use in the text. To me, Bhutani's work was seminal and should be available to all professionals caring for newborns because it allows the nurse to quickly and easily identify babies "jumping the tracks," and advocate for the care the neonate requires. There are many examples of figures I could provide that help us provide daily care that are becoming unaffordable. Educating professionals and building practice using the evidence may be very difficult if a budget is too small.
-M. Terese Verklan, PhD, CCNS, RNC, FAAN
Professor and Neonatal Clinical Nurse Specialist
University of Texas Medical Branch
School of Nursing Galveston
Graduate School of Biological Sciences
Galveston, Texas