1. Olson, DaiWai M. Editor

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I was barely 1-paragraph into writing a completely different editorial when I made a fatal mistake. One trick for overcoming writer's block is to do something different for a few minutes. I made the mistake of checking social media. Everything happened so quickly that I did not see it coming. My demise was so swift that I had no time to react.

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We've all been there. One post caught my eye. There was an error that made me cringe; they had written "cant" without an apostrophe! A quick scan and I noted that the content was also factually inaccurate. That's when I committed my error-I commented. I helpfully pointed to the spelling error and then provided a link to a peer-reviewed resource that would help them see their error in logic. Ugh! Within seconds, I was bombarded with responses. Rage, hate, threats, and vitriol quickly made me realize that I had accidently entered an echo chamber.


Echo chambers exist where all members of a group agree upon a set of beliefs. These beliefs are amplified and reinforced with no dissenting views allowed. Because members hear nothing but their own beliefs, the ideas are accepted as fact. Any statement that contradicts the echo chamber must therefore be wrong. Although the advent of social media may seem to have given rise to echo chambers, this phenomenon is not new and it is not limited to social media.


Echo chambers likely exist because they boost self-confidence. Talking to people who think like I think is very comforting. Being reassured that I have been right all along makes me feel good. Echo chambers bring a sense of fellowship and belonging. However, there is a sinister side. In 1347, the echo chamber supported that cats (not rodents) were responsible for the plague. Before 1500, the flat-earth echo chamber ruled humanity. And, it is easy to imagine the all male membership of some well-to-do club in 1830 dispatching with certainty the fallacy of women's suffrage.


Modern healthcare is not immune to the sinister side of the echo chamber; a fact summed up in the words, "I do not know what you learned before, but in our unit...." As a novice in 1983, I knew with great certainty that only a heretic would suggest that squirting water into the lungs of an intubated patient was a bad idea (saline lavage). In fact, I was quite comfortable in that echo chamber. At least, until other nurses stepped up to conduct a series of studies that produced such overwhelming evidence that I was forced to accept that I had been wrong.1 Admittedly, the shift away from saline lavage did not occur quickly-it took decades-and there may still be a few holdouts left.2


Over the centuries, we have learned that, as strong and powerful as echo chambers seem to be, they can be defeated. All you need is an overwhelming amount of evidence. Although it sounds daunting, acquiring an overwhelming amount of evidence is not as hard as you think. Actually, if you are reading this, then you are well on your way.


The Journal of Neuroscience Nursing is an open platform for topics that affect neuroscience nurses. This is your space to defeat the echo chamber. As the editor, I do not agree with every author, but I am willing to read and publish every viewpoint-with 1 caveat. Whatever you write must be clearly written and supported by peer-reviewed evidence. If you publish in the Journal of Neuroscience Nursing (or any journal), then you contribute to the evidence. You help build the case for change.


The Editor declares no conflicts of interest.

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1. Ackerman MH. The effect of saline lavage prior to suctioning. Am J Crit Care. 1993;2(4):326-330. [Context Link]


2. Leddy R, Wilkinson JM. Endotracheal suctioning practices of nurses and respiratory therapists: how well do they align with clinical practice guidelines? Can J Respir Ther. 2015;51(3):60-64. [Context Link]