1. Montana, Bridget J. MS, APRN, MBA

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It seems so long ago; it seems like yesterday. It started out with a few nurses; it now requires many nurses. The growth seemed steady; now it is phenomenal. We were barely noticed; now we are invited to the table. There have been changes that were minor; the impact was major. We are nurses dedicated to promoting excellence in end-of-life (EOL) care. We are the Hospice and Palliative Nurses Association (HPNA), an organization mission-driven to promote the highest professional standards of hospice and palliative nursing by studying, researching, and exchanging experiences and ideas leading to improved nursing practice; encouraging nurses to specialize in the practices of hospice and palliative nursing; fostering the professional development of nurses, individually and collectively; responding to the changing needs of HPNA members and the populations they represent; and promoting recognition of hospice and palliative care as essential components within the healthcare system.


This issue of JHPN kicks off the 20th year anniversary for HPNA. Subsequent issues will carry on the theme of celebration. It is a time to reflect on our past, cherish the present, and celebrate the future.


Looking back over the past 20 years, we should be proud of the accomplishments of the founding nurses, past boards of directors, and the past 11 presidents. Their contributions of talent, wisdom, and vision created a solid foundation that supports HPNA today. Since 1986, HPNA (originally HNA), committed to its mission, grew as EOL nursing practice flourished.


The early years began with the logo of the fan, symbolic of "Hospice Nurses Fanning Professional Development" (Spring 1996 Conference Planning Day). Ironically, the "wave of a fan" like a butterfly's wings produced small changes that created major shifts in EOL nursing practice (the "butterfly effect"). Today, the logo stands strong behind the vision of HPNA "Leading the Way."


Past presidents have become legends, ahead of their time, driven to advance excellence in EOL nursing practice. Today, the drive is intense as the principles of EOL care span the continuum of care for those experiencing a life-limiting illness.


In the past, we experienced continual growth and evolution. Recently, the board restructured its responsibilities and structured the organization with systems to "pull" from the expertise of its membership to promote evidence-based practice and create educational materials, clinical tools, position statements, and research. The voice of HPNA is more prominent now than ever before. We are a resource for perspective, expertise, and support on national issues and public policy that have an impact on nursing staff at all levels and those whom nurses serve.


HPNA has always valued collaboration. We are the founding member of the Coalition with the American Academy of Hospice and Palliative Medicine and the National Hospice and Palliative Care Organization. This fosters opportunities for a collective voice and shared support on major initiatives. HPNA was one of five organizations to develop the National Consensus Project Guidelines. We now are responsible for the updates and continued promotion of the guidelines into practice. This project is significant and lays a foundation for practice beyond the hospice model.


This year marks the third annual joint conference with American Academy of Hospice and Palliative Medicine and HPNA. Great opportunities to present research to support the value of evidence-based practice occur at this conference.


The membership has changed over the years and now comprises 8,000 members: APN, RN, LP/VN, and NA. Through the use of technology, we now have six special interest groups which provide members with a forum to network and share information with their peers. There are monthly teleconferencing sessions conducted to enhance education throughout the country. The Web page has expanded its services and provides an array of information and access to clinical tools. The future use of technology will be prominent as a way to reach more members.


In 2003, the organization formed an alliance with HPNA, Hospice and Palliative Nurses' Foundation, and National Board for Certification of Hospice and Palliative Nurses called the Alliance for Excellence for Hospice and Palliative Nursing. The alliance has strengthened communication and coordination of program and services.


The reasons to celebrate are numerous. As we lead the way to the future, there will be challenges that will confront us. Among these are an aging nursing workforce with fewer individuals entering the profession, nurses practicing in all settings with budgetary constraints, and regulatory and legislative policies that will affect how care is delivered. Yet, there has never been such an opportunity for us-a point in history when the nation is calling out to HPNA members to help lead the way in clinical practice and prepare the next generation of nursing clinicians and leaders in healthcare. HPNA is ready and structured and has a vision that will lead the membership forward.


HPNA continues to be a true leader through the use of technology, evidence-based practice, education, research, collaboration, and utilizing volunteers to create the vision and the voice to influence and promote excellence in EOL care.