1. Kirton, Carl A. DNP, MBA, RN, ANP


Making a commitment to learning, growth, and change.


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Growing, evolving, and progressing are part of the natural order of things. In my almost 40 years as an RN, I have seen enormous evolution and elevation of nurses in the delivery of health care. One of the hallmarks of that development is an increase in nursing practice specialization. Before I left my last position and joined AJN, I hired a Registered Nurse First Assistant, Robotic Surgery-a highly specialized RN with advanced training to assist in technically advanced surgical procedures-an opportunity in nursing that didn't exist some 40 years ago.

Figure. Carl A. Kirt... - Click to enlarge in new windowFigure. Carl A. Kirton

Specialization benefits the health system in many ways. It ensures that patients receive care from individuals who are the most knowledgeable and proficient in their area of practice. Nurses in specialty practice ensure that care evolves to reflect current standards and use their knowledge to impact their work at a micro and macro system level. They can be innovators, scientists, teachers, and policy influencers. Nursing specialty practice organizations can improve practice and patient care by encouraging members to continue learning new and improved methods of patient care. As Ruth Young, founding editor of the Journal of Obstetric, Gynecologic, and Neonatal Nursing said in a 1973 editorial, "With an organized approach, with common interests and a unified common purpose, a specialty practice organization can provide intellectual stimulation, provide for sharing of ideas and generally advance the specialty."


With the new year, AJN continues to evolve as a journal. To begin, we are introducing two new monthly columns in this issue. Specialty Spotlight will provide a brief focus on a particular specialty area of nursing practice. Readers will have the opportunity to "meet" outstanding clinicians who describe the significant contributions that practitioners of the specialty make to nursing and health care at large. These clinicians will also address the issues that impact the specialty and describe the formal and informal methods employed to influence the care of the populations they serve. For some of the columns, you may recognize and celebrate the work of your colleagues. For others, it will be an opportunity to explore the clinical, educational, leadership certification, or advanced practice opportunities in a unique area of professional practice. In this inaugural installment, Crystal Miller, a certified RN infusionist, describes the advanced training, equipment proficiency, and diagnostic skills required of an infusion nursing professional. We hope you find that this column documents the evolving multifaceted professional opportunities afforded to the RN.


Our understanding of and conversations about diversity, equity, and inclusion (DEI) are also evolving, and with this in mind we have started a column called Focus on DEI. While these tough issues have always been present, adequately addressing them is hard work-uncomfortable, yet necessary. More importantly, the relevance of these issues to practice might get lost in academic discussion, organizational trainings, and enterprise-wide initiatives designed to check the DEI box. As our workforce and patient populations become more diverse and inclusive, the skills nurses need to work in these environments will continue to evolve. I am sure that each of you made a commitment to DEI in your workplace but keeping abreast of and expanding your knowledge in this area can be herculean. To this end, each month, we will tap into the expertise of both nursing and nonnursing thought leaders who are doing highly relevant DEI work that has bearing on the practicing nurse. I am delighted that Felesia Bowen accepted our invitation to author our first Focus on DEI column. When discussing the column with each prospective author, my basic requirement was to have them keep the nurse with a patient care assignment in mind. Why is your topic important to them? How and why is this issue salient to practice? So as not to overwhelm, these pieces will be both brief and practical. Consider making them a part of your change of shift huddles, journal clubs, and staff meeting agendas. In this way, your DEI commitment no longer becomes a "checking the box" activity, but an active commitment to learning, evolving, and change. We hope you enjoy both of these new columns and follow along as the journal continues to evolve.