1. Mcilvoy, Laura

Article Content

Over the last 40 years, the Journal of Neuroscience Nursing (JNN) has evolved as the primary source of neuroscience nursing knowledge. This article examines how the clinical content of JNN has changed over the decades, reflecting the growth of nursing as a profession, the gains in scientific knowledge, and the technology explosion within the neuroscience community.


The first issue of the then-titled Journal of Neurosurgical Nursing was published in 1969. This premier issue featured clinical articles on patients with cervical spondylosis, percutaneous cordotomy, hyperirritable carotid sinus mechanism, and traumatic head injury. The predominance of articles detailing the nursing care of a variety of neurosurgical conditions continued throughout the 1970s. The first article published in the United States on intracranial pressure (ICP) monitoring, contributed by the University of Chicago, appeared in 1971 (Moody & Mullan, 1971). JNN published the first nursing article on ICP monitoring in 1974; this piece examined the nursing assessment of patients with increased ICP (Jimm, 1974). That publication was closely followed in 1975 by two articles detailing the nursing involvement and responsibilities related to ICP monitoring (Bell, Lorig, & Weiss, 1975; Nikas & Konkoly, 1975). The 1970s were also remarkable for the cutting-edge topics found in articles, such as nursing care in the surgical management of intracranial aneurysms (as well as ruptured aneurysms), autonomic hyperreflexia in spinal-cord injuries, protocols for and nursing management of patients on barbiturate therapy for increased ICP, the nursing concepts underlying induced hypothermia, and the then-new concept of a stroke unit.


Clinical nursing articles continued to dominate the journal during the 1980s, but nursing research was beginning to emerge. In 1986 the title of the publication was changed to Journal of Neuroscience Nursing, which more accurately reflected the broad topic range of the clinical articles. For example, articles on nursing management of problems such as back pain after discectomy, status epilepticus, hydrocephalus, vasospasm secondary to subarachnoid hemorrhage, alterations in movement and mentation, Alzheimer disease, myasthenia gravis, and diabetes insipidus appeared. In 1986, Pam Mitchell introduced to JNN readers the nursing diagnosis of decreased intracranial adaptive capacity, a diagnosis that has endured the test of time and remains on the North American Nursing Diagnosis Association's (NANDA) list of approved nursing diagnoses.


During the 1970s and early 1980s, JNN published two to three physician-authored articles per issue. During the late 1980s, doctorally prepared neuroscience nurses began to appear as authors, and physician authors became rare. It is interesting that only from 1981 to 1990 did the authors' credentials appear after their names in the table of contents. Also during the 1980s, articles noted for their forward thinking began to appear, including "Defining Neurosurgical and Neurological Nursing Practice: Establishing Our Clinical Parameters," published in 1983 (DeJanovich & Stewart, 1983a, 1983b) and "The Traumatic Coma Data Bank: A Nursing Perspective," published in 1988 (Marshall et al., 1988a, 1988b).


During the 1990s, nursing research became the dominant type of article, but strong clinical articles that incorporated in-depth pathophysiology into the discussion of the conditions continued. It was during the 1990s that literature on neuroscience "gizmos and gadgets" appeared, as inevitably it is the nurse who must understand the technology of such gadgets and incorporate them into the bedside care of the patient. Articles on technology, such as arteriojugular oxygen content measurement, electroencephalographic interpretation, endovascular therapies, laser and ultrasound therapies, bedside cerebral bloodflow monitoring, nasoduodenal feeding tubes, and vagal-nerve stimulators, appeared and explained the applications and implications of these technologies for nursing staff. This trend has continued into the 2000s, with articles on the technology of brain tissue oxygen monitoring, brain temperature, automated pupillometry, and deep brain stimulators.


During the late 1990s and early 2000s, articles describing how nurse-led multidisciplinary teams could successfully change a hospital system and improve patient outcomes were published. During the 2000s, JNN has featured scientific reviews of literature to lay the foundation for evidence-based practice. Increased attention to cell-level pathophysiology, along with its implications for understanding disease progression and management, has been given in articles published during this period. Authors of clinical articles shifted their focus to presentation of case studies on topics such as West Nile encephalitis virus, bispectral index monitoring; lumbar burst fracture associated with bowel, bladder, and sexual dysfunction; normal pressure hydrocephalus; and neurofibromatosis.


It was fascinating to review the last 40 years of JNN from a clinical standpoint and to see the first articles published by nurses who have since become neuroscience nursing legends. The relevance and timeliness of the journal's clinical content have been impressive since its earliest years. As we progress through the next 40 years, let us strive to continue to publish articles that help nurses at the bedside, in the clinics, and in the community to excel in their clinical practice.




Bell, M., Lorig, R., & Weiss, M. (1975). Nursing involvement with monitoring of ICP. Journal of Neurosurgical Nursing, 7(1), 28-31. [Context Link]


DeJanovich, J., & Stewart, R. (1983a). Defining neurosurgical and neurological nursing practice: Establishing our clinical parameters. Part 1. Journal of Neurosurgical Nursing, 15(2), 112-118. [Context Link]


DeJanovich, J., & Stewart, R. (1983b). Defining neurosurgical and neurological nursing practice: Establishing our clinical parameters. Part 2. Journal of Neurosurgical Nursing, 15(3), 179-182. [Context Link]


Jimm, L. (1974). Nursing assessment of patients for increased intracranial pressure. Journal of Neurosurgical Nursing, 6(1), 27-38. [Context Link]


Marshall, S., Cayard, C., Foulkes, M., Hults, K., Gautille, T., Charlebois, D., et al. (1988a). The traumatic coma data bank: A nursing perspective. Part 1. Journal of Neuroscience Nursing, 20(4), 253-257. [Context Link]


Marshall, S., Cayard, C., Foulkes, M., Hults, K., Gautille, T., Charlebois, D., et al. (1988b). The traumatic coma data bank: A nursing perspective. Part 2. Journal of Neuroscience Nursing, 20(5), 290-295. [Context Link]


Mitchell, P. (1986). Decreased adaptive capacity, intracranial: A proposal for a nursing diagnosis. Journal of Neuroscience Nursing, 18(4), 170-175. [Context Link]


Moody, R., & Mullan, S. (1971). Head injury monitoring: A preliminary report. The Journal of Trauma, 11(6), 458-462. [Context Link]


Nikas, D., & Konkoly, R. (1975). Nursing responsibilities in arterial and intracranial pressure monitoring. Journal of Neurosurgical Nursing, 7(2), 116-122. [Context Link]