Yale Journal of Biology and Medicine. Focus: nursing. Introduction.

As Virginia Henderson, a legendary nurse scholar and former Yale School of Nursing Research Associate, stated in 1966, “The unique function of the nurse is to assist the individual, sick or well, in performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible.” It is with this core principle that nursing has evolved from the time of Florence Nightingale, a pioneer who modernized nursing during the Crimean War in the 1850s, to the redefinition of nursing roles and responsibilities during World War II to the present day.

Now with more than 3 million nurses in the United States, the profession makes up the largest segment of the nation’s health care workforce [1]. Nursing is arguably undergoing yet another revolution with a vast array of educational programs and levels by which practice is employed (such as the Doctor of Nursing Practice, the advanced practice registered nurse, and certified registered nurse anesthetist, to name a few). Nurses are practicing in hospitals, schools, homes, retail health clinics, long-term care facilities, the military, and community and public health centers [1,2]. What was once thought of as nursing ― a nurse in a white hat and starched dress performing care for the patient at the bedside ― is no longer a unique reality [3]. Nurses today serve as leaders on policy issues, such as health care reform and population-centered task forces, as scientists and researchers in laboratories across the country, as educators in hospitals and academic institutions, as administrators, and even as business associates in a variety of industries [4]. Nursing has changed dramatically over the past 50 years, and this issue of the Yale Journal of Biology and Medicine highlights the diversity in nursing research and practice and tremendous contributions nurses are making to science and health care.

Nurses are leaders in biobehavioral research and link the interactions between behavioral, biological, and psychosocial processes in practice. For example, Sanner, Frazier, and Udtha evaluate whether levels of platelet serotonin differ between individuals with acute coronary syndrome who screen positive or negative for depressive symptoms. Purdy provides a perspective that integrates behavior and biology using relationships between the stress response and chronic diseases as exemplars. This article also demonstrates the ideal fit of psychiatric nurse practitioners in assessing and intervening in these multifactorial processes.

The complexity of research has also resulted in many nurses analyzing research methods and methodology. Clark uses a descriptive correlational research design to assess if body mass index is an adequate predictor of obesity in an at-risk female African American population. Another at-risk population for a variety of chronic diseases is older adults. As the numbers of older adults increase, research involving elderly individuals is of paramount importance. However, this group is often excluded from studies. Knechel addresses the challenges and barriers of enrolling older adults in intervention studies and provides suggestions for solutions to these barriers.

Nurses are developing and implementing innovative health promotion and disease prevention interventions. With the explosion of technology, Internet-based interventions are becoming increasingly popular. Whittemore, Chao, Popick, and Grey provide a systematic literature review that describes, synthesizes, and evaluates research on school-based Internet obesity prevention programs for adolescents.

Paralleling the increasing difficulties posed by a complex health care system and the increasing acuity of the patients for whom nurses care, the roles of nurses are evolving and expanding. Parkosewich describes the critical forces that are changing the role of the staff nurse in hospital settings. She also presents barriers that need to be overcome and the infrastructure created by Yale-New Haven Hospital to advance the scholarly work of nurses at this hospital.

The practical experiences, perspectives, and insights that nurses have also make them ideally situated to influence policy and health care legislation. Leary and Diers provide a case review of the Nevada Hepatitis C public health crisis. The article demonstrates the importance of whistleblower protection laws and the need for continued attention to this issue.

Nurses are increasingly involved in global health; however, these situations often present dilemmas. This is especially true when nurses conduct research in international settings. For instance, Sampson, Caldwell, Taylor, and Taylor bring attention to the challenges of following the U.S. Institutional Review Board guidelines and practices in non-Western countries.

These articles highlight the integral role that nurses play in the future of health care and science as advised by the recent Institute of Medicine (IOM) report [1]. The IOM report suggests higher standards of education and training for nurses, partnering with other health care professions to redesign health care in the United States, and pays special attention to improving information infrastructure with better data collection. From original contributions to perspective articles, this issue of YJBM exemplifies many of these themes. While the IOM, an independent nonprofit organization that works outside the government, backs nursing as a science and profession, the National Institutes of Health (NIH) has also identified the importance of nursing to driving science and health care. In 1986, the NIH established the National Institute of Nursing Research (NINR) to further nursing research.

Often questions arise as to what exactly defines nursing research. The NINR states that nursing research develops knowledge built on the foundation of science for use in clinical practice, to prevent disease and disability, manage and eliminate symptoms caused by illness, and to enhance end-of-life and palliative care [5]. The NINR’s strategic plan focuses on these themes with the goal of developing the next generation of nurse scientists. While these goals are all commendable, the most important component lies in the application of nurses advancing health, driving improved quality and access to care, and basing interventions on evidence-based practice. Due to professional organizations such as the National League for Nursing, the American Association of Colleges of Nursing, and the American Nurses Association, partnering with government entities, achieving higher educational objectives, and providing better care of the individual is now possible. While the profession’s role is ever changing and expanding with new technology, leadership opportunities, and scientific approaches, the core sentiment of nursing provided by Virginia Henderson is ever present. This only makes nursing more diverse and critical to improving the lives of individuals across their lifespans. We hope you appreciate this issue, which highlights the depth and breadth of nursing, and come to a greater understanding of the profession’s crucial role in health care and society.