Featured: Politics and Professional Nursing Journals

Politics and Professional Nursing Journals

Peggy Chinn and Shawn Kennedy

Nurse Author & Editor, 2017, 27(4), 5

Professional journals, while dedicated to the concerns of a particular discipline, are published in a cultural and political context that inevitably affects the content of the journal. Nursing journals are no exception and there are multitudes of issues that find their way to the Editor’s desk, presenting a choice of if, how, and when an issue should be addressed in the journal pages. While there is debate concerning the place of political content in professional journals (Glick, Clarfield, Strous, & Horton, 2015), we believe that such content is inevitable for nursing journals since all professional nursing content touches on, or is touched by matters of social, cultural, and political consequence. Objectivity is simply not possible in light of our professional ethics, standards, and contract with society,

Readers of nursing journals come from all possible political, religious, and value traditions which means that unsurprisingly, any time a nursing journal publishes content that touches on a controversial topic, some readers will cheer, others will remain neutral, and some will object. Nonetheless, as a discipline that is grounded in the value of promoting health and well-being for all, nursing journal editors have a duty to assure that the content of their journals reflect this value, even when the topic is controversial, hotly debated, and perhaps even divisive in political terms.

A host of local, national, and international political matters that influence our discipline are taken for granted, or not recognized, because of assumptions embedded in the cultures in which readers, editors, and publishers live and work.  For example, the content of English-language journals published in the United States might reflect the assumption that nursing is practiced in a for-profit environment, where economic constraints operate differently from those in countries where  government subsidies ensure healthcare for all. Other issues more clearly rise to the top and are easily recognized as controversial and political. Issues such as gun violence, safe needle exchange, and women’s reproductive rights present a clear dilemma for journal editors who must decide how to proceed when these kinds of issues are at the forefront and clearly relate to the underlying nursing value of promoting health, well-being and self-actualization.

At this particular time in history, with political views deeply divided and with a shrinking common ground from which to work, editors of journals face difficult decisions related to controversial content. The fact is that Editors cannot simply ignore these issues. Ignoring an issue, not speaking out, or taking a stand translates to endorsement of the status quo, which may not be in the interest of health and human well-being and go against our professional ethics. Even when journal content reflects all sides of a controversial issue, it is impossible to treat all sides as equally plausible when it is clear that some choices are harmful to health and our ability to provide high quality nursing care, while other choices prevent harm and promote health and nursing excellence.

Controversial and political content can show up in obvious ways, by deliberate choice, while in other instances it crops up in unexpected ways. Editors can choose, even solicit, opinion pieces or articles that address certain controversial topics.  For journals that cover current events in nursing and healthcare, it is inevitable that this coverage will touch on current controversial topics. In other instances, an article on a seemingly “neutral” topic might prompt responses that amplify the controversial issues embedded in the content. A review article on women’s health that includes clinical content on contraception and abortion may become a “hot button” for those who are opposed to these interventions. A research report that addresses health disparities among certain cultural groups might raise heated debate concerning a term used to represent or describe selected cultural groups. An article describing a nursing approach to assessment of a child for signs of physical abuse might appear just at the time a high-profile child abuse case appears in the news, creating an outcry—both positive and negative—from readers who now see this content in light of the case that is in the news.

The extent to which a journal covers controversial content is influenced by the journal’s purpose, the direction and values of the journal leadership, including the editor, associate editors, and advisory board members, and the journal’s historical record that sets a “tone” related to controversial matters. A journal with a specific value stance, such as the Journal of Christian Nursing, is expected to take a certain stand on many issues, and to publish content that addresses controversial issues that arise from its particular perspective. Journals with a focus that does not obviously point to a value stance, such as CIN: Computers, Informatics, Nursing or the Journal of Nursing Administration, can still encounter issues surrounded by controversy, in this case value issues involved in developing electronic medical records.  Journals with a clear clinical focus, such as Heart & Lung: Journal of Acute and Critical Care or Journal of Infusion Nursing are less likely to deal with political issues, but since there are many controversial issues touching clinical practice, the editorial leadership of the journal plays a major role in the extent to which controversy appears in the journal content.

The American Journal of Nursing (AJN), for example, was founded in 1900 at a time in history when world-wide conflict escalated into two world wars. The first editor, Sophia Palmer, had a strong commitment to the early development of the profession and provided editorial leadership to bring controversial issues to the forefront. The journal included content of clinical relevance, as well as content addressing nursing’s place relative to the political issues of the day. As an example, during the first 40 years of the journal, the United States government and a number of other governments worldwide provided education for women to enter nursing as a way of increasing the nursing workforce in their military services. This context created strong controversy within the nursing profession and the editorial leadership of the journal took on the challenge of giving voice to all who either supported, or objected to nurses being involved in war. Palmer’s tone set the stage for AJN’s editorial charge. As the legacy journal of American nursing, AJN’s subject matter therefore has to and should include discussion of all issues that may have an effect on the health and well-being of those we care for, as well as issues related to how we as nurses provide that care effectively. It serves not just its readership, but the profession, covering issues that may be unpopular but important, documenting how nurses think about such issues and how nursing as a profession responds (or not) to pressing issues of the times.

Advances in Nursing Science was established in 1978 when  nursing theory and research had become firmly established, but with a very limited number of journals focusing on the development of nursing knowledge. The founding of ANS was heavily influenced by the mid-20th century movements that challenged the assumptions of traditional science, notably critical-social theories and philosophies that emerged in Europe and in feminist movements worldwide. Hence the purpose of ANS was to publish content that met the highest standards of scholarship, and that also brought to light insights challenging the status quo of scientific conduct. This social context called for content that was on the cusp of change. Articles appeared (and still appear) that provide sound rationale for questioning what is taken for granted, and pointing to new directions in the conduct and focus of nursing scholarship that improves nursing and healthcare.

Reader Responses

At this moment in history when political ideologies are deeply divided, and public talk involving controversy lacks substance and often, facts, we believe that it is time for nurses and the nursing profession to step up to the challenge of healing our discourses involving controversy. Hostile, even vitriolic confrontations are a fundamental threat to human well-being; we believe that nurses and the profession can demonstrate healing in our public discourses. Nursing journals, by publishing content that reflects controversy and disagreement can lead the way to demonstrate the art of disagreement. Nursing journal content provides you, the reader, an opportunity to enter into discussions of various points of view and values in a positive and constructive way. In a recent New York Times opinion column, Bret Stephens wrote:

. . . no country can have good government, or a healthy public square, without high-quality journalism — journalism that can distinguish a fact from a belief and again from an opinion; that understands that the purpose of opinion isn’t to depart from facts but to use them as a bridge to a larger idea called “truth”; and that appreciates that truth is a large enough destination that, like Manhattan, it can be reached by many bridges of radically different designs. In other words, journalism that is grounded in facts while abounding in disagreements (Stephens, 2017).

Nursing journals have a duty to provide the “healthy public square” in our discipline, presenting well-founded facts and using reasoned opinion to prompt healthy discussion of vital issues that shape nursing, the quality of care, and the well-being of those we serve.  Your role, as a reader, is to enter into the discussion of the issues, bringing to the discussion an open mind, well-conceived opinions and perspectives on an issue, and a commitment to unveil matters of disagreement in a way that informs all of our understanding of the issues.  As Editors, we want to hear from you, and welcome your contribution to our larger discussion! Just keep it civil, open, reflecting your eagerness to listen and understand the basis on which our disagreements rest!

References

  1. Glick, S., Clarfield, A. M., Strous, R. D., & Horton, R. (2015). Academic debate: Publications which promote political agendas have no place in scientific and medical journals, and academics should refrain from publishing in such journals. Rambam Maimonides Medical Journal, 6(1), e0003. https://doi.org/10.5041/RMMJ.10178
  2. Stephens, B. (2017, September 24). The dying art of disagreement. The New York Times. Retrieved from https://www.nytimes.com/2017/09/24/opinion/dying-art-of-disagreement.html

About the Authors

Peggy Chinn, RN, PhD, FAAN is the Editor-in-Chief of Advances in Nursing Science, author of a few books, and manager or co-manager of several websites/blogs, including INANE. She is an Author-in-Residence for Nurse Author & Editor.

Maureen “Shawn” Kennedy, MA, RN, FAAN is Editor-in-Chief, American Journal of Nursing and a member of the Authors-in-Residence for Nurse Author & Editor.

NAE 2017 27 4 5 Chinn Kennedy

Copyright 2017: The Authors. May not be reproduced without permission.
Journal Complication Copyright 2017: John Wiley and Sons Ltd