It is quite fitting that I should be invited to write the December editorial because the holiday season is my favorite time of year. I thought a seasonal theme for my remarks might be appropriate. With apologies to Charles Dickens, I have penned a new version of A Christmas Carol.
It is December 24, and you are nestled snug in your bed, weary from physical and emotional toil. Suddenly you awaken, sensing that you are not alone. A blurry figure dressed all in white - white clothing, white shoes, white cap - reaches out to you. Startled, you cry out "Who are you?" The phantom answers, "I am the Ghost of Nursing Past. We are going back many years." You take her hand and instantly find yourself hovering over an ancient hospital in 1965. What do you see?
* A patient is in cardiac arrest Nurses frantically page a physician because only they can do CPR.
* Patients with psychiatric illness shuffle about in a Thorazine haze or sit passively, responding only to the disordered thoughts in their heads.
* Fathers smoke in the obstetrics waiting room while their wives labor behind closed doors.
* A patient is provided a bedpan because he is on bed rest for 3 weeks following a myocardial infarction.
* Parents are shooed out of pediatrics when visiting hours are over.
* Confused elderly patients are sedated and restrained for their own protection.
You awaken with a start! How could such horrifying practices exist? Your heart pounds and you are wet with perspiration. You finally calm down and drift off to sleep. Once again you awaken to a presence in the room. This time an apparition in blue scrubs hangs above your bed, a stethoscope draped around his neck. Fearfully, you demand, "Who are you?" He replies, "I am the Ghost of Nursing Present" and takes you by the arm. You float over your community and see amazing changes from Nursing Past.
* Thousands of citizens are trained on CPR Day to respond immediately to life-threatening emergencies.
* Patients with psychiatric illness receive psychotropic and moodaltering drugs that allow many of them to hold jobs, have families, and be treated as outpatients.
* Fathers are supporting their wives throughout the entire birth process.
* Patients are encouraged to get out of bed just days after a myocardial infarction.
* A mother sleeps on a fold-out bed beside her hospitalized child.
* Patients with dementia putter about unfettered in safe, pleasant settings.
* Home health care teams teach families to manage intravenous therapy and mechanical ventilators.
Returning to your bed, you ponder what you have just seen. Relieved that nursing has advanced since "ancient" times, you fall asleep once more, only to be awakened by another presence. You blink but cannot see it clearly. The vague form identifies itself as the Ghost of Nursing Future. You expect it to take your hand and show you what will be, but that does not happen. "Show me the future!" you demand, but the form gradually fades.
In Dickens' tale, Scrooge sees a lonely, sad future of his own making. Just as Scrooge's future was a consequence of his past and present, our future as nurses will be determined by what we do now. Perhaps this issue of the Journal ofGerontologkal Nursing provides a glimpse into Nursing Future with articles that address not only the continual development of new technology and drug therapy, but also the fundamental and essential nursing skills of assessment and listening. As nurses, our challenge is to shape the future of nursing in a positive way - to bring the Ghost of Nursing Future into focus with an image that will inspire pride in us all.