Editorial
New Year 2014 Lucy Bradley-Springer, PhD, RN, ACRN, FAAN Key words: HIV, health care reform, nursing, poverty, prevention Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not. Theodor Geisel (Dr. Seuss, 1904–1991)
January 2014. We made it. The new year brings the usual fresh starts, recycled resolutions, accumulations of scars and wrinkles, and, ultimately, a return to the routine. For me, the new year reminds me that I need to come up with suitable ideas for six new editorials. Sometimes it just isn’t easy. But this morning, I heard a commentator on the radio who had a similar problem. He said that he’d already said enough about his key issues and that any additional comments would be ‘‘.like Shawn Hannity expressing his original views about President Obama every day’’ (DeFord, 2013). Instead, he proceeded to give brief comments about his top 12 issues. I thought that was a great idea and that it would be a good way to start the new year’s worth of editorials. The good news is that I don’t have 12 issues, so here we go.
Poverty Is. The root of all evil. I have explained my views on the part that poverty plays in the HIV epidemic (Bradley-Springer, 2012c), but I am also convinced that poverty’s impact goes way beyond HIV and is an inescapable contributor to most of the inequities in the world. For instance, I recently visited a museum exhibit about the Titanic where I learned that 61% of the first-class passengers and 42% of the second-class passengers survived, but only
24% of the third-class passengers and crew survived (Fowler, n.d.). One of the museum staff asked me how I liked the exhibit and I told her that it really reinforced the benefit of being rich, but she wouldn’t buy it. Turns out there was a big push to emphasize that the Titanic was one of the first ships to provide plumbing and meals for passengers in all classes, and she just wasn’t going to allow that money made a difference. Oh well, I don’t win them all.
Health Care Reform Will. Be in our future. The Patient Protection and Affordable Care Act (ACA) rolls out this month after dodging Congressional bullets, judicial reviews, and an incredibly botched early enrollment process. The ACA is the United States’ attempt to finally meet the standards of the rest of the developed world and to, in the process, catch up with countries that have better population health outcomes despite spending less money on health care services and systems (Bradley-Springer, 2009). To be honest, we didn’t get what we wanted – or needed – with this reform. As Flowers (2013) said, ‘‘This is what happens when a basic issue such as health care is determined by politics instead of policy’’ ({ 2). Flowers (and I) would have preferred a single payer system. But the ACA is what we have and we need to see what we can do with it. It sure would be nice to get the 45–48 million uninsured people in the United States into care, to find people with undiagnosed HIV infection, and to provide the newly-diagnosed with resources and services. These not-so-simple steps could contribute significantly to making the calls for the end of HIV a reality.
JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. 25, No. 1, January/February 2014, 1-3 http://dx.doi.org/10.1016/j.jana.2013.10.005 Copyright Ó 2014 Association of Nurses in AIDS Care
2 JANAC Vol. 25, No. 1, January/February 2014
Prevention Doesn’t. Get the credit it deserves. One nice thing about health care reform is that it has already been covering prevention interventions; insurance companies can no longer charge co-pays for many prevention procedures including HIV tests, mammograms, and diet counseling. The ACA is finally going to elevate prevention health care to a more appropriate level in the United States. I have been whining about HIV prevention for years, and I won’t quit asking for pragmatic – even if controversial – prevention methods such as needle and syringe exchange (Bradley-Springer, 1997), safe injection facilities (Bradley-Springer, 2003), and talking about sex (Bradley-Springer, 1999). Harm reduction really does make a difference.
Nurses Are. The backbone of health care all over the world. I’m a little bit prejudiced, but I think nurses are amazing. Nurses have skills and knowledge and talents that most people can’t even imagine. Nurses save lives, they comfort, they cure, they care, and they make differences for individual, community, and public health. Nurses are essential ingredients in making prevention and health care reform happen. Nurses also make differences for people living in poverty. Unfortunately, nurses are also the health care profession that is most likely to be ignored, discounted, and skipped over when big (and even small) decisions are made (Bradley-Springer, 2012a). Some of that is our fault because we are often the first to give our power away and the last to advocate for ourselves. Organizations such as the Association of Nurses in AIDS Care (ANAC) and the American Nurses Association are there for us and they work hard, but it will take more than that. Over the years I have encouraged nurses to stand up, express their concerns, offer solutions, take on leadership roles, and demand respect (Bradley-Springer, 2012b). As ANAC’s Nursing: A Call to Action campaign reminded us: nurses provide the vast majority of health care all over the world. Because of that, nurses know what is needed and we need to be at decision-making tables. I know it is an effort to take on these tasks, but it is
time to speak up and volunteer. to lead a new adherence program in your clinic, to sit on a committee, to make a difference.
And Finally, JANAC Celebrates. Its 25th Anniversary. JANAC came to life in 1989, shortly after ANAC was founded. The fact that we had a journal that early shows the vision, intelligence, and passion of our founding members. It is also a tribute to all of the editors, board members, authors, reviewers, and publishers of JANAC. I imagine all of these people over the last 25 years offering their best efforts – small and large – to make a fledgling journal from a small organization thrive. And we have. Since the current editorial team took over, JANAC has come to a place where we have an excellent flow of manuscript submissions, a dedicated editorial board, an extremely supportive home organization in ANAC, an innovative and forward-looking publisher in Elsevier, and the ability to look pragmatically at what we are doing and what we need to do. This month, all of those pieces came together to allow us to publish the second supplemental issue on trauma and abuse. Check it out. I cannot thank Carol (Pat) Patsdaughter, our Associate Editor, and Kristen Overstreet, our Managing Editor, enough; it is just not possible. They make my life so much easier. I am also at a loss for words when I try to thank the most precious members of the JANAC team: our readers. We are blessed to be a part of this community of nurses and other HIV care providers, ANAC members, and community partners. I am grateful for all of you.
References Bradley-Springer, L. (1997). Needle and syringe exchange: Pride and prejudice (commentary). Journal of the Association of Nurses in AIDS Care, 8(5), 18-20. http://dx.doi.org/10. 1016/S1055-3290(97)80025-8 Bradley-Springer, L. (1999). Prevention, politics, and ‘‘having sex’’ (editorial). Journal of the Association of Nurses in AIDS Care, 10(3), 15-16. http://dx.doi.org/10.1016/S10553290(05)60116-1
Bradley-Springer / Editorial Bradley-Springer, L. (2003). Not yet ready for prime time? Safe injection facilities in the overall prevention scheme (commentary). Journal of the Association of Nurses in AIDS Care, 14(5), 71-72. http://dx.doi.org/10.1177/105532 9003252139 Bradley-Springer, L. (2009). Health care reform: What is our problem? (editorial). Journal of the Association of Nurses in AIDS Care, 20(6), 421-422. http://dx.doi.org/10.1016/j. jana.2009.09.002 Bradley-Springer, L. (2012a). Doctor, doctor (editorial). Journal of the Association of Nurses in AIDS Care, 23(1), 1-3. http:// dx.doi.org/10.1016/j.jana.2011.12.002 Bradley-Springer, L. (2012b). Does nursing have a future? (editorial). Journal of the Association of Nurses in AIDS
3
Care, 23(2), 95-96. http://dx.doi.org/10.1016/j.jana.2012.01. 004 Bradley-Springer, L. (2012c). Social determinants (editorial). Journal of the Association of Nurses in AIDS Care, 23(3), 181-183. http://dx.doi.org/10.1016/j.jana.2012.03.001 DeFord, F. (2013, October 16). You asked for it: Frank Deford’s top 12 list. Retrieved from http://www.npr.org/2013/10/16/ 234790227/you-asked-for-it-frank-defords-top-12-list. Flowers, M. (2013, October 14). Beyond the spin, some facts about the Affordable Care Act. Retrieved from http://www.aljazeera. com/indepth/opinion/2013/10/beyond-spin-some-facts-aboutaffordable-care-act-2013101483653308300.html. Fowler, D. (n.d.). Titanic facts. Retrieved from http://www. titanicfacts.net/titanic-survivors.html.
New Year 2014 Lucy Bradley-Springer, PhD, RN, ACRN, FAAN Key words: HIV, health care reform, nursing, poverty, prevention Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not. Theodor Geisel (Dr. Seuss, 1904–1991)
January 2014. We made it. The new year brings the usual fresh starts, recycled resolutions, accumulations of scars and wrinkles, and, ultimately, a return to the routine. For me, the new year reminds me that I need to come up with suitable ideas for six new editorials. Sometimes it just isn’t easy. But this morning, I heard a commentator on the radio who had a similar problem. He said that he’d already said enough about his key issues and that any additional comments would be ‘‘.like Shawn Hannity expressing his original views about President Obama every day’’ (DeFord, 2013). Instead, he proceeded to give brief comments about his top 12 issues. I thought that was a great idea and that it would be a good way to start the new year’s worth of editorials. The good news is that I don’t have 12 issues, so here we go.
Poverty Is. The root of all evil. I have explained my views on the part that poverty plays in the HIV epidemic (Bradley-Springer, 2012c), but I am also convinced that poverty’s impact goes way beyond HIV and is an inescapable contributor to most of the inequities in the world. For instance, I recently visited a museum exhibit about the Titanic where I learned that 61% of the first-class passengers and 42% of the second-class passengers survived, but only
24% of the third-class passengers and crew survived (Fowler, n.d.). One of the museum staff asked me how I liked the exhibit and I told her that it really reinforced the benefit of being rich, but she wouldn’t buy it. Turns out there was a big push to emphasize that the Titanic was one of the first ships to provide plumbing and meals for passengers in all classes, and she just wasn’t going to allow that money made a difference. Oh well, I don’t win them all.
Health Care Reform Will. Be in our future. The Patient Protection and Affordable Care Act (ACA) rolls out this month after dodging Congressional bullets, judicial reviews, and an incredibly botched early enrollment process. The ACA is the United States’ attempt to finally meet the standards of the rest of the developed world and to, in the process, catch up with countries that have better population health outcomes despite spending less money on health care services and systems (Bradley-Springer, 2009). To be honest, we didn’t get what we wanted – or needed – with this reform. As Flowers (2013) said, ‘‘This is what happens when a basic issue such as health care is determined by politics instead of policy’’ ({ 2). Flowers (and I) would have preferred a single payer system. But the ACA is what we have and we need to see what we can do with it. It sure would be nice to get the 45–48 million uninsured people in the United States into care, to find people with undiagnosed HIV infection, and to provide the newly-diagnosed with resources and services. These not-so-simple steps could contribute significantly to making the calls for the end of HIV a reality.
JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. 25, No. 1, January/February 2014, 1-3 http://dx.doi.org/10.1016/j.jana.2013.10.005 Copyright Ó 2014 Association of Nurses in AIDS Care
2 JANAC Vol. 25, No. 1, January/February 2014
Prevention Doesn’t. Get the credit it deserves. One nice thing about health care reform is that it has already been covering prevention interventions; insurance companies can no longer charge co-pays for many prevention procedures including HIV tests, mammograms, and diet counseling. The ACA is finally going to elevate prevention health care to a more appropriate level in the United States. I have been whining about HIV prevention for years, and I won’t quit asking for pragmatic – even if controversial – prevention methods such as needle and syringe exchange (Bradley-Springer, 1997), safe injection facilities (Bradley-Springer, 2003), and talking about sex (Bradley-Springer, 1999). Harm reduction really does make a difference.
Nurses Are. The backbone of health care all over the world. I’m a little bit prejudiced, but I think nurses are amazing. Nurses have skills and knowledge and talents that most people can’t even imagine. Nurses save lives, they comfort, they cure, they care, and they make differences for individual, community, and public health. Nurses are essential ingredients in making prevention and health care reform happen. Nurses also make differences for people living in poverty. Unfortunately, nurses are also the health care profession that is most likely to be ignored, discounted, and skipped over when big (and even small) decisions are made (Bradley-Springer, 2012a). Some of that is our fault because we are often the first to give our power away and the last to advocate for ourselves. Organizations such as the Association of Nurses in AIDS Care (ANAC) and the American Nurses Association are there for us and they work hard, but it will take more than that. Over the years I have encouraged nurses to stand up, express their concerns, offer solutions, take on leadership roles, and demand respect (Bradley-Springer, 2012b). As ANAC’s Nursing: A Call to Action campaign reminded us: nurses provide the vast majority of health care all over the world. Because of that, nurses know what is needed and we need to be at decision-making tables. I know it is an effort to take on these tasks, but it is
time to speak up and volunteer. to lead a new adherence program in your clinic, to sit on a committee, to make a difference.
And Finally, JANAC Celebrates. Its 25th Anniversary. JANAC came to life in 1989, shortly after ANAC was founded. The fact that we had a journal that early shows the vision, intelligence, and passion of our founding members. It is also a tribute to all of the editors, board members, authors, reviewers, and publishers of JANAC. I imagine all of these people over the last 25 years offering their best efforts – small and large – to make a fledgling journal from a small organization thrive. And we have. Since the current editorial team took over, JANAC has come to a place where we have an excellent flow of manuscript submissions, a dedicated editorial board, an extremely supportive home organization in ANAC, an innovative and forward-looking publisher in Elsevier, and the ability to look pragmatically at what we are doing and what we need to do. This month, all of those pieces came together to allow us to publish the second supplemental issue on trauma and abuse. Check it out. I cannot thank Carol (Pat) Patsdaughter, our Associate Editor, and Kristen Overstreet, our Managing Editor, enough; it is just not possible. They make my life so much easier. I am also at a loss for words when I try to thank the most precious members of the JANAC team: our readers. We are blessed to be a part of this community of nurses and other HIV care providers, ANAC members, and community partners. I am grateful for all of you.
References Bradley-Springer, L. (1997). Needle and syringe exchange: Pride and prejudice (commentary). Journal of the Association of Nurses in AIDS Care, 8(5), 18-20. http://dx.doi.org/10. 1016/S1055-3290(97)80025-8 Bradley-Springer, L. (1999). Prevention, politics, and ‘‘having sex’’ (editorial). Journal of the Association of Nurses in AIDS Care, 10(3), 15-16. http://dx.doi.org/10.1016/S10553290(05)60116-1
Bradley-Springer / Editorial Bradley-Springer, L. (2003). Not yet ready for prime time? Safe injection facilities in the overall prevention scheme (commentary). Journal of the Association of Nurses in AIDS Care, 14(5), 71-72. http://dx.doi.org/10.1177/105532 9003252139 Bradley-Springer, L. (2009). Health care reform: What is our problem? (editorial). Journal of the Association of Nurses in AIDS Care, 20(6), 421-422. http://dx.doi.org/10.1016/j. jana.2009.09.002 Bradley-Springer, L. (2012a). Doctor, doctor (editorial). Journal of the Association of Nurses in AIDS Care, 23(1), 1-3. http:// dx.doi.org/10.1016/j.jana.2011.12.002 Bradley-Springer, L. (2012b). Does nursing have a future? (editorial). Journal of the Association of Nurses in AIDS
3
Care, 23(2), 95-96. http://dx.doi.org/10.1016/j.jana.2012.01. 004 Bradley-Springer, L. (2012c). Social determinants (editorial). Journal of the Association of Nurses in AIDS Care, 23(3), 181-183. http://dx.doi.org/10.1016/j.jana.2012.03.001 DeFord, F. (2013, October 16). You asked for it: Frank Deford’s top 12 list. Retrieved from http://www.npr.org/2013/10/16/ 234790227/you-asked-for-it-frank-defords-top-12-list. Flowers, M. (2013, October 14). Beyond the spin, some facts about the Affordable Care Act. Retrieved from http://www.aljazeera. com/indepth/opinion/2013/10/beyond-spin-some-facts-aboutaffordable-care-act-2013101483653308300.html. Fowler, D. (n.d.). Titanic facts. Retrieved from http://www. titanicfacts.net/titanic-survivors.html.
