Symmetry, Slovakia, and the Impact Factor of Snowdrops

This week I was pleased to be able to write an Editorial for a new nursing journal, the Journal of Nursing: theory, research, education which is published by a group of my colleagues working for the, Jessenius Medical Faculty located in Martin, Slovakia. This is part of the Comenius University of Bratislava. The Editorial was for the 2nd edition of the journal, due out in March this year.

I have been part of the group that developed the idea of a journal for Slovakian nurses and was delighted to be asked to become a member of the Editorial Board. For me, it is a real privilege to be part of what I believe will be a contributing force for change in the way research can be used to improve nursing care for patients, their families and the communities they come from.

I first went to Slovakia in 1996 to present a paper at what was the 2nd International Conference on Education in Nursing, This was the first paper I had ever presented. I have been going back to Slovakia every other year since then! My first paper was entitled The changing nature of the UK nurse education system: concerns and challenges and explored the impact on UK nurse education of the internal market system in the NHS. And last year, at the 9th conference, I presented two key note papers: Thoughts in Search of an Evidence Based Thinker, and Bricolage: The importance of context to nursing research and practice.

Whilst the conference is a modest affair, no more than a hundred delegates, I really enjoy being a part of these events. They provide a much needed showcase for research and other scholarly activity that has been undertaken by academics, practitioners, those responsible for managing services and for those involved in developing health care policy in Slovakia (and the neighbouring countries). The presentation of nursing work is well received and for some, the congress provides a first opportunity to share their work with a wider audience of peers. Unfortunately my knowledge of the Slovak language is still limited, but many of the presentations use English and there is always expert simultaneous translation available. From the first time I went there, I have been made to feel very welcome my Slovakian colleagues.

Martin was, and to some extent remains, a tortuously difficult place to get to. On that first occasion, I had to fly to Prague, and then take an overnight train to Slovakia. This was at a time when passports were checked at every border and the train journey was punctuated by border guard and police checks every few hours. It was a very interesting experience. When I arrived (at 06.30) in the morning, I was offered breakfast by my very hospitable hosts. It was at this point that I discovered Slovakia didn’t quite know how to deal with vegetarians. The plate, piled high with fatty bacon and sausages was gently declined, and after much discussion the bacon and sausages was unceremoniously removed, and more eggs and mushrooms added. This seemed to be the solution at all those early meals, remove the meat, and double the potatoes and cabbage – thankfully, things have got a lot better these days and most restaurants offer a few vegetarian options on thier menus. Sadly, the large tumblers full of very fine Slovakian apple cognac served with each meal (even breakfast) have largely disappeared.

That the conference has spawned a new journal is brilliant. The journal provides a place for both empirically based research papers and for papers that present the changes made in practice around treatments, interventions, the organisation of services and the care that can be provided. Importantly for me the journal welcomes papers that present new ideas on how nurses can be prepared for practice or how they can improve their knowledge and skills. There are now some 35,000 nurses working in Slovakia, and the number of graduate nurses has risen by some 1500% since 2000 whereas the numbers of every other health profession has remained static. In Slovakia, and elsewhere, this change in educational achievement should give an increasingly powerful voice to nurses. As the provision of health care is affected by the wider international economic problems facing nations, using this voice to ensure that new ways of working (often with less resources) does not impact negatively on the provision of high quality nursing care and treatment becomes increasingly important. I am committed to making sure the work of the journal helps in this regard.

Back at the ranch, I am embroiled with discussions about the Research Excellence Framework (REF), journal papers and the importance (or not) of impact factors. The impact factor was devised by the founder of the Institute for Scientific Information, Eugene Garfeild. It is a measure that reflects the number of citations that papers published in academic journals achieve. As such the impact factor is used to note the relative importance of a particular journal in relation to another. Journals with higher impact factors are deemed to be more important than those with lower ones. The Journal or Nursing: theory, research, education is unlikely to attract an impact factor for a number of years if ever – but does it mean that as academics we should avoid trying to get our work published in this journal. I think not!

Interestingly, and contrary to many popular beliefs the current REF exercise (a process that adjudges the quality and power of recent research on a national and international level) which is predominately concerned with the published outputs of academics, will not take into account the impact factor of the journals within which papers are published. This is a long overdue stance that perhaps recognises that the impact of published work does not rely entirely on how often a particular piece of work is cited in the work of others. I am passionate about getting my ideas and those of my colleagues, published. Since that first conference paper presentation in 1996, I have published my PhD, 83 peer reviewed papers, book chapters and research reports, 96 conference papers, 26 non- peer reviewed papers and 133 blog postings. In all of this time I have only published 2 single authored papers, preferring instead to write with others.

And driving home on Friday night, after enoying an evening of wonderful conversation and friendship, I turned onto my drive, and my headlights picked up the naturally seeded drifts of snow drops lining the drive. These tiny white flowers standing tall and proud in the cold night air were perfect reminders that whatever we do Mother Nature will always find a way of providing the impact we need to remind us of what is really important.