Value and vulnerability: reflections on joint appointments.

Abstract For more than 20 years, joint appointments between nursing education and nursing service have been recommended as a strategy to foster excellence in nursing education and nursing practice, bridge the theory-practice gap, and promote clinically relevant research. This article discusses the termination of a joint-appointment initiative after research that had demonstrated its success in terms of benefits to both agencies and satisfaction for the incumbents in the positions. It presents the value and vulnerability of joint academic-clinical agency joint appointments based on critical analysis of the academic literature juxtaposed with our research and subsequent experience with four joint appointments between a faculty of nursing and a home-care agency. Top-level administrative support and understanding of the potential of such positions are crucial for the nurses involved, and the positions themselves become vulnerable in times of change and fiscal restraint.