Nursing in the 21st century: alternate paths*

Abstract

The nursing profession has the opportunity to choose one of two alternate paths as it enters the 21st century. One is a dependent path the other is independent. By virtue of a licence nurses have authority to practice their profession independently. Yet some nurses, health care policy makers, and administrators of institutions and agencies, formulate and implement roles and activities for nurses in order to fulfil the aims of medicine and institutional bureaucracy. This problem 'forces' nursing to travel a dependent path. A view is set forth that the problem stems from the collective failure of nursing to articulate and implement a function and product distinct from that of medicine and of other professions. Making this distinction is critical to the charting of an independent path. Nursing's past and present are examined in terms of the service nursing does in fact provide for society. This operationally defined role of nursing is presented in marked contrast to the definition of nursing currently being promulgated by the American Nurses' Association. Collective articulation of a distinct function and product are set forth as a prerequisite for nurses to assume professional authority as they practise. This will safeguard consumers of professional nursing as well as the work and future of nursing as an independent profession.