The Nursing Profession: Tomorrow and beyond

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Edited by: Norma L. Chaska

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  • Front Matter
  • Subject Index
  • Part I: Professionalization

    Part II: Nursing Education

    Part III: Nursing Theory

    Part IV: Nursing Research

    Part V: Nursing Practice

    Part VI: Nursing Administration—Service

    Part VII: Nursing Administration—Academic

    Part VIII: The Future of Nursing

    Part IX: Summary

  • Copyright

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    Dedication

    IN MEMORY OF my parents James and Edna and Wolcott Dean Baird

    DEDICATED TO J.C. and Lieutenant Colonel (Retired) Shirley M. Chaska Baird, EdD sister, friend, and mentor throughout my professional career

    About the Editor

    NORMA L. CHASKA, PhD, RN, FAAN, is a leader in nursing education and nursing administration. Currently, she is a consultant for academic administration in universities.

    Her educational preparation includes a diploma in nursing from St. Marys School of Nursing, Saint Marys Hospital, Rochester, Minnesota; a bachelor of science in nursing (BSN) degree from the School of Nursing, The Catholic University of America, Washington, DC; a master of science (MS) degree from the School of Nursing, Boston University; and a doctor of philosophy (PhD) degree in sociology from Boston University. Prior to her graduate education, she held numerous clinical and administrative positions in most every specialized area of nursing for a total of 15 years of experience in nursing practice. Upon earning her doctoral degree she was on the staff of the Mayo Clinic, Rochester, Minnesota, for 2½ years conducting patient and health care research.

    Dr. Chaska has had 22 years of significant experience in nursing education and academic administration. She has held faculty positions at Boston University, the University of Minnesota, and at the School of Nursing, Indiana University, Indianapolis, and in the Department of Sociology, School of Liberal Arts, Indiana University—Purdue University at Indianapolis (IUPUI); faculty and administrative positions at the University of Illinois, College of Nursing in Chicago; the School of Nursing, Medical College of Georgia in Augusta, and most recently as Professor and Dean of the School of Nursing at the University of San Francisco, San Francisco.

    Dr. Chaska is widely sought as a consultant for academic administration in universities and for nursing education programs. She has served on national research and nursing education review teams for funding of proposals submitted for nursing research and nursing education programs. She has been active in numerous professional organizations. She was elected to Sigma Theta Tau International in 1963, elected as a Fellow in the American Academy of Nursing in 1978, Sigma Xi Scientific Research Society in 1978, and listed in Who's Who of World's Women in 1983. She has been awarded numerous other faculty and service honors.

    Throughout her academic career, Dr. Chaska has drawn extensively on her clinical experience in service and research settings. This background is also reflected in her numerous presentations, publications, and consultations. The underlying theme that frequently is cited as a quote in her many presentations and speeches is as follows:

    I shall pass through this world but once. Any good therefore that I can do let me do it now, for I shall not pass this way again.

    Source Unknown

    A major concern in all her work is the evolution of nursing as a profession. This concern is most evident in her four texts: The Nursing Profession: Views Through the Mist, McGraw-Hill, 1978; The Nursing Profession: A Time to Speak, McGraw-Hill, 1983; The Nursing Profession: Turning Points, C.V. Mosby, 1990; and her latest book, The Nursing Profession: Tomorrow and Beyond, Sage, 2001. The Views Through the Mist textbook was the first nursing issues type of book ever published. The Time to Speak book received the American Journal of Nursing Book of the Year Award in 1983 for Nursing Education and Nursing Administration, and the Turning Points volume received that same award in 1990.

    List of Contributors

    • THE NURSING PROFESSION: Tomorrow and Beyond (2001)
    • Editor: Norma L. Chaska, Sage Publications, Inc., Thousand Oaks, CA
    • Jacqueline Agnew, PhD, RN, FAAN
    • Associate Professor and Director
    • Occupational Health Nursing Program, Department of Environmental Health Science and Division of Occupational Health
    • School of Hygiene and Public Health, Johns Hopkins University
    • Baltimore, MD
    • Judith W. Alexander, PhD, RN, CNAA
    • Associate Professor
    • Department of Family and Community Health Nursing
    • College of Nursing, University of South Carolina
    • Columbia, SC
    • Carole A. Anderson, PhD, RN, FAAN
    • Dean and Professor
    • College of Nursing, Ohio State University
    • Columbus, OH
    • Ida M. Androwich, PhD, RNC, FAAN
    • Associate Professor
    • Community, Mental Health and Administrative Nursing
    • Marcella Niehoff School of Nursing, Loyola University
    • Chicago, IL
    • Sara E. Barger, DPA, MN, RN, FAAN
    • Dean and Professor
    • Capstone College of Nursing, University of Alabama
    • Tuscaloosa, AL
    • Diane M. Billings, EdD, RN, FAAN
    • Associate Dean for Teaching, Learning, and Information Resources
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • Diana L. Biordi, PhD, RN, FAAN
    • Professor and Assistant Dean
    • School of Nursing, Kent State University
    • Kent, OH
    • Donna L. Boland, PhD, RN
    • Associate Professor and Associate Dean for Undergraduate Programs
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • Mary G. Bourbonniere, MSN, RN
    • Doctoral Candidate
    • School of Nursing, University of Pennsylvania
    • Philadelphia, PA
    • Peter I. Buerhaus, PhD, MS, RN, FAAN
    • Associate Dean for Research and Valere Potter Professor
    • School of Nursing, Vanderbilt University
    • Nashville, TN
    • Jacquelyn C. Campbell, PhD, RN, FAAN
    • Associate Dean for the PhD Programs and Research and Anna D. Wolf Endowed Professor
    • School of Nursing, Johns Hopkins University Baltimore, MD
    • Michael A. Carter, DNSc, RN, FAAN
    • Dean and Professor
    • College of Nursing, University of Tennessee-Memphis
    • Memphis, TN
    • Norma L. Chaska, PhD, RN, FAAN
    • Consultant
    • Academic Administration for Universities and Editor
    • San Francisco, CA
    • Peggy L. Chinn, PhD, RN, FAAN
    • Professor
    • School of Nursing, University of Connecticut
    • Storrs, CT
    • Euisoo Choi, MSN, RN
    • Project Officer
    • Primary and Secondary Prevention Program
    • Hornsby Ku-ring-gai Ryde
    • Division of General Practice
    • Wahroonga, Sydney, Australia
    • Margaret M. Conger, EdD, RN, CM
    • Professor
    • Department of Nursing, Northern Arizona University
    • Flagstaff, AZ
    • Inge B. Corless, PhD, RN, FAAN
    • Professor
    • Graduate Program in Nursing, MGH Institute of Health Professions at Massachusetts General Hospital
    • Boston, MA
    • Anne J. Davis, PhD, DSC (H), RN, FAAN
    • Professor Emerita
    • School of Nursing, University of California-San Francisco San Francisco, CA
    • Professor
    • Nagano College of Nursing, Komagane City
    • Nagano, Japan
    • Carol Deets, EdD, RN
    • Professor and Associate Dean for Research and Director of the Doctoral Program
    • College of Nursing and Health, University of Cincinnati
    • Cincinnati, OH
    • Jacqueline A. Dienemann, PhD, RN, CNAA, FAAN
    • Clinical Associate Professor
    • School of Nursing, Georgetown University
    • Washington, DC
    • Joanne M. Disch, PhD, RN, FAAN
    • Professor of Nursing
    • Director, Katharine J. Densforth International Center for Nursing Leadership
    • Katherine R. and C. Walton Lillehei Chair of Nursing Leadership
    • School of Nursing, University of Minnesota
    • Minneapolis, MN
    • Eleanor Donnelly, PhD, RN
    • Professor
    • Department of Environments for Health
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • Shirley L. Dooling, EdD, RN
    • Professor and Dean Emerita
    • Marcella Niehoff School of Nursing, Loyola University—Chicago
    • Chicago, IL
    • Virginia J. Duffy, PhD, RN, CS, NP
    • Advanced Practice Registered Nurse—PMH
    • Owner: PsychSense, A Mental Health Education & Consulting Company
    • Co-Owner: Health Answers-Health Consultation On Line
    • Rochester, NY
    • Jacqueline Fawcett, PhD, RN, FAAN
    • Professor Emerita
    • School of Nursing, University of Pennsylvania
    • Philadelphia, PA
    • Professor
    • Geraldene Felton, EdD, RN, FAAN
    • Professor and Dean Emerita
    • College of Nursing, The University of Iowa
    • Iowa City, IA
    • Executive Director
    • National League for Nursing Accrediting Commission
    • New York, NY
    • Anastasia Fisher, DNSc, RN
    • Postdoctoral Scholar
    • Department of Psychosocial and Community Health
    • School of Nursing, University of Washington
    • Seattle, WA
    • Mary L. Fisher, PhD, RN, CNAA
    • Associate Professor
    • Department of Environments for Health
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • Joyce J. Fitzpatrick, PhD, MBA, RN, FAAN
    • Professor, Endowed Chair and Dean Emerita
    • Frances Payne Bolton School of Nursing, Case Western University
    • Cleveland, OH
    • Editor
    • Nursing and Health Care Perspectives, National League for Nursing
    • New York, NY
    • Juanita W. Fleming, PhD, RN, FAAN
    • Special Assistant to the President for Academic Affairs
    • University of Kentucky
    • Lexington, KY
    • Marilyn E. Flood, PhD, RN
    • Associate Dean, Academic Programs
    • School of Nursing, University of California-San Francisco
    • San Francisco, CA
    • Robin Dawn Froman, PhD, RN, FAAN
    • Professor, Associate Dean for Research, and Director for the Office for Nursing Research and Scholarship
    • School of Nursing, University of Texas Medical Branch
    • Galveston, TX
    • Barbara C. Gaines, EdD, RN
    • Consultant for Curriculum Development and Evaluation and Professor Emerita
    • School of Nursing, Oregon Health Sciences University
    • Portland, OR
    • Rose M. Gerber, PhD, RN
    • Associate Professor Emerita
    • College of Nursing, The University of Arizona
    • Tucson, AZ
    • Patricia A. Grady, PhD, RN, FAAN
    • Director
    • National Institute of Nursing Research, National Institutes of Health
    • Department of Health and Human Services
    • Bethesda, MD
    • Mikel L. Gray, PhD, RN, CUNP, CCCN, FAAN
    • Nurse Practitioner
    • Department of Urology, University of Virginia
    • Charlottsville, VA
    • Associate Professor
    • School of Nursing, University of Virginia Health Sciences Center
    • Charlottsville, VA
    • Hurdis M. Griffith, PhD, RN, FAAN
    • Dean and Professor
    • College of Nursing, Rutgers, The State University of New Jersey
    • Newark, NJ
    • Sheila A. Haas, PhD, RN
    • Professor and Dean
    • Marcella Niehoff School of Nursing, Loyola University-Chicago
    • Chicago, IL
    • Barbara Habermann, PhD, RN
    • Postdoctoral Scholar
    • Department of Family and Child Nursing
    • School of Nursing, University of Washington
    • Seattle, WA
    • Assistant Professor
    • School of Nursing, University of Alabama-Birmingham
    • Birmingham, AL
    • Sally Brosz Hardin, PhD, RN, FAAN
    • Professor and Director
    • PhD Nursing Program
    • Barnes College of Nursing, University of Missouri-St. Louis
    • St. Louis, MO
    • BevelyJ. Hays, PhD, RN
    • Associate Professor
    • College of Nursing, University of Nebraska
    • Omaha, NE
    • Janet Heinrich, DrPH, RN, FAAN
    • Associate Director
    • Health Finance and Public Health, U.S. General Accounting Office
    • Washington, DC
    • Sharon E. Hoffman, PhD, MBA, RN, FAAN
    • Senior Vice President for Academic Affairs
    • Spalding University
    • Louisville, KY
    • Linda Hollinger-Smith, PhD, RN
    • Assistant Dean for External Affairs and Associate Professor
    • College of Nursing, Rush University
    • Chicago, IL
    • Director of Nursing
    • Rush Primary Care Institute, Rush-Presbyterian-St. Luke's Medical Center
    • Chicago, IL
    • Eun-Ok Im, PhD, MPH, CNS, RN
    • Assistant Professor
    • School of Nursing, University of Wisconsin-Milwaukee
    • Milwaukee, WI
    • Jean F. Jenkins, PhD, MSN, RN
    • Clinical Nurse Specialist and Consultant for the National Cancer Institute, National Institutes of Health
    • Department of Health and Human Services, Public Health Service
    • Bethesda, MD
    • Cheryl B. Jones, PhD, RN, CNAA
    • Associate Professor
    • School of Nursing, University of North Carolina-Chapel Hill
    • Chapel Hill, NC
    • Dorothy A. Jones, EdD, RN, FAAN
    • Professor
    • Adult Health Department
    • School of Nursing, Boston College Chestnut Hill, MA
    • Nurse Scientist
    • Massachusetts General Hospital
    • Boston, MA
    • Rebecca A. Patronis Jones, DNS, RN, CNAA
    • Director and Professor
    • School of Nursing & Health Sciences, Texas A&M University-Corpus Christi
    • Corpus Christi, TX
    • Charlie Jones-Dickson, EdD, RN, FAAN
    • Professor
    • School of Nursing, University of Alabama-Birmingham
    • Birmingham, AL
    • Christine E. Kasper, PhD, RN, FAAN, FACSM
    • M. Adelaide Nutting Chair, Professor and Director of Doctoral Programs
    • School of Nursing, Johns Hopkins University
    • Baltimore, MD
    • Sarah B. Keating, EdD, RN, C-PNP, FAAN
    • Former Dean and Professor Emerita
    • Samuel Merritt-Saint Mary's Intercollegiate Nursing Program
    • Oakland, CA
    • Karlene M. Kerfoot, PhD, RN, CNAA, FAAN
    • Senior Vice President for Nursing and Patient Care Services and Chief Nurse Executive and Associate Dean, Nursing Practice
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • Clarian Health Partners, Inc.
    • Methodist—UI—Riley
    • Indianapolis, IN
    • Shake Ketefian, EdD, RN, FAAN
    • Professor and Director of Doctoral and Postdoctoral Studies and Director of International Affairs
    • School of Nursing, University of Michigan
    • Ann Arbor, MI
    • Hesook Suzie Kim, PhD, RN
    • Professor
    • College of Nursing, University of Rhode Island
    • Kingston, RI
    • Professor II
    • Institute of Nursing Science, Faculty of Medicine, University of Oslo
    • Oslo, Norway
    • JoEllen Koerner, PhD, RN, FAAN
    • President
    • Global Nursing Academy
    • Boulder, CO
    • Beverly Kopala, PhD, RN
    • Associate Professor
    • Marcella Niehoff School of Nursing, Loyola University–Chicago
    • Chicago, IL
    • Mary Jo Kreitzer, PhD, RN
    • Director
    • Center for Spirituality and Healing
    • Academic Health Center, University of Minnesota
    • Minneapolis, MN
    • Phyllis Beck Kritek, PhD, RN, FAAN
    • Florence Thelma Hall Distinguished Professor of Nursing
    • School of Nursing, University of Texas Medical Branch
    • Galveston, TX
    • Lois A. Lane, JD, MSN, RNCS
    • Former Associate Dean of Service Innovation
    • Assistant Clinical Professor
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • PhD Student-Health Care Ethics, Saint Louis University
    • Saint Louis, MO
    • Ramon Lavandero, MA, MSN, RN
    • Director of Development and Strategic Alliances
    • American Association of Critical-Care Nurses
    • Aliso Viejo, CA
    • Elizabeth R. Lenz, PhD, RN, FAAN
    • Anna C. Maxwell Professor of Nursing Research and Associate Dean for Research and Doctoral Studies
    • School of Nursing, Columbia University
    • New York, NY
    • Andrea R. Lindell, DNSc, RN
    • Dean and Schmidlapp Professor of Nursing College of Nursing and Health
    • Associate Senior Vice President for Interdisciplinary Education
    • University of Cincinnati Medical Center
    • Cincinnati, OH
    • Carol A. Lindeman, PhD, RN, FAAN
    • Dean and Professor Emeritus
    • School of Nursing, Oregon Health Sciences University
    • Portland, OR
    • Ada M. Lindsey, PhD, RN, FAAN
    • Dean and Professor
    • College of Nursing, University of Nebraska Medical Center
    • Omaha, NE
    • Marilyn Loen, PhD, RN
    • Professor
    • Department of Nursing, Metropolitan State University
    • St. Paul, MN
    • Carol O. Long, PhD, RN
    • Assistant Professor
    • College of Nursing, Arizona State University
    • Tempe, AZ
    • Kathleen M. McCauley, PhD, RN, CS, FAAN
    • Associate Professor of Cardiovascular Nursing and Acting Associate Dean and Director of Undergraduate Studies
    • School of Nursing, University of Pennsylvania
    • Cardiovascular Clinical Specialist
    • Hospital of the University of Pennsylvania
    • Philadelphia, PA
    • Maureen P. McCausland, DNSc, RN, FAAN
    • Chief Nursing Executive
    • University of Pennsylvania Health System
    • Professor of Nursing Administration and Associate Dean for Nursing Practice
    • School of Nursing, University of Pennsylvania
    • Philadelphia, PA
    • Margaret L. McClure, EdD, RN, FAAN
    • Professor
    • New York University
    • New York, NY
    • Mary Ann McDermott, PhD, RN, FAAN
    • Professor
    • Department of Maternal–Child Nursing
    • Marcella Niehoff School of Nursing, Loyola University-Chicago
    • Director
    • Center for Faith and Mission, Loyola University-Chicago
    • Chicago, IL
    • Elizabeth A. McFarlane, DNSc, RN, FAAN
    • Associate Professor
    • School of Nursing, The Catholic University of America
    • Washington, DC
    • Afaf I. Meleis, PhD, Dr. PS (Hon), RN, FAAN
    • Professor
    • Department of Community Health Systems
    • School of Nursing, University of California-San Francisco
    • San Francisco, CA
    • Kenneth P. Miller, PhD, RN, CFNP, FAAN
    • Professor and Associate Dean for Research and Clinical Scholarship
    • College of Nursing, University of New Mexico, Health Sciences Center
    • Albuquerque, NM
    • Betty M. Neuman, PhD, RN, FAAN
    • Independent International Consultant
    • Watertown, OH
    • Amy A. Nichols, EdD, RN
    • Associate Professor
    • School of Nursing, San Francisco State University
    • San Francisco, CA
    • Steven V. Owen, PhD
    • Professor
    • School of Nursing and Department of Preventive Medicine and Community Health
    • Senior Statistician
    • Office of Biostatistics, University of Texas Medical Branch
    • Galveston, TX
    • Craig Paterson, LLB, MA
    • PhD Candidate-Health Care Ethics and Adjunct Faculty
    • Department of Philosophy, Saint Louis University
    • Saint Louis, MO
    • Shannon E. Perry, PhD, RN, FAAN
    • Professor and Director
    • School of Nursing, San Francisco State University
    • San Francisco, CA
    • Daniel J. Pesut, PhD, RN, CS, FAAN
    • Professor and Chairperson
    • Department of Environments for Health
    • School of Nursing, Indiana University
    • Indianapolis, IN
    • SueEllen Pinkerton, PhD, RN, FAAN
    • Senior Vice President and CNO
    • Shands Health Care, Shands Jacksonville
    • Jacksonville, FL
    • Timothy P. Porter–O'Grady, EdD, PhD, RN, FAAN
    • Senior Partner
    • Tim Porter-O'Grady, Inc.
    • Atlanta, GA
    • Carol H. Pullen, EdD, RN
    • Associate Professor and Assistant Dean
    • Rural Nursing Education
    • College of Nursing, University of Nebraska
    • Omaha, NE
    • Larry Purnell, PhD, RN, FAAN
    • Professor
    • College of Health and Nursing Sciences, University of Delaware
    • Newark, DE
    • Richard W. Redman, PhD, RN
    • Professor and Associate Dean
    • School of Nursing, University of Colorado Health Sciences Center
    • Denver, CO
    • Andrea Renwanz-Boyle, DNSc, RN
    • Associate Professor
    • School of Nursing, San Francisco State University
    • San Francisco, CA
    • Karen R. Robinson, PhD, RN, FAAN
    • Associate Director for Clinical Operations
    • Veterans Affairs Medical Center
    • Fargo, ND
    • Mary Ann Schroeder, PhD, RN, FAAN
    • Senior Data Analyst
    • Harris Methodist Health System
    • Fort Worth, TX
    • Elizabeth F. Sefcik, PhD, RN, CS
    • Professor and School Nurse Coordinator
    • School of Nursing & Health Sciences, Texas A&M University-Corpus Christi
    • Corpus Christi, TX
    • Joan L. F. Shaver, PhD, RN, FAAN
    • Dean and Professor
    • College of Nursing, University of Illinois–Chicago
    • Chicago, IL
    • Grayce M. Sills, PhD, RN, FAAN
    • Professor Emerita
    • College of Nursing, Ohio State University
    • Columbus, OH
    • Mariah Snyder, PhD, RN, FAAN
    • Professor
    • School of Nursing, University of Minnesota
    • Minneapolis, MN
    • Kathleen R. Stevens, EdD, RN, FAAN
    • Professor, School of Nursing
    • Director, Academic Center for Evidence-Based Nursing
    • The University of Texas Health Science Center at San Antonio
    • San Antonio, TX
    • Editor, Online Journal of Knowledge Synthesis for Nursing
    • Eileen M. Sullivan-Marx, PhD, RN, FAAN
    • Assistant Professor
    • School of Nursing, University of Pennsylvania
    • Philadelphia, PA
    • Katherine A. Thomas, MN, RN
    • Executive Director
    • Texas Board of Nurse Examiners
    • Austin, TX
    • Sandra P. Thomas, PhD, RN, FAAN
    • Professor and Director
    • PhD Program in Nursing
    • College of Nursing, University of Tennessee
    • Knoxville, TN
    • Patricia E. Thompson, EdD, RN
    • President
    • Sigma Theta Tau International
    • Associate Professor and Associate Dean for Baccalaureate Education
    • College of Nursing, University of Arkansas for Medical Sciences
    • Little Rock, AR
    • Marita G. Titler, PhD, RN, FAAN
    • Director of Research, Quality, and Outcomes Management
    • Department of Nursing Services and Patient Care, University of Iowa Hospital and Clinics
    • Iowa City, IA
    • Catherine M. Todero, PhD, RN
    • Associate Professor and Associate Dean of Undergraduate Programs
    • Project Director, UNMC—Cosmopolitan Mobile Nursing Center
    • College of Nursing, University of Nebraska Medical Center
    • Omaha, NE
    • Mary Wakefield, PhD, RN, FAAN
    • Professor and Director
    • Center for Health Policy, Research and Ethics
    • College of Nursing and Health Sciences, George Mason University
    • Fairfax, VA
    • Jean M. Watson, PhD, RN, HNC, FAAN
    • Former Dean and Distinguished Professor of Nursing-Scoville-Murchinson Endowed Chair in Caring Science
    • School of Nursing, University of Colorado Health Sciences Center
    • Denver, CO
    • Elizabeth E. Weiner, PhD, RN, FAAN
    • Professor of Nursing; Director, Center for Academic Technologies; Acting Associate Director, Academic Information Technology Services
    • College of Nursing and Health, University of Cincinnati Medical Center
    • Cincinnati, OH
    • Rosalee C. Yeaworth, PhD, RN, FAAN
    • Professor Emerita and Dean Emerita
    • College of Nursing, University of Nebraska
    • Omaha, NE
    • Carolyn J. Yocom, PhD, RN, FAAN
    • Associate Professor
    • College of Nursing, Rutgers, The State University of New Jersey
    • Newark, NJ
    • Lani Zimmerman, PhD, RN
    • Associate Professor and Chair
    • Adult Health and Illness Department
    • College of Nursing, University of Nebraska Medical Center
    • Omaha, NE
    • Writing the Introduction for the Book
    • Margretta M. Styles, EdD, RN, FAAN
    • Professor Emerita and Former Dean
    • School of Nursing, University of California-San Francisco
    • San Francisco, CA
    • Past President, American Nurses Association, International Council of Nurses, and American Nurses Credentialing Center
    • Currently, Consultant, ANCC

    Preface

    Two roads diverged in a yellow wood,

    And sorry I could not travel both

    And be one traveler, long I stood

    And looked down one as far as I could

    To where it bent in the undergrowth;

    Then took the other, as just as fair,

    And having perhaps the better claim,

    Because it was grassy and wanted wear;

    Though as for that the passing there

    Had worn them really about the same,

    And both that morning equally lay

    In leaves no step had trodden black.

    Oh, I kept the first for another day!

    Yet knowing how way leads on to way,

    I doubted if I should ever come back.

    I shall be telling this with a sigh

    Somewhere ages and ages hence:

    Two roads diverged in a wood, and I

    I took the one less traveled by,

    And that has made all the difference.

    Robert Frost (1916/1993, p. 1)

    The poem, The Road Not Taken, by Robert Frost illustrates the predominant theme throughout this volume—that there are various paths that nursing as a profession can take. Nursing as a profession always has had choices to make regarding directions for the future. But for the 21st century, options abound. So too do the challenges. Following the leadership provided by the contributing authors in this volume—through the roads of professionalization, education, theory, practice, administration, and the future—professionals will be enabled to choose “paths” that make a difference.

    The purpose of this book is to provide an in-depth global scope and study of nursing as a profession. Specifically, its aim is to project patterns of thought and considerations about the state of nursing now and far beyond into the future of the 21st century. You will find perspectives that are challenging, disconcerting, and refreshing. The content should cause you to reflect, consider, and dialogue regarding the various paths presented. Then, positioning to move forward on a path can occur.

    This book is a companion to The Nursing Profession: Views Through The Mist, 1978, and The Nursing Profession: A Time to Speak, 1983, both published by McGraw-Hill; and The Nursing Profession: Turning Points, published by C. V. Mosby in 1990. The text, The Nursing Profession: Views Through The Mist, 1978, was the first nursing issues type of textbook ever published. The second and third texts were recipients of the American Journal of Nursing Book of the Year Award for 1983 and 1990, respectively. This year 2001 volume is similar in format to the 1990 text.

    For each book, persistent effort was made to provide original writing by nurse authors who represent diverse disciplines in their doctoral preparation. Thus this volume contains 78 original chapters by 105 contributing authors. All 78 primary authors for the chapters are doctorally prepared, representing the disciplines of nursing, sociology, psychology, anthropology, philosophy, education, and law. All coauthors are doctorally prepared with exception of four who are master's prepared or doctoral candidates. Twenty of the 105 contributing authors also were authors in either Views Through The Mist, A Time To Speak, or Turning Points. Eighty-five of the contributors are new to this volume. Two of the authors have appeared in all four textbooks. The contributors represent all geographic regions of the United States and include one person in Japan, one in Norway, and another in Australia, who currently are employed professionally in those countries. The contributors are recognized leaders in the profession of nursing. Sixty-four of the contributing authors are elected Fellows of the American Academy of Nursing.

    Nine Parts comprise this book: Profession-alization, Nursing Education, Nursing Theory, Nursing Research, Nursing Practice, Nursing Administration—Service, Nursing Administration—Academic, The Future of Nursing, and Summary. An Introduction that leads off with lines from Robert Frost's poem provides the opening for each Part. You are encouraged to reflect on the poet's lines for their relevance to the content of the chapters in each Part. Each chapter has a Concluding Statement by the author(s) and ends with Editor's Questions for Discussion.

    The Summary Part consists of a final chapter, Paths to Make a Difference. In this chapter, I highlight particular points of the contributing authors. I then trace the predominant patterns and themes introduced in the chapters and Parts. I identify paths that the authors have projected to make a difference for the profession in the future far beyond. The Concluding Statement includes a synthesis of these paths that, if followed—I believe—will make a difference.

    By reading the volume, reflecting on the questions, and positing possible answers, you should be able to gain a comprehensive perspective of the profession. The questions should be of value to practitioners, graduate and undergraduate students, faculty, and administrators alike. Consequently, you as a responsible or aspiring professional may contribute to unification of the profession and attainment of personal and the profession's goals. In so doing, it seems appropriate to heed the words of Ursula K. LeGuin: “It is good to have an end to journey towards; but it is the journey that matters, in the end” (1969, p. 220).

    Acknowledgments

    This volume owes its existence to significant shared interest and concern for nursing on the part of the contributing authors, who had the difficult task of addressing complex subjects in nursing within the confines of minimal pages. Their patience and good will in responding to stringent deadlines are gratefully appreciated. Shirley Dooling particularly warrants special recognition. Though ill, she insisted on completing her portion of the chapter for which she was responsible. Shirley passed away February 19, 2000.

    Appreciation is extended to numerous colleagues and friends who advocated completion of this fourth book and provided a strong support network. Particularly, Sister M. Ann O'Brien, PBVM; Phyllis Beck Kritek, PhD, RN, FAAN; and Richard K. Grosboll, Esq., are acknowledged in gratitude for paving the road and illuminating the path toward developing this book. I am most indebted to my sister Shirley M. Chaska Baird, EdD, RD, for her invaluable comments and supportive suggestions related to the total manuscript. In addition, I am most grateful for the support of my sister, Marjorie, and brothers, James and Willard—and their spouses: Paul, Vivian, and Jill; my nephews and nieces—Benjamin, Paula, Allan, Peggy, Judy, Angela, Edna, Susan, Jeffrey, James, and Amy and their spouses: Dave, Randy, Dirk, Bill, Scot, Steve, Susan, Kelly, and Cornel; and my great nephews and great nieces—Ryan, Kelly, Katie, Mark, Travis, Nathan, Alyssa, Christopher, Krista, Britta, Joseph, and Bea Louise. Whereas the elders have long traveled successfully on the road of life and the middle generation is well established on unique paths, it is the youngest cohorts of the family whom we expect will choose distinctive roads. I particularly thank these great-nephews and great-nieces who have provided love, support, and entertainment in ways exceptional to each of them. Without this close family network, this volume would not have been possible.

    Finally, I would be remiss if I did not acknowledge my special feline family Peppermint Pete and Peppermint Pattie. They faithfully wagged their furry tails in my face early each morning to “get to work” and diligently guarded me at the computer on my desk, lest I take too many “breaks.” While lying on top of a stack of papers, they occasionally voiced their approval or disapproval of my work. Unfortunately, though they tried to assist in typing on occasion, their prancing across the keys caused too many errors. But without them, this book could never have been completed!

    I am most grateful to Julianne Tolson, Internet Applications Specialist, San Francisco State University, who tutored me in the computer machinations that sometimes are overwhelming. Her expert technical support prevented innumerable crises.

    I extend special appreciation to Dan Ruth, Acquisition Editor, Sage Publications, Inc., for initially encouraging me to edit this volume and to Rolf Janke, Editorial Director, and Sanford Robinson, Senior Production Editor, for their sustained support and encouragement. I thank Leticia Gutierrez, Contracts Coordinator, for her development and management of contracts for all participants in this volume. I am particularly grateful to Michele Lingre, Books Marketing Manager, for her interest, advice, and development of marketing materials, and to Heidi Van Middlesworth, Editorial Assistant, for her counsel in the production of this volume. My association with all at Sage Publications, Inc., is valued highly.

    Norma L.Chaska
    References
    Frost, Robert. (1916/1993). The road not taken. In Robert Frost, The road not taken and other poems (p. 1). New York: Dover Publications, Inc. Originally published by Henry Holt and Company (1916).
    Le Guin, U. K. (1969). The left hand of darkness. New York: Ace Books.

    Introduction: Victories for Nursing: Beyond Tomorrow

    The Nursing Profession: Tomorrow and Beyond! Much is promised in that title. And much is delivered in these pages.

    In reviewing the manuscript, I was impressed by the credentials and diverse expertise of the authors, awed by their knowledge and insight, caught up in the sweeping scope of topics, and impelled by the currents of the future—and was reminded of one of the most powerful moments of my career.

    In the summer of 1995, as President of the International Council of Nurses, I was privileged to address an audience of Greek dignitaries and nurses from all over the world at sunset in an ancient outdoor theater at the foot of the Acropolis in Athens. Against such a backdrop, on a stage where legendary Greek philosophers had spoken, it was for me a moment of great challenge. I stretched my vision to its limits, raised my arms in V configuration, and exhorted those sitting on the grassy, stone steps to anticipate and celebrate seven ultimate victories for nursing:

    Education: The Foundation of All Nursing

    Victory will be declared and celebrated the day that every nation has accepted that, as a minimum standard, nurses will be prepared comparably to other professions.

    Practice: The Purpose of the Profession

    Victory will be declared and celebrated the day that all countries have established regulatory and health care systems enabling nurses to practice autonomously to the full extent of their substantial and expanding capabilities and to be properly accountable for that practice.

    Research: The Source of Knowledge for Nursing Practice

    Victory will be declared and celebrated the day that nurses everywhere contribute to, access, and conscientiously utilize growing libraries of nursing research findings.

    Management: An Essential for Influence and Accountability

    Victory will be declared and celebrated the day that, in all health care settings, well-qualified and equipped nurse executives are responsible and accountable for all nursing care and for all nursing personnel and that nurses are optimally positioned within the highest echelons of health care systems.

    Socioeconomic Welfare: An Incentive and Reward, an Entitlement for Respected Professionals

    Victory will be declared and celebrated the day that nurses receive the same salaries and benefits as other professionals with equivalent preparation, value, and responsibilities.

    Ethics: The Conscience of Nursing

    Victory will be declared and celebrated when all nurses are skilled in identifying and analyzing ethical issues, when all nurses speak out on behalf of patients who are unable to be advocates for themselves, and when nurses are recognized in all circles where ethical problems and issues are addressed.

    Policy: The Might of Nursing

    Victory will be declared and celebrated the day that a nurse, backed by a unified and respected profession, first occupies the position of Director-General of the World Health Organization.

    I concluded that evening in Athens on a high note by asserting that these victories should be anticipated by the profession, victories to be achieved through the minute by minute, day by day personal victories of nurses everywhere.

    Why did I choose to speak of victories for a profession absorbed in its own development? Because I have been strongly influenced by the views of my husband, a clergyman, that prayers should be affirmative, not beseeching God to do something, but rather thanking God that it shall be done. We must have a vision and then move confidently and inexorably toward its achievement.

    This volume reminds me of that moment in three respects. First, there is acknowledgment herein of the many sectors in which nursing must strive and succeed—socialization, education, theory, research, practice, administration, ethics, economics, regulation, workplace advocacy, organizational development, and health care policy. These sectors are linked, and therefore each is critical; to fail in some is to weaken others.

    Second, the themes of Tomorrow and Beyond and choosing the right paths to victory resonated that evening and pervade the rich discourse nourished within these covers. Writings such as these, widely disseminated and utilized, help us to see the challenges, to view the choices, and to select the paths—the means toward the desired future. These chapters, these leaders point the way. They do so principally by stimulating forward thinking and posing provocative questions for discussion.

    Third, that occasion in the ancient Greek theater comes to mind because it focused on anticipated victories, the goals. To select the paths, we must know the destination. We may dispute the particular victories posed that evening. We must not dispute, however, the need for each of us to have such a vision. Early in the reading of this book—to reap its benefits to the fullest—you must begin to articulate your own ultimate goals for the profession.

    The final chapter, Paths to Make a Difference, should inspire you to hope that nursing will achieve the victories so reachable by the paths chosen and mapped by the authors. Each of you—administrator, practitioner, faculty member, graduate student, or undergraduate student alike will help make it all possible through individual acts and personal victories.

    Margretta Madden Styles, EdD, RN, FAAN

    Professor Emerita and Former Dean

    School of Nursing, University of California

    San Francisco, CA

    Past President, American Nurses Association,

    International Council of Nurses, and

    American Nurses Credentialing Center

    Currently, Consultant, ANCC


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