Reflections and projections on nursing

The author looks at the environment within which nurses work and the services that are being delivered in the health care delivery system. These observations serve as the background for predictions about what nursing must do and become to honor its stewardship to the public. Today's environment is consumer driven, multicultural, and multigenerational. The consumer expects information and reserves the right to make decisions on his or her own behalf. It remains up to nursing to read the cues correctly and use the resources that the consumer brings to the nurse-patient relationship. Nurses have the innate skills to fill this role, turning dependency to self-care. Care in the new millennium is characterized by integrated systems, electronic and computer technology, specialization, and inter/transdisciplinary practice. The transition to more community-based services makes independent decision making essential.