The holiday season is upon us, and with that comes the inevitable New Year's resolutions. I'm urging you to think critically about a resolution this year; this year you need to create a resolution that could make all the difference in your life next year and for many years to come.

Here's the question: What's next for you as a nurse? This is the appropriate time to think about this because everything is about to change in healthcare. I'm not exaggerating here. No matter what your political views are about the Affordable Care Act (now called "Obamacare" by many) it is the law. This is going to have a tremendous effect on you as a nurse, and on your patients. What are you going to do to meet the challenges of the new universal healthcare that will be available (indeed, mandated) to everyone in the United States? Are you aware that there is NO POSSIBLE WAY that the 32 million new healthcare recipients can be cared for by the 878,194 physicians in the country? By contrast, there are over 3 million RNs in the United States. Who will be taking up the slack? The numbers tell the story. It will be the nurses, no doubt. But how? RNs will need to be responsible for patient visits on their own. That means an incredible opportunity for nurses to influence the future health of generations of Americans. How will we do it? First, nurses must have more education. Technology doesn't stop. Advances in care don't stop. We must all adapt and move forward, or be left behind. You may feel you were educated to be a staff nurse on a hospital floor, but nursing of the future (the very near future) will be different. Sure, staff nurses will still be needed, but the GREATEST NEED will be for primary care nurse practitioners. Want a wide range of opportunities? Here they are.

I have always been a big proponent of higher education for nurses, but now the need is not just theoretical, but clinically critical. If you knew my children (now adults), they would tell you that one of the questions I always asked them when discussing their professional futures was "Where do you want to be in 5 years?" That is the perfect question for each of you to ask yourselves now. As healthcare changes in immeasurable ways, where do you want your nursing future to go? Here's my advice: go back to school. If you have a diploma in nursing, enroll in a BSN program. If you have an AAN, enroll in a BSN program. If you have a BSN, get a master's degree, a DNP, or a PhD. If you love clinical care, become a nurse practitioner. If you love administration, get an advanced degree in that. If you want to teach, get a doctorate. I know, it all seems daunting. You have your work, maybe a family, things you want to do, time you need to spend on other things. But your future as a nurse depends on asking yourself where you want to be in 5 years. When the Affordable Care Act gets into full swing (it will take a few years to work out the kinks, I'm sure), are you going to be ready to deliver expert primary care or hospital care as a practitioner? That's what the country will need. Many, many nurse practitioners. We will become the caretakers of record, the primary care providers for the millions of new recipients of healthcare in the US. I'm here to tell you that you can do it. It may seem out of reach, but over the past decade hundreds of online programs have cropped up, and you can do your learning and studying to go from an RN to a BSN or RN to a MSN at home, after the kids go to bed, and on your days off. Check out the American Association of Colleges of Nursing website for all the info you need (aacn.nche.edu). Sure, it's hard. It takes concentration and guts to make it happen, but you can do it. Keep your eyes on the prize. Isn't it worthwhile to stretch yourself to your limit for 2 or 3 years in order to prepare yourself for your next 10 or 20 years of professional work? Wouldn't you like to be one of the sought-after well-educated nurses who will blaze the trail for nurses in the future? Thousands of nurses are doing it right now, and so can you. I guarantee that the learning will excite you. Plus, nurses with higher degrees generally earn more money, are more valuable to healthcare systems, and demonstrate high satisfaction with their professional independence.

So, what's next for you? Where do you want to be in 5 years? This year, make a resolution that can really make a difference in your life.