Despite the large numbers of nurses actively practicing in today's healthcare workforce, demand continues to outstrip supply, and the gap is growing wider. Other health professions are likewise experiencing workforce gaps, resulting in service limitations in ways we have never before experienced. It would be preaching to the choir to describe the critical role that nurses play in assuring the delivery of safe, high quality, and evidence-based care. Beyond practice wisdom, research has demonstrated the link between access to professional nursing care and outcomes achievement. So, in light of an aging workforce and public, and increased demand for nurses to practice in multiple settings and with a spectrum of increasingly complex patient and client groups, how can we build quality oriented healthcare organizations for not only today, but also for tomorrow.

According to renouned economist John Kenneth Galbraith, "there are only 2 groups of forecasters-those who do not know, and those who do not know they do not know. I try to avoid public identification with either one."1 Despite these words of warning, projections on workforce demand for nurses suggest growing needs and shrinking supply, a dilemma which no single strategy nor the simple passage of time will cure. Nursing and health care have no time to lose in developing the "pipeline" of those to enter the field. At the same time, we must aggressively pursue developing innovative approaches to extending and potentiating the role and impact of professional nurses for individuals and the public. How do we use this precious resource-the nurse-to do those things that can only be done by those with the scientific knowledge base and expertise of a nurse. Education and practice are called to collaborate in new and more intensive ways. New approaches, as well as refined old approaches must be considered. "Outside of the box thinking," an overused phrase, must be the focus of the day. It is clear that the recruitment game-which is a zero sum game-will not take us where we all need to go in meeting the healthcare needs of the public. We are at a time when we must find ways to put competition aside, work together, and invent new approaches to care delivery.

Quality of care cannot be achieved without appropriate availability of professional nursing and nurses. What are you doing-today-to create a brighter future than projections suggest? If we're not actively finding solutions, we are losing ground.

-Patricia Schroeder RN, MSN, MBA

Journal Editor

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