With the worldwide nursing workforce issues of nursing shortage, inadequate numbers of faculty to teach the students who wish to enter nursing programs, and a major part of the workforce nearing retirement, the 21st century looks fairly pessimistic. This issue of NAQ looks for a favorable change in practice environments, which will enable a more positive future for nursing. As this era of restructuring where and how we work is demonstrated in this issue of NAQ, we are reminded that the future of nursing as a profession is dependent on how and what we teach in nursing education. More than 50% of the nation's faculty in schools of nursing are not doctorally prepared, and even those who are, do not necessarily have preparation to teach. An even greater problem is that of the faculty we have, more than 50% are 55 years old, and soon we will have no one to teach the future nurses.

I am confident that we, as a profession, will have the fortitude to restructure the educational preparation of nurses to meet the demands of the future patient population, which is also aging and living longer. The professional edicts of baccalaureate entry into nursing invoked a devastating schism among nurses that has never been healed. I participated as a leader in speaking to the nursing workforce of the late seventies and early eighties. If we realistically look at the data for new graduates, most are educated in associate degree (AD) programs. In 1997 we had 92,900 newly licensed nurses, 55% were AD prepared: 33% were BSN prepared, and 5% were diploma prepared. Why? Many are second career entries into nursing and do not have the financial resources to attend 4-year programs. So why aren't we developing more innovative programs that articulate the nurse into continuing on to the next degree, with no penalty or repetition of nursing practice and course work taken in the associate degree or diploma programs? Then we would encourage the nurse to gain more knowledge for better patient care.

But, let us look at what the new practice environment has to offer through the editorial leadership of Joan Trofino, EdD, CNAA, FAAN, who is guest editor for this timely issue. Dr. Trofino is an experienced and innovative nurse executive, author, speaker, and educator with a passion to improve nursing practice outcomes through transformational leadership and professional models of nursing that provide professional autonomy and job satisfaction to staff nurses. A lifelong east-coast resident, in 1999 Joan and her husband followed the sun to Las Vegas, Nevada, where she joined the faculty of the University of Nevada, Las Vegas, as an associate professor. She has developed certificate programs in nursing case management and nursing administration and continues to pursue the development of strategies for implementation of transformational leadership and innovative practice models through research, publications, and speaking.

Maybe, in my lifetime, we will see a reuniting of nursing education and practice with those who teach being based in a solid practice arena. Yes, we need those who focus on education and research, but we also need to have "teaching practitioners" who truly know the clinical and organizational setting in which students are learning. Although I am concerned about future preparation of nurses and those who teach them, I would be remiss in not giving attention to the lack of solid programs for those who will be the future leaders and administrators in these diverse practice arenas. We all need a change in attitude, and we might have to give up our sacred spaces, whatever they might be. Whatever supply of nurses is available will have to be thought of differently. Clinical decision-making activities surely have priority over nonnursing tasks and activities. A misuse of a nurse is a prostitution of the individual. This applies to nursing faculty, who have far too many nonnursing activities to do, which deplete their energies for teaching nursing. Support systems to uphold the priority work of the nurse are essential to our future. With limited numbers of caregiving nurses and teachers of nurses, talents must be used wisely.

Nurses throughout the country are pleading to take the stress out of the work environment. A recent study conducted by NurseWeek and the American Organization of Nurse Executives revealed that this is the number one factor why nurses leave nursing or change jobs. They cited the stress as caused by the nursing shortage having a negative impact on patient care. Time is inadequate for collaboration with teams or to carry out doctors' orders and limits the ability of nurses to maintain patient safety and time to be able to observe and detect patient complications early. Nurses simply do not have enough time for their patients. When asked what was needed to retain nurses, 58% indicated higher salaries, 50% indicated better staffing, and 48% indicated more respect from management.

It would seem with all these problems so evident in the media that nurses don't like being a nurse. Nurses like nursing and would recommend nursing as a career to others, and that is good news. So many potential students want to become nurses, but there is no room for them in our schools of nursing both baccalaureate and associate degree programs. We need every kind of nurse for the future health, welfare, and safety of our nation. Look at your staff nurses giving care today, and see that they are doing excellent jobs, despite the stressful environment.

Whatever the future brings, we know we have the public on our side, because we are among the most trusted professions. The advertising campaign initiated by Johnson & Johnson during the Olympics has spearheaded a remarkable awareness of the need for nurses. It also has shown to the public who nurses are and the various kinds of work we do throughout our communities, and not only in hospitals as most people thought. We also are the focus of many state legislatures and funding initiatives at the federal level. Just imagine the impact we would have if we ever got our collective act together. There is so much diversity among us, even in our 100 plus organizations. Why should anyone listen to us when we can't seem to agree on whom we are and what we need to secure a nurse workforce for the future of health care?

Nursing has established a new level of professionalism, and our world is changing into a very high technology care system. As well, more sophisticated consumers know more than we do about their needs and care. The computer has afforded us a unique opportunity to streamline everything but the care of people in a most sensitive and humane way in this complex care system. No matter what the future brings us, we are the life force of health care. We have only one direction to travel as we set our sights for the future and that is to keep our roots of caring strong as we branch into new ventures of nursing practice and education.