Most of us can remember nursing 20 years ago. We remember why there was a mass exodus from the profession: low pay for workload, undesirable shift hours, working on weekends, poor treatment, and the availability of other roles for nurses outside direct patient care. Add to this the aging of nurses, and a crisis developed.

Now we're trying to teach customer service to an untrusting workforce and support a rising legal liability. How do we recover the spirit of nursing? Can you imagine an ICU trauma patient, who survives injuries, but is left blind due to lack of eye care by nurses? This is just one of many realities we must identify, teach in nursing school, add to protocols, and include in unit-specific orientation, for those nurses who may not have been taught that nursing practice includes independent nursing care based on the nursing process.

How we determine readiness to provide direct care must be reassured without assumptions. We quickly learned the need to orient to documentation and technology. We now must add liability, risk, the spirit of nursing practice, the nursing process, customer service, and a multidisciplinary team concept.