Thoughts on nursing: where it has been and where it is going.

Where? Where it has been and where it is going? WHEN I AGREED to speak about values for the future of nursing education, I had no idea that this talk would coincide with one of the most intense periods of personal reflection of my life. As I began to put my thoughts together, I realized that I could not keep a scholar's distance from my subject. I could not speak in a third-person voice. In a way, the topic trapped me, because nursing values are at the heart of my own reflections and struggles. Therefore, what I say today reflects both an important time in my own life and, I believe, in the life of nursing itself. My mother died this summer. She was a nurse, and she was my role model in nursing as in so much else. Her professional values and the ways in which she lived them had a profound influence on me. My mother was an inspiration for my daughter as well. During the three years of my mother's illness, Jessica grew to see nursing as her own career choice and recently began her educational journey toward the goal of being a nurse. During this same period, I left my work in public service to resume my academic career, focusing on graduate nursing education. I am sure it is not surprising, then, that I have been thinking a great deal about nursing -- where it has been and where it is going. Thus, this is my framework for today. I have looked back into our shared past as nurses and the exemplar of my mother; where we are today; and the future we are helping to create for nursing, for my daughter, and for those she will serve. As we all know, the nursing profession is replete with what my mother would call "lofty" values. They are described and categorized in a rich literature and taught in our programs. I will not review our scholarship in this area today. Rather, I have selected the five enduring values that I see holding the most promise for our future. These are the values that have shaped the very core of our profession, and, most disturbingly, they may be the values that are in greatest jeopardy today. Let us begin with the value that might appear to be the most obvious of all -- caring. Our thoughts on caring have evolved, from the notion of "taking care of" to the notion of "self-care." My mother's diploma program trained her to take care of patients. My own bachelors program focused on the value of promoting self-care. I do not know what my daughter will learn -- it is hard to tell where our science of caring will take her. However, there is a timeless value of caring that linked my mother and me together, despite our educational and generational differences -- that is, the core value of caring in a committed way about the well-being of people. I believe that this fundamental value is what has allowed nursing to move from the approach of "doing for" to the current focus on enabling and empowering. At their very best, theory, science, and intervention are inspired by and anchored to this core value. Caring about the well-being of people is also what helps make the critical distinction between being of service and being subservient -- it is the intent that gives our tasks and actions meaning. However, unless we educators consistently demonstrate a broad and committed concern for the well-being of people, we risk losing this important value as we move forward. I want to share a story that may illustrate my concern. When the United States was engaged in the Persian Gulf War, news reports included live coverage from the cockpits of fighter planes. I remember seeing one clip in which there was a so-called engagement of an American plane with an Iraqi fighter. I watched and listened with fascination as our pilot "scored." His missile hit the plane of his opponent, sending it down in flames. As this happened, I could hear the elated cheers of the pilot. Similar scenes took place as bombs were expertly "applied" to Baghdad. What chilled me as I watched was that the people who suffered and died in these scenarios were absent -- it all seemed like a game. …