[This article was originally published in Nursing Leadership, 27(2)]
Nursing is on the verge of a major shift in both its work and its value. Since the time of Nightingale, nurses have been caring for the sick and have developed a growing presence in the acute care environment, where the majority of nurses practise today (McDonald 2010). Yet, the very foundations of nursing are grounded in the community, and nursing is fundamentally driven by the urge to advance and maintain health and prevent illness (Dossey 2005). While many nurses practise in just such pursuits, the majority are employed by hospitals and health systems in the care of the sick. The medical model, which has dominated Western medicine for the majority of the 20th century, has consumed much of the nursing profession's energies and focus (Goldsmith 1993; Haven 1869; Sarma et al. 2012). Medicine's ability to advance treatment modalities and surgical interventions, and to refine drug therapies, has reinforced a predominating tertiary model of medical services and care that has ultimately focused on late-stage, late-engagement interventions and care services (Wilson et al. 2012).
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