Nursing faces a challenging future due to both a projected nursing shortage and changing needs of patients. This will require greater flexibility, an increased knowledge base, and a strengthening of our caring foundations through more evidence-based practices. A nursing taxonomy needs to be determined so that we can support the research of nursing effectiveness through the use of technology. Institutions will need to increase their investments in continuing education, nursing research, and technology to enable more efficient and effective nursing practice. New relationships will need to be forged and new roles designed to maximize the profession's contributions to patient care. Questions that have been asked for decades regarding differentiated nursing practice and entry level into practice will need to be answered. This article describes a large suburban hospital's strategic initiatives that have been designed to meet the nursing challenges of the 21st century.
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