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Psychiatric nursing in an era of change.

1. A critically important question we must ask ourselves is: Are we equipped to handle the challenges and fully exploit the new opportunities that are ahead? To do this, we must manage change more effectively. 2. We need to restructure our whole system of education. The time has come to settle the issue of entry into practice and to establish one statutorily defined nurse that everybody will know as the American nurse, without any need to qualify the definitions. 3. Managing change and managing to change require effective leadership; that is, the capability to monitor, facilitate, and enhance communication and negotiation across boundaries. Boundaries include those of role, race, age, social status, sexual orientation, and other characteristics that differentiate. These characteristics, however, enrich and liven the discourse among us.