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Nursing care: professional progress.

Nursing in the United Kingdom is currently taking decisions that will enable it to attain mature professional practice--or fail to. It is argued that professions are designed to serve vulnerable people competently and that competent nursing is not reliably achieved by the untrained or those in training. Competent nursing requires qualified nurses who can work in partnership with patients and help them manage their own health and an educational system which facilitates both the initial and continuing mastery of nursing knowledge and skills. Aspects of learning, including the clinical environment, are discussed. The contractual relationship between nurses and doctors is discussed and the need to develop competence in inter-professional work. Developments in clinical nursing since 1970 are reviewed including beliefs about nursing, models for practice, the organization of nursing, the development of clinical research and the demand for new knowledge and skills from qualified nurses. It is concluded that much of the essential thinking about the nature of professional nursing has been successfully achieved and that nursing in the United Kingdom should now take the decisions and actions to achieve a professional education and professional nursing practice.