This book developes 12 themes (definitions of nursing, nursing knowledge, changing education, changing practice, health care quality, governance, health care reform, health care costs, personal and professional assertiveness, role conflict, cultural diversity and ethics) in a format which informs and encourages students and praticing nurses to think critically about their profession and to help them make intelligent decisions. The text includes the insights and analysis of more than 100 well-known and respected nursing leaders, and each section is concluded with a discussion of international health issues by nursing leaders from other countries. New to this edition is the discussion of essential new topics including the use of nursing assistants, computer-based patient records, shared governance, nursing's agenda for health care reform, hospital work redesign, risk of exposure to blood-borne pathogens, child abuse and advance directives. Current nursing issues are introduced by describing various roles, including staff nursing, nursing research, advanced practice, nursing education and nursing administration.