Carper's patterns of knowing in nursing have been consistently cited in the nursing literature since they appeared in 1978. The degree to which they represent nursing knowledge in the mid-1990s is explored, and a major modification is suggested--the addition of a fifth pattern, sociopolitical knowing. The article also suggests modifications to the model for nursing knowledge put forward by Jacobs-Kramer and Chinn to enable this model to be used more effectively as a framework for exploring processes of inquiry into nursing knowledge and practice.

<h4>ABSTRACT</h4> <P>A generational age transformation is occurring in nursing classrooms across the United States. Nurse educators need to prepare for the different values and expectations of students from Generation X and the newly emerging Generation Y in the educational environment. This quantitative, descriptive research begins to examine the preferences and expectations of these generations regarding teaching methods. </P> <h4>AUTHORS</h4> <P>Received: September 29, 2004</P> <P>Accepted: May 20, 2005</P> <P>Dr. Walker and Dr. Elliott are Associate Professors, Dr. Martin, Ms. Norwood, Mr. Mangum, and Dr. Haynie are Assistant Professors, and Ms. White is Instructor, The University of Mississippi Medical Center, School of Nursing, Jackson, Mississippi. </P> <P>Address correspondence to Jean T. Walker, PhD, RN, Associate Professor, The University Mississippi Medical Center, School of Nursing, 2500 North State Street, Jackson, MS 39216; e-mail: <a href="mailto:jwalker@son.umsmed.edu">jwalker@son.umsmed.edu</a>. </P>

We all know great leadership when we see it. Outstanding nurse leaders, guided by a moral compass, simultaneously see the big picture and the consequences at micro level. While policy and politics determine health and nursing practice, most nurses just want to get on with their day job. They carry out decisions made by others but have little say in them, and weak influence or status, although they are increasingly knowledgeable and skilled. In settings where policy decisions are made ‐ parliaments, governments, and boardrooms ‐ nurse leaders are often neither heard nor heeded. This is starting to change. The global Nursing Now campaign is working with the International Council of Nurses, and the World Health Organization, to create and strengthen strategic nursing leadership, as modelled by the International Council of Nurses’ Global Nursing Leadership Institute. A new window of opportunity is opening, with the bicentennial of Florence Nightingale's birth in 2020. Now is the moment!

Global health matters to every nurse everywhere. In this article we outline why. We highlight some important health issues confronting the world today; explore how these issues are being tackled; and consider the implications for nursing. We describe how nurses are making a difference in the challenging contexts, range and complexity of nursing work round the globe, and we conclude with a call to action. Nurses can influence, and become, policy-makers and politicians, and explain to them why the Sustainable Development Goals cannot be reached without strengthening nursing. In this International Year of the Nurse and Midwife, the window of opportunity is open, but it will not stay open for long. Nurses and midwives globally and locally must be ready to jump through it. We ask you to join hands, and join us.