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Society has demonstrated a major need for expanded gerontological and geropsychiatric nursing services. Current needs have not yet been met and the call for service will increase throughout the balance of this century and beyond. Social responsiveness demands that nurses: (1) formally establish their clinical authority in care of the aged; (2) lobby for public policy which enables the provider professional to control the practice environment, rather than be controlled by it; (3) improve the educational preparation of nurses to care for the aged; and (4) expand the professions' scientific and research base in this area. The national professional organization of registered nurses, the American Nurses' Association, provides leadership to influence the course of nursing as it continues to provide vital services in a dramatically changing environment.

The author looks at the environment within which nurses work and the services that are being delivered in the health care delivery system. These observations serve as the background for predictions about what nursing must do and become to honor its stewardship to the public. Today's environment is consumer driven, multicultural, and multigenerational. The consumer expects information and reserves the right to make decisions on his or her own behalf. It remains up to nursing to read the cues correctly and use the resources that the consumer brings to the nurse-patient relationship. Nurses have the innate skills to fill this role, turning dependency to self-care. Care in the new millennium is characterized by integrated systems, electronic and computer technology, specialization, and inter/transdisciplinary practice. The transition to more community-based services makes independent decision making essential.

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