There is a certain paradox within the nursing profession: there have never been as many professional nurses worldwide, education is better, there is more research activity, and the re-sources being allocated to nursing have increased in relative terms; yet, in spite of all of these advances,a number of unfavorable trends are emerging.Over the last decade particularly, there has been a shift in many countries in the public perception of nursing. Nurses are seen less as kind, honest,caring people and more as ambitious, technical experts. Political and fiscal pressures in many western countries are leading the trend to replace registered nurses with health care assistants. Nursing, in some countries, is moving toward a medical-technical expert role with caring relegated to volunteers, family, and health care assistants. The profession’s response to such changes—the impact of technological change, increased globalization, the explosion in scientific innovations, and profound changes in the social order of most societies—is to call for more leaders, better education and a look back to the “good old days” when life was more straightforward.