In the first of two articles, Alison Kitson outlines the fundamental elements of nursing, and how they should be protected and communicated. She argues that having the ability to care for the patient as a whole person is the essence of good nursing practice, in which a range of environmental and organisational conditions prevail, and over which the nurse must be in control. Similarly, basic observation and practical skills in traditional nursing must be evident before nurses can be assured they have met basic needs. She considers the effect of health care and other changes on nursing, along with strategies for ensuring that the essence of nursing is protected. The second article will appear next week.