The culture of nursing engagement: a historical perspective.

Work engagement is key to organizational efforts to retain nurses and mitigate future nursing shortages. In their dual role as caregivers and organization "keepers," nurses may already have the key to creating a culture of engagement. The characteristics and benefits of "engaging" work environments are captured in nursing professional practice models, as evidenced by a quarter century of research on Magnet hospitals and professional practice. An inflection point, providing an opportunity for transformational change in the nursing work environment, may be generated by a critical need for nurses and a call for healthcare delivery system redesign. This article explores this opportunity for change by (1) examining history and nursing's deep roots in professional practice and its journey as an evolving profession and (2) mapping the growth of hospitals and the advancement of nursing's role in the United States, in the context of organizational theory. Finally, it examines the relationship and alignment of goals between the Institute of Medicine's call for system redesign and professional practice model elements, as the potential infrastructure for change. Focusing on the past and today provides us with a beginning framework from which to move expeditiously toward creating a culture of nursing engagement now.