Expanding our Nightingale horizon: seven recommendations for 21st-century nursing practice.

Today's global health problems may seem insurmountable. Antibiotic-resistant microbes are increasing, and more economic, environmental, and social factors are affecting health. Health care costs keep rising. Hot politics and the chronic global nursing shortages all threaten the future of health care delivery. Also, diseases in many war-torn regions clearly place all humanity's health at risk. How can nurses possibly address these larger "global" challenges? To consider this question--and what nurses might do to contribute solutions--this article looks at the wider horizon of health care problems and how Florence Nightingale faced similar bigger health issues in her time. The health problems of today require renewed vision and the participation of committed citizens who take an active role in the promotion of human health-both locally and globally. By learning more about Nightingale's legacy, nurses actually attain a significant breadth and depth of knowledge and skill to share in these endeavors. Based on a review of Nightingale's responses and insights, seven recommendations are shared for consideration. While continuing the practices we have established, nurses can also create new, innovative, and relevant practice arenas, becoming--like she did in her time--global change agents for the sake of human health. From her broader viewpoint, Nightingale passed her global vision to us in order to extend our own horizons of possibility: remembering who we are, considering what we can do, who we care for, and why.