By monitoring the major social, economic, and political forces affecting health care, one can predict how these forces may impact the role of occupational health nurses. 2. Nursing can and must chart its own course in the midst of these social, economic, and political changes. 3. Changes which have major implications for occupational health nurses are: health care needs, cost containment, multi-hospital chains, alternative approaches to health care, the workplace, ethical concerns, biomedical technology, nursing shortage, and oversupply of physicians. 4. Nursing implications can also be drawn in the areas of autonomy, political skills, and education. Active involvement and a desire to shape professional change and the future of nursing are keys.