Implications of the use of unlicensed personnel: a nursing perspective.

Many nurses express a tremendous sense of frustration as once again they believe that individuals outside of the nursing profession are moving ahead to dictate the future of nursing practice. A realistic viewpoint reveals that throughout the evolution of the nursing shortage, nurses have not identified effective strategies to deal with manpower problems. Patient needs continue to grow in their complexity and the shortage of licensed nurses to meet those needs remains unresolved. The critical level of our current situation and the proposal of alternatives by nonnursing groups and individuals have given nursing the incentive to take action. Regardless of the motivating force, now is the time for nurses, individually and collectively, to take an active role in addressing the realities of the nursing shortage. All viable alternatives and strategies need to be explored. Proposals for the use of unlicensed nursing personnel may offer acceptable short- and long-term means of resolving current problems. These new ideas and ways of thinking about nursing practice should not be cast aside, but neither should they be implemented without the involvement of nurses. Every nurse must be committed to examining such alternatives, understanding the implications for nursing practice, and supporting the model that best reflects nursing's vision of the future in maintaining high-quality patient care.