Anthony, Maureen, and Nina Barkell
The United States faces a serious nurse workforce shortage, with estimates of a 20% shortfall by the year 2010. This shortage is thought to be the result of an aging nurse workforce and the movement of women into professions previously dominated by men. There is also a growing dissatisfaction with work conditions that has resulted in nurses leaving the profession. It is critical that professional concerns of nurses are understood. Articles about professional issues are often written by administrators and educators who are removed from the day-to-day issues of practicing nurses. Letters to editors of nursing journals provide a forum for rank-and-file nurses to express their experiences and concerns. The purpose of this qualitative study was to broaden the context for understanding nurses’ professional concerns as voiced through letters to the editor of the American Journal of Nursing from 1900 to 2005. Two issues from each year were randomly selected. Line-by-line analysis was used to code, categorize and analyze the data. Five themes emerged: selfcare versus self-sacrifice, nursing’s emphasis on holistic care; educational and professional preparation; nurse-physician relationships; and the image of the nurse. The recurrent nature of these themes has important implications for nursing education, clinical practice, leadership and research.