Is nursing under new management or is it a matter of semantics?

Managed care, in addition to being driven by the hegemony of market concerns, has truly bitten into the clinical hegemony. Nursing has recognized this new order and is attempting to manage the situation with new paradigms before other non-nursing entities do. The issue for nursing has become how to allow the patient to drive the health care delivery system while preparing for change and not fearing nursing's loss of preeminence as a clinical authority in its own right. At the same time, nursing must protect a valued and needed profession.