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Increasingly, stakeholders in the health care community are recognizing nursing as key to solving the nation's health care issues. This acknowledgment provides a unique opportunity for nursing to demonstrate leadership by developing clinical nurse leaders to collaborate with the multidisciplinary care team in driving evidence-based, safe quality, cost-effective health care services. One approach for nursing success is standardizing the entry-level education for nurses and developing a uniform professional development and career advancement trajectory with appropriate incentives to encourage participation. A framework to guide and provide scientific evidence of how frontline nurses can be engaged will be paramount. The model for professional excellence and career advancement provides a framework that offers a clear path for researchers to examine variables influencing nurses' professional development and career advancement in a systematic manner. Professional Excellence and Career Advancement in Nursing underscores professional preparedness of a registered nurse as central to leadership development. It also describes the elements that influence nurses' participation in professional development and career advancement under 4 main categories emphasizing mentorship and self-efficacy as essential variables.

Nurse educators have the professional obligation to promote a positive learning environment for all nurses and students in our increasingly diverse society. In order for the future diverse nursing workforce to succeed, nurse educators must embrace diversity in its broader sense. This article discusses the role of nursing educators in promoting a culturally appropriate and inclusive learning environment and provides strategies for meeting the learning needs of an increasingly diverse nursing workforce.

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Internationally Educated Nurses (IENs) are, and will continue to be an important part of the nursing workforce in the United States and throughout the world. They bring a variety of knowledge, skills, and experience to their new practice areas. Although the benefits of their knowledge, skills, and experience can be enhanced by successfully integrating them in the healthcare system of their new country, this may be a challenging process. The transition challenges of IENs are not due to lack of knowledge or clinical skills, but rather are linked to socio-cultural differences, including the structure of the healthcare systems; language subtleties such as use of idioms, acronyms, and abbreviations; and unfamiliarity with their new surroundings. Transitional programs can serve to bridge the practice gaps between IENs’ previous and new experiences. The Hospital of the University of Pennsylvania TIENS (Transitioning Internationally Educated Nurses for Success) Program is presented as a model to help organizations develop programs for IENS to ease their transition into the U.S. healthcare system. This article explains why IENs are a key component of the U.S. nursing workforce now and for the foreseeable future, presents a rationale for transition programs that support successful integration of IENs to the U.S. practice environment, describes a model Transition Program, and advocates for the development of a national policy to standardize transition programs for IENs in the United States.

care services and systems are fundamental to any society, and health status is directly proportional to standard of living. This article analyzes and compares two of the major health care systems of the world, the National Health Service (NHS) of the United Kingdom and the health care system of the United States; it also references community care nursing. Both health care systems were founded on high ideals and have been able to deliver results to a large extent. However, there will always be areas for improvements. These areas are enumerated and analyzed in this article. This analysis can provide some guidance to the best possible health care delivery model. It has been said that the United States has structured health care as a commodity, whereas the United Kingdom has considered it a part of the welfare state. Neither model, however, has fully accomplished the goal of meeting quality, equitable access, and cost effectiveness.

The only thing necessary for the triumph of evil is for good men to do nothing.-Edmund Burke Vestal 1 asserted that being Black is bad for your health and the etiology of disparities in health care is pervasive racism. Disturbingly, African Americans are not the only historically marginalized group in the United States that experience racial injustice in health care. Persistent harm, poorer outcomes, and inequities are associated with the legacy of racism in health care delivery. Historically marginalized groups are socially vulnerable to external stressors due to racial oppression and discriminatory practices. And inequities, creating high socially vulnerable index communities 2,3 comprised primarily Black, Indigenous, people of color (BIPOC), and Latinx. These individuals experience harm through higher health risk exposures, unequal access to health services, and a lack of empowering resources. A body of evidence documents disparities to be rooted in racism and discriminatory health care practices and racism is embedded in structural and systemic inequities. 4,5 After accessing the health care system, BIPOC and Latinx individuals are more likely to receive substandard and/or disparate treatments due to health care providers' conscious and unconscious bias and discriminatory and culturally disconnected health care practices. 6,7

Background: Career advancement programs recognize nurses in the clinical area. Despite the advantages, not all nurses participate in the process. Purpose: To identify factors that influence career advancement among internationally educated nurses (IENs) and those educated in the United States (UENs). Methods: IENs and UENs participated in an online survey, which consisted of 2 open-ended questions asking them to discuss opportunities and barriers that have influenced participation in career advancement. Responses were analyzed using quantitative and qualitative content analysis. Results: Healthy work environment, commitment to advancement in the profession by the individual nurse and availability of external support by family, organization, and/or mentors positively influenced career advancement. Barrier themes were poor work environment, complacency, and competing priorities. Nurses identified limited opportunities to advance in areas of interest as a reason for less participation. Conclusion: Organizational leadership plays an important role in creating environments where nurses can advance their careers.