As I visit nurses throughout the Mountain West region, I never cease to be amazed at their resilience and determination to continue practicing nursing in an era of the most severe nursing shortage. Are we having difficulty recruiting people into nursing or are we not ready to educate those who want to enter nursing? We know many nurses are discouraged since the downsizing and layoffs in the '80s and '90s, and some have turned to other careers.

The challenges for nurses and health care have become increasingly complex with business, law, politics and economics as the major driving forces-not the essence of nursing practice: patient care. The money/politics of the Clinton health care reform attempts have affected the nursing profession in an adverse way. As a Medicare recipient in an HMO plan, I am surrounded by less healthy seniors, so I know the patient care shortfalls. The layoffs of nurses occurred as HMOs were formed and mergers between hospitals and business ventures took place.

Today, with the economic downturn, many are choosing nursing as a second career and others who left nursing are returning. The politics of health care have contributed to the shortage of nurses in practice and education. Can and should politics be a major force in re-energizing nursing education and practice? The U.S. House of Representatives and Senate have been working on passing the Nurse Reinvestment Act (HR 3487 and S 1864).

Nursing as a profession is seriously shortchanged in the Nurse Reinvestment Act. Medical education receives $9 billion a year in federal funds while nursing receives $100 million. More than 5,700 qualified students were denied admission to nursing schools because of a lack of faculty to teach nursing. Fifty percent of the faculty are not doctorally prepared and faculty in many schools of nursing have no preparation in teaching. Yes, enrollment in entry-level baccalaureate programs increased last fall, but the number of students in the pipeline is still insufficient to meet the projected demand for a million new nurses during the next 10 years. We will see what the response is to the various legislative actions to address the nursing shortage and how it plays out.

I do know that if we ever get our collective act together, we can make a difference, but we never seem to agree, negotiate and concede our differences for the larger effort of the entire nursing profession. So we continue in our individual bailiwicks, such as the lack of cohesiveness for all of nursing education, including associate degree, diploma and practical nursing along with the baccalaureate degree, in our legislative politics.

We have beaten the baccalaureate-entry-into-nursing drum for too long. We need every kind of nurse for the future health, welfare and safety of our nation. Look at the staff nurses giving care today, and you'll see they are doing an excellent job with diploma or associate degree preparation. In 1997, we had 92,900 newly licensed nurses. Fifty-five percent were AD prepared, 33 percent BSN and 5 percent diploma. We want to recruit all qualified individuals into nursing. We could be so politically powerful as the largest health care provider workforce, if only we would unite.

To paraphrase Walt Kelly's comic strip character, Pogo: "We have met the enemy and it is us.