As my career in nursing has progressed, I have enjoyed the exploration of historical nursing. I have been enlightened by reading about nursing in its beginnings and throughout the 20th century. This has become a hobby of mine. My mom, who earned her BSN from the University of Colorado in 1949, as well as other friends and colleagues, have helped me amass boxes of nursing memorabilia that I would like to direct to a "National Museum of Nursing" (as soon as one exists).

Through the years, it has been interesting to look at all the changes that have confronted health care. Yet nursing has continued to hold on to some things that do not necessarily serve us well. I look at how we practice and manage nursing today and realize that some aspects about nursing are long overdue for the discard box.

For example, can we please ditch the old 7 a.m., 3 p.m. and 11 p.m. shift divisions? Even when we started with 12-hour shifts, we just fit them into the existing scheduling pattern beginning at 7 a.m. As the issues of an aging nursing workforce are acknowledged, I have been giving this considerable thought. What if we moved the "day" shift to 6 a.m., then scheduled four-hour blocks around the clock? Nurses could work variable shifts from four to 12 hours in length. Staffing levels could be adjusted more frequently to respond to patient scheduling of surgery and procedures.

Computers could coordinate the meshing of 8s and 12s easily, and nurses could more easily blend their work schedules with parenting and the demands of life. Shift differentials could be attached to the four-hour blocks based on demand. If you want to work between 10 a.m. and 2 p.m., fine, we'd love to have you. If you want to work 2 to 6 a.m., we will make it worth your while. The bottom line is that it seems to make more sense and be more responsive to the needs of nurses today.

Here's another one: We could make a lot more room for students in our clinical settings if we did not structure student rotations in such a rigid manner. Patients theoretically are available to students 24 hours a day, seven days a week. Yes, even Mondays during faculty meetings. Perhaps a week or two of continuous clinicals makes more sense than one or two four- to six-hour clinical visits a week in the span of five to eight weeks. We need to find ways for students to taste real nursing long before they don a cap and gown.

OK, now this may get a few people's dander up, but how about you and 20 or 30 other nurses forming a professional corporation to create your own profit-sharing plan and a customized benefit and retirement plan? Create a compensation program for you and your partners, then find the best hospital at which you would like to work. Negotiate yourselves a great deal with financial incentives for quality and service. This means you cut out the middle person (union or registry) and simply make your own deal. While perhaps this idea is not for every nurse, I can think of more than a few who would relish the opportunity.

Even though you may think I have lost my mind, my point here is that there is an urgent need for us to look at our options differently and create our own future. Do not let our old habits and rituals keep us from exploring the future. Do not be one who says, "Oh, we couldn't do that" or "That wouldn't work."

The real question is, why not?

Discuss this and other topics with your colleagues at www.nurseweek.com/rnvillage.