Understanding Nursing Backwards: The Evolution of Nursing as a Profession

Background Becoming a profession, attaining professionalism, and transmitting a professional identity have been ongoing projects within nursing since the 1860s. To gain an understanding of nursing's attention on these three processes, the authors examined them from the context of self-regulation, a key hallmark of professionalism. Method Historical understandings of self-regulatory processes associated with nursing organizational representation, education standards, and regulatory requirements were traced. Mapping these understandings involved searching the literature and websites to outline historical events aligned with formation of professional nursing organizations for education, practice, and regulation, including accreditation and licensure. Results Past opportunities for nursing professional organizations to coordinate and collaborate with respect to self-regulation were missed such that fragmentation exists and persists within the discipline, with multiple organizations overseeing numerous professional and self-regulatory standards and processes. Conclusion Different paths need to be taken to create a future that better serves the discipline and meets its public obligations. [ J Nurs Educ . 2025;64(2):99–108.]