Russia does not have a chief nurse at the Ministry, indicating the health care system does not recognize the importance of nursing nor nurses' ability to self-organize and manage nursing services. Many nurses, including chief nurses, believe nursing is an extension of medicine. Russian nursing needs practice standards and a standard definition of nursing specialty for independent nursing practice. The Russian health system lacks interdisciplinary cooperation. Many chief nurses are not ready for interdisciplinary care delivery. Generally this nursing generation does not see benefit in reorganizing nursing services nor having new nursing roles. Without recognition of the independent nursing role, they cannot see a basis for cooperation with physicians or other disciplines as such cooperation can only function effectively between independent partners.
There are 32 universities for 89 territories creating access problems to higher education. Currently, the goal of higher nursing education is manager preparation. There is a two-fold need: provide clinically focused advanced education so nurses can implement care innovations and clinical research and upgrade education for students and practicing nurses to gain knowledge about new nursing roles and health care as a system, thus diminishing the nurse as doctor assistant view. Use of new educational methods and electronic technologies will help nurses have access to needed knowledge more easily. Addressing these common concerns, especially through international nurse collaboration, Russian nursing can create a more constructive future.