PURPOSE:This research explored the voices of nurses in contemporary times and unraveled nurses' situations for the purpose of generating a substantive theory to guide and refine nursing practice.
METHOD:The  grounded  theory  methodology  of  qualitative  research  was  utilized patterned mainly in the works of Glaser and Strauss. Criterion sampling was used in the selection of 31 participants and the basis for selection was employment in the hospital, academe, and community and being part of different levels of management (nurses from top, middle, first, and staff levels). Theoretical sampling also informed the final list of study informants and was conducted by snowballing that consisted of 10  participants.  The  data  gathering  procedures  included  the  combination  of interviews, observations, and document and literature analysis.
FINDINGS:The study revealed three major themes: (1)nursing as a profession,(2)Nightingale in the 21st century:life of a nurse in today's context,and (3)the challenges and opportunities to quality of nursing care.
CONCLUSION:Nursing   is   dynamic,   complex,   diverse,   expanding   and   highly contextualized. Nursing is a field that grows with time and nurses are adaptive to the widening demands of their profession. The goal of nursing remains a Nightingale's pledge  and  an  endeavor  amidst  nurses'  constant  battle  between  motivations  and challenges.  The  Integrated  Systems  Approach  to  Nursing  Care  model  was developed to be used as a framework for sound decision-making in nursing practice.Nursing,  nightingale  and  beyond  is  a  picture  of  struggles,  success,  and  potential solutions to the predicaments surrounding the nursing profession.
CLINICAL RELEVANCE:The  study  has  potential  to  help  health  managers  and  policy implementers in providing assistance to nurses in enhancing their knowledge and skills, increasing their emotional and psychological resilience and in revitalizing their commitment to the nursing profession.It may also aid in  the  reconsideration  of institutional policies and set-ups toward collaborative and enabling work environment. In addition, it may serve as a guide in creating proactive health governance, in facilitating nurses' work motivation  and  retention  through  the  due  implementation  of nursing law and other statures for the welfare of health workers, in providing additional plantilla position for nurses in the country, and in increasing funding for health programs to create more learning and practice environment for nurses. Lastly, the utilization of the theory  can  be  used  in  developing  a  more  responsive  nursing practice.