Rolled into general health services, an invisible part of a hospital room rate, nursing is overdue for its own professional identity. One hallmark of a true profession is universal use of a specialized vocabulary by members. Standardized nursing terminologies provide a consistent basis for communicating the unique contributions of nursing to direct patient care and to research. Nursing has the dubious advantage of having seven recognized term sets serving numerous purposes but undermining the goal of consistency, key to widespread recognition and acceptance. Adoption of a single vocabulary appears doubtful, though two stand out for active support, currency and free availability. Widespread use of a standardized nursing terminology will come with time, consistent use, incorporation into nursing education and reference in professional health care and nursing journals. Cross mappings to important medical terminologies are necessary for interoperability and use in health and nursing informatics research.