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This paper develops an argument that the choice of occupational strategy for nursing in the last century still has implications today. Nurses have retained a hierarchical principle of organization and have, albeit reluctantly, retained an in-service pattern of training. They have been concerned about recurrent shortages of nurses and this has influenced modes of development. These factors contribute to a continuity which is apparent in both ‘Salmon’ and ‘Briggs’, the two most influential reports on British nursing in recent decades. Such continuities in nursing development tend to preclude the raising of fundamental questions about the nature of nursing work and the manner in which it might be changed.