The purpose of this qualitative study was to broaden the context for understanding nurses' professional concerns as voiced through letters to the editor of the American Journal of Nursing from 1900 to 2005. Two issues from each year were randomly selected. Line-by-line analysis was used to code, categorize, and analyze the data. The following five themes emerged: self-care versus self-sacrifice; nursing's emphasis on holistic care; educational and professional preparation; nurse-physician relationships; and the image of the nurse. The recurrent nature of these themes has important implications for nursing education, clinical practice, leadership, and research.