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Immune surveillance of the brain is regulated by resident non-neuronal cells and the blood-brain barrier.1 Dys-regulation of immunosurveillance is a hallmark feature of several diseases2–5 including brain tumors6 that interact with and rely heavily on immune cells,7 suggesting that disrupting the neuroimmunology of tumors could slow their progression. Yet few tools are available to control brain immunology in vivo with local precision, and fewer yet are used for therapeutic intervention. 2 Here, we propose engineered cytokines as a neuroimmune-modulation platform. We demonstrate that the residence time of cytokines in the brain can be tuned by binding them to the extracellular matrix or synthetic scaffolds. We then show that the aluminum hydroxide adjuvant (alum) is retained in the brain >2 weeks. Tethering of inflammatory cytokines such as interleukins (IL) 2 and 12 to alum yields extended neuroinflammation and brain immunosurveillance after intracranial administration, while avoiding systemic toxicity. In mouse models of both immunologically hot and cold brain tumors, the intracranial deposition of alum-tethered cytokines causes significant delay in tumor progression. RNA profiling reveals that engineered cytokines engage both innate and adaptive immunity in the brain. These findings suggest that engineered cytokines can reprogram brain immunosurveillance, informing the development of future therapies for neuroimmune diseases.

A history of discrimination against racial and religious minorities at the University of Minnesota, maintained by powerful administrators who were subsequently honored with named buildings, was reflected in acts and patterns of racism in admissions and housing, within the School of Nursing. This article recounts well-documented examples of racial bias, particularly the story of Frances Mchie Rains, the first nurse of color to graduate from the University of Minnesota School of Nursing and a pioneer in overcoming racial barriers.

© 2020 by the authors., Age-related decoupling of auditory nerve fibers from hair cells (cochlear synaptopathy) has been linked to temporal processing deficits and impaired speech recognition performance. The link between both is elusive. We have previously demonstrated that cochlear synaptopathy, if centrally compensated through enhanced input/output function (neural gain), can prevent age-dependent temporal discrimination loss. It was also found that central neural gain after acoustic trauma was linked to hippocampal long-term potentiation (LTP) and upregulation of brain-derived neurotrophic factor (BDNF). Using middle-aged and old BDNF-live-exon-visualization (BLEV) reporter mice we analyzed the specific recruitment of LTP and the activity-dependent usage of Bdnf exon-IV and -VI promoters relative to cochlear synaptopathy and central (temporal) processing. For both groups, specimens with higher or lower ability to centrally compensate diminished auditory nerve activity were found. Strikingly, low compensating mouse groups differed from high compensators by prolonged auditory nerve latency. Moreover, low compensators exhibited attenuated responses to amplitude-modulated tones, and a reduction of hippocampal LTP and Bdnf transcript levels in comparison to high compensators. These results suggest that latency of auditory nerve processing, recruitment of hippocampal LTP, and Bdnf transcription, are key factors for age-dependent auditory processing deficits, rather than cochlear synaptopathy or aging per se., We acknowledge grants from the Deutsche Forschungsgemeinschaft FOR 2060 project RU 713/3-2 (W.S., L.R., D.M.), Projektnummer 335549539/GRK 2381 (P.M.), SPP 1608 RU 316/12-1 (L.R.), and KN 316/12-1 (M.M, M.K.), Siegmund Kiener Stiftung (D.S.) and BFU2016-76580-P (T.S).

This essay speaks to the legacy value of nurses' caring for all people, no matter how they feel about the person's values or lifestyle, including the current issues around gender identity and sexual orientation. This legacy is deeply imbedded in the moral ethics of nursing and supports the proposition that if there isn't caring, it isn't nursing.

The compendium of extraordinary operational skills required, the lack of recognition about the exact nature of nursing work, and deeply imbedded negative mind-sets result in staff nurses experiencing guilt and anger rather than the satisfaction of knowing they made a difference in someone’s life because of the nursing care they gave. A change of mind-set from entitlement thinking to entrepreneurial thinking, with an emphasis on maximizing available resources, will empower nurses to understand that they have the right and the responsibility to decide what to do and what not to do when there is more work to do than time available.

To explore the effect of "Primary Nursing" on nursing-sensitive patient outcomes, staff-related outcomes and organisation-related outcomes.Primary nursing is one example of a care pattern that has recently been implemented in many countries.Before-after study.This study was conducted in an Italian hospital. We observed patient-related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of primary nursing and in 3,169 inpatients after its implementation. Staff-related outcomes (nursing competence and diagnostic thinking) and organisation-related outcomes (empowerment and team climate) were collected from 369 nurses. From a subgroup of inpatients, we collected data regarding their satisfaction with the care provided.After the implementation of primary nursing, some nursing competencies and diagnostic thinking were improved, so were organisation-related outcomes. Our data showed that the number of inpatients with urinary catheter infections (5.5% vs. 4.3%) and venous catheter infections (peripheral: 2.2% vs. 1%; central: 5.6% vs. 1%) was significantly decreased; also, the numbers of falls (2.4% vs. 1.9%) and pressure ulcers (4.8% vs. 4%) decreased, although these decreases were not statistically significant. Overall, the implementation of primary nursing increased patient satisfaction with nursing care (193.57 vs. 210.21).Primary nursing improved staff-related outcomes, nursing-sensitive patient outcomes and organisation outcomes.Our results show that primary nursing has the potential to positively impact on inpatients, nurses and organisations. Moreover, the implementation of this care pattern is feasible.

Systemic corticosteroids have been the mainstay of treatment for various hearing disorders for more than 30 yr. Accordingly, numerous studies have described glucocorticoids (GCs) and stressors to be protective in the auditory organ against damage associated with a variety of health conditions, including noise exposure. Conversely, stressors are also predictive risk factors for hearing disorders. How both of these contrasting stress actions are linked has remained elusive. Here, we demonstrate that higher corticosterone levels during acoustic trauma in female rats is highly correlated with a decline of auditory fiber responses in high-frequency cochlear regions, and that hearing thresholds and the outer hair cell functions (distortion products of otoacoustic emissions) are left unaffected. Moreover, when GC receptor (GR) or mineralocorticoid receptor (MR) activation was antagonized by mifepristone or spironolactone, respectively, GR, but not MR, inhibition significantly and permanently attenuated trauma-induced effects on auditory fiber responses, including inner hair cell ribbon loss and related reductions of early and late auditory brainstem responses. These findings strongly imply that higher corticosterone stress levels profoundly impair auditory nerve processing, which may influence central auditory acuity. These changes are likely GR mediated as they are prevented by mifepristone.-Singer, W., Kasini, K., Manthey, M., Eckert, P., Armbruster, P., Vogt, M. A., Jaumann, M., Dotta, M., Yamahara, K., Harasztosi, C., Zimmermann, U., Knipper, M., Rüttiger, L. The glucocorticoid antagonist mifepristone attenuates sound-induced long-term deficits in auditory nerve response and central auditory processing in female rats.

Substance use disorder is a serious problem in nursing that is often invisible and not well understood or well handled. It tears at the social contract between nursing and society and disrupts the trust so essential to that contract. The American Nurses Association Code of Ethics contains clear language about a nurse’s duty to take action to protect patients and to ensure the impaired nurse gets assistance. Specific interpretive statements provide useful guidance in dealing with this problem.

Marie Manthey, founder of Creative Health Care Management, interviews Parmeeth “Par” Atwal, whose first career included representing the National Association of Community Health Centers as an attorney, editor of a major health policy journal, and a senior position in the Office of the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. He then became an active participant in the health care system, earning a bachelor of science in nursing, working in cardiac critical care, and now becoming a family nurse practitioner. He shares his perspective on the divide between health care policy and regulation, and the delivery of direct patient care.

Communication and collaboration skills are important now among health professionals and are likely to become absolutely vital in the future. Health care team efficiency will be the hallmark of clinical and financial success as care delivery systems continue to evolve. Teaching these skills to beginning health professions students, with reinforcement throughout their education, is an exciting development in academia.

Beth Beaty discusses with Marie Manthey and Joanne Disch, organizers of the recent Summit of Sages, their efforts to bring nurses from around the world together to think and talk about social justice. They share their belief that social justice is a part of the fabric of nursing. A Summit of Sages encouraged participants to a higher level of involvement in their communities. Marie and Joanne hope their example will lead to expanded cooperation between businesses and academic institutions. Beth: We recently completed a very successful Summit of Sages, our second, at the University of Minnesota School of Nursing. Let's start by discussing the history of the Summit of Sages. Where did the idea for this meeting of the minds come from? Marie: I think it was Joanne's idea first-bringing a group of people together to talk about their contributions. Joanne: I was teaching undergraduates in the leadership course in the School of Nursing in 2002 or so, and I mentioned a person I had worked with who really influenced my thinking: Claire Fagan, who is the former dean of the School of Nursing at the University of Pennsylvania and was actually the first woman president of an Ivy League university. My students had no idea who she was, and I was appalled. I really felt we needed to have an event that recognizes phenomenal nursing leaders and introduces them to the younger generation of nurses. I thought about creating a library of nursing leaders, and then realized how neat it would be to bring all these people together. Then Marie and I talked about the idea of a Summit of Sages around the topic of nursing leadership, and of course it was logical that Marie be one of the sages for that first conference: She has certainly influenced my thinking as well as that of literally hundreds of thousands of nurses. So that is the origin of the Summit of Sages: the idea that we have to help the younger generation of nurses learn about the thinking of these wise women and men. Marie: I think the idea of calling it a summit was just such a good word; it was the right word choice because we both knew right from the very beginning that we wanted it to be a gathering of people from all different aspects of nursing, all different walks of nursing, all different types of positions. We didn't want it to be just a presentation of leaders talking at an audience. We wanted it to be a gathering of specific leaders talking about leadership, so calling it a summit was the absolute right choice. It's unique compared to the typical conferences within our profession. Beth: I am also interested in how you came up with the idea of sages. Was there special meaning for that specific term? Joanne: Well, a sage is a wise person. I guess we liked the alliteration of Summit of Sages. Sue Ellen Pinkerton, PhD, RN, FAAN, an independent nursing consultant who was cochair of the first summit, was also very involved in these decisions. The idea of the first conference was that it would be these nursing leaders who were known by name-internationally known. We wanted a word to connote wisdom, not just being well-known. That is, having wisdom to share. As Marie said, it wasn't meant to be presentations but rather reflections. Our most recent summit had a deliberate twist on the idea of sages because our speakers weren't all nurses, nor were they internationally known, but they exemplified people right next to us on a daily basis who are sages. With the topic of social justice, we really showed that there are people who walk among us who are wise men and women. Beth: How did you choose your first group of sages? And then compare that to how you chose the group for the second summit. Joanne: The processes were very different. The first group was chosen mostly by Sue Ellen Pinkerton and me. We were planning a summit-we weren't using the word sages yet-and there were these people who just stood out. There certainly were other influential people we could have selected. …

Reflective practice is an approach in which you look at events from your practice and analyze them. It involves thinking about your work in a particular structured way, sometimes with the help of a reflective journal, log or diary. . . . Reflective practice requires a conscious effort on your part . . . It is a particular way of thinking about situations, analyzing them and learning from them. You then test out what you learned by building it into your practice. -(Vaughan and Manthey, 2001) Marie Manthey: Why did reflective practice become so well developed in the U.K.? What was the main impetus for its development? Barbara Vaughan: I think it was the culmination of a number of different factors, including the following: * The move to higher education and the thirst for a bett er understanding of the knowledge base for practice; * The work we were starting on nurse-led services, which was driven pragmatically and professionally; * The development of new paradigm research and the inadequacy of traditional research methods to explore "soft " subjects; * The development of nursing as a research-based discipline; * The work of Donald Schon, on the high, hard ground of certainty in the academic ivory tower and the soft , messy ground of practice; * The calling to account of clinicians and the development of clinical supervision; * The lecturer-practitioner (LP) movement; and * The Nursing Development Units movement-that is, the governmentsponsored initiative to support nursing's exploration of new and innovative ways of developing their contribution to patient care. In addition, the clinical supervision development, which is closely linked to reflective practice, got support from the government, which also helped (though this did not always mean that the development was properly understood). Manthey: Was it linked to the tutor-practitioner movement, or were these separate developments? Vaughan: The drive behind the lecturer-practitioner development was primarily the inadequate educational system and the dichotomy between teaching and practice. The two had moved years apart and what was taught was certainly not what was practiced. As we were developing the curriculum along a new line, and working through the LP role, a colleague in social policy introduced me to Donald Schon's work. We used his principle of "action in learning" as a basis for the curriculum philosophy. It had been used in architecture, teaching, and other areas, but not much in health. It seemed to take offfrom there, but was linked with the other things I mentioned. Manthey: Have you seen reflective practice strengthen care delivery models? What impact does it have on the knowledge base for practice? Vaughan: Have no doubts that when used well, it influences clinical care. . . . However, it is critical that it is well managed and not used in either a punitive way or as a means of cathartic expression. It should be a true learning position for all concerned. When we are helping people to develop reflective skills, I usually use the four domains of knowledge that Barbara Carper first wrote about in 1972. Her work is widely used in books on nursing knowledge now. The way it has developed is to take a critical incident, as Patricia Benner may use an exemplar, and think back to what knowledge was drawn on from an empirical, personal, aesthetic, and moral basis. …

"I think that if the Christian Scientists had more science and the doctors had more Christianity it wouldn't make any difference which ye called in-if ye had a good nurse" (Dunne, 1901, p. 9). Finley Peter Dunne's "Mr. Dooley" was a Chicago newspaper column that frequently satirized society and politics in the late 19th century. This quote of his reflects the already changing perception of the importance of good nursing, thankfully leaving the image of Sairy Gamp, the slatternly nurse from Charles Dickens's Martin Chuzzlewit, far behind. In Education for Nursing, James Gray (1960) states that this change in att itude can be att ributed to the revolution in caring for ill people that was sparked by Florence Nightingale. Learning from her success in minimizing mortality among wounded soldiers in the Crimean War and her subsequent reform efforts in England, pioneering nursing professionals in America established organized education programs for nurses. Supported by Nightingale's frequent correspondence, crusaders such as Isabel Hampton Robb, Lavinia Dock, Adelaide Nutt ing, and Lillian Wald modeled their professional lives aft er her example. Nevertheless, the medical establishment did not agree that nurses should be educated. In fact, information about signs and symptoms of illness and the effects of various drugs was censored from nursing programs. Into this arena came Richard Olding Beard. He was a "tiny man with piercing black eyes, pink cheeks, a crisp style of utt erance, and an authoritative manner" (Gray, 1960, p. 16). As the chairman of the physiology department at the University of Minnesota School of Medicine, there is litt le obvious reason why he should become the champion of university education for nurses, but that is exactly what he did. In 1909, when the university leadership and the medical academic community were struggling to find legislative and financial support for the first university hospital building, Beard was able to create the first university-based nursing education program in the world. The pioneering nurse leaders of the time greatly appreciated Beard's insight, passion for nursing, and ability to achieve breakthroughs. While other leaders in medicine were working to restrict the education of nurses, and hospital leaders were exploiting student nurses as a source of cheap labor, Beard's intense focus on the need for higher education for nurses was breaking through considerable resistance. When Beard announced at a joint meeting of the Society of Superintendents of Training Schools for Nurses and the Associated Alumnae of the United States and Canada that the University of Minnesota would open the first program for collegiate-level education of nurses, "while the audience rose to its feet in glad acclaim of the good news," Isabel Hampton Robb sat and wept "tears that came from a deep gratitude." She told Dr. Beard that "the dream of her life" was about to be fulfilled (Gray, 1960, p. 19). Beard's support of nursing education never wavered. In the 1920s a new debate raged about nursing education. Concerned about the high cost of private duty nursing, Dr. Charles Mayo initiated a campaign for two levels of nursing education. He wrote an article that was published in the popular press titled "Wanted-100,000 Girls for Sub-Nurses." Nursing leaders saw this initiative as an immediate and powerful danger. Nicknamed the "Nestor of Nurses" by his colleagues, Beard responded vigorously and eloquently in an article also published in the popular press. Not that current education programs (other than the University of Minnesota's) were necessarily well-run or easily defended. In a speech before the Central Council of Nursing Education in 1922, Beard described "with complete knowledge and no admonition, the way of the old-fashioned 'institutional' schools of nursing" where "pupil nurses were exploited for the benefit of the hospitals." He commented that the length of the course was determined not by the students' needs but by the hospitals' needs. …

Richard Olding Beard, founder of the University of Minnesota School of Nursing, was a passionate and eloquent champion of educating rather than simply training nurses and of the contributions professional nurses make to social justice by improving the health care of society. The issues he wrote and spoke about are the same issues raised in contemporary discussions of entry-level preparation for nursing. "Is anything the same?" asked a group of amateur historians reviewing evidence of enormous changes in nursing practice over the years: pictures of wards full of iron lung patients in the polio epidemics of the 1940s and 1950s, documents about smallpox and cholera epidemics and their impact on nursing, and the risky reality of tuberculosis nursing in past decades-none of these are on the radar screens of nurses today. As we pondered this question, we came across an article titled "The Educated Spirit of the Nurse," written by Richard Olding Beard (Beard, 1922a) It seemed that this article might answer our question, and I am delighted to say I believe it does just that. Richard Olding Beard founded the University of Minnesota School of Nursing in 1909. He was a remarkable physician whose foresight about the profession of nursing was practically clairvoyant. His interest in nursing education began a few years earlier when he met Isabel Hampton, later Isabel Robb, at Johns Hopkins. Her passion about the importance of educating rather than simply training nurses convinced him that nursing should be taught in an academic rather than a hospital setting. By 1908, he had persuaded both the University of Minnesota School of Medicine and the Board of Regents that the university should open the first school of nursing in an academic setting. By 1909, the University of Minnesota School for Nurses (the name by which it was known until 1920) was established. To the best of our knowledge, it is the first continuously operating nursing school started in an academic institution anywhere in the world. Beard wrote prolifically and eloquently and left an amazing body of work that provides deep insight into his wisdom and passion about health, about the role of women in the world, and about the impact nursing can make in advancing social justice. The significance of this particular article lies in his vision of the characteristics and qualities nurses should have and how these qualities should be advanced through the educational process. In the opening paragraph, he supposes that a cross section of nurses is not so very diff erent from a cross section of any other "calling" of women and men, including teachers or physicians. Then he says, "I wish it were. I have a feeling that it ought to be. The participants in a calling so distinctive as that of nursing should have a quality all their own" (p. 239). There are three points of emphasis in Beard's article: the principle of intelligent selection of students, the principles to be used in the process of "educating the spirit," and the mission that nurses thus educated have in providing health care. He describes at length his beliefs about the selection of candidates to study nursing. He is very clear that a combination of "mature purpose and essential fitness" is a first requirement. "If we are to look for the spirit of nursing-the educated spirit of the nurse-we must have the material into which it may be fused" (p. 240). Beard uses the word fitness to refer to maturity coupled with intelligence. He recognized that maturity is not always synonymous with age and suggested many ways to ensure that students of nursing have a mature purpose. At that time, a high school diploma was not required in most hospital training programs but was a prerequisite for being a college student. He felt that 2 years of liberal arts education would promote maturity. Applying his views to the present, the phenomenal growth of postbaccalaureate certifications and graduate degrees is adding a strong new dimension of maturity to the nursing profession. …

In regularly scheduled, informal gatherings of nurses and others who care about the nursing profession, participants fi nd support, encouragement, enlightenment, and hope. What started 9 years ago as a single evening of discussion about nursing among four graduate nursing students, their instructor, and me has grown into a regular schedule of monthly gatherings with an e-mail list of more than 150 participants. Although most participants are nurses, other friends and colleagues also attend. The only requirement is an interest in nursing and a desire to talk about it. Each salon is a unique event attended by anywhere from 5 to more than 20 people. There is no carryover (except in people's memory) from one salon's discussion topics to the next. The themes of each salon comprise one or two topics that emerge from the issues, ideas, and feelings the participants bring to share. There is no formal agenda, and there are no minutes and no action steps-just a shared experience of touching the reality of nursing at a depth of meaning that enriches the practice and the experience of the participants. Over the years, a format has evolved, a function created, and an outcome achieved. The format is a modifi ed Socrates Cafe, the function is healing, and the outcome is hope. THE FORMAT There are several key elements to the salon format, which combines the inclusiveness of open-space technology (Owen, 2008) with the good conversation practices of the Socrates Cafe (Phillips, 2001). Open-space technology involves how individuals are invited and how the event is convened. Information about the salon is passed by word of mouth or online. Individuals who attend a salon are encouraged to tell others about it and to bring a friend next time. There are no selection criteria. To be on the mailing list, an individual only has to express a desire to be "on the list." People on the list are notifi ed by e-mail of the dates of upcoming salons, and RSVP by e-mail or phone. Salons in and around the metropolitan areas of Minneapolis and St. Paul, Minnesota, are listed online on the events calendar of the local Zeta chapter of Sigma Theta Tau International (http://www.nursing. umn.edu/STTI/Events/home.html), and attendees can RSVP directly from those links. Every eff ort is made to keep stress out of this event. There are no requirements or expectations. Dress is casual. Food is provided. No one need worry about preparing something to say, bringing food for a potluck, or being put on the spot in any way. The atmosphere is deliberately low key, informal, and friendly. The topic emerges from the Socrates Cafe conversation format. During the meal, attendees check in by answering the question, "What is on your mind about nursing tonight?" An eff ort is made to keep these comments brief and to refrain from entering into a topic discussion at this time. After everyone has been heard, the group chooses the major topics for the night based on the themes that emerge from the check-in. An in-depth discussion, using good conversation principles, ensues. …

Mehrere Faktoren haben den Anspruch an die zu leistende Pflege verandert und die Pflegenden bis heute in ein Dilemma gesturzt. Der eine Faktor war der Einzug der Pflegeplanung in die Grundausbildung und in der Folge das Einsickern in das pflegerische Berufsfeld, ein anderer war die Reflexion uber den Gegenstand und Inhalt von Pflege (die Pflegetheoriedebatte). Weitere sind der Wissenszuwachs, der sich aus der Pflegeforschung und der Verbreitung des Internets ergibt, und die veranderten Anspruche der Patienten. All dieses hat bei vielen Pflegekraften den Anspruch an die zu leistende Pflege verandert, weil sie Ausloser waren, die pflegerischen Routinen zu hinterfragten, und den Blick auf die Patienten veranderten. Der Patient war nicht mehr »die Galle« oder die »Oberschenkelfraktur« aus Zimmer XY. Er oder sie war Herr oder Frau Muller mit einem Leben vor und nach dem Krankenhausaufenthalt oder dem Einzug in das Pflegeheim.

Since its development in the 1960s, primary nursing has become the model of care delivery in many health care settings. Over time, myths have developed about primary nursing’s relevance in environments with high acuity, varying skill mixes, diverse staffing patterns, and short lengths of stay. This article addresses those myths.

For decades the question has been asked, "Is nursing a calling?" And for decades the answer to this question has moved from "yes" to "no" and back like a swinging pendulum. In this issue of Creative Nursing, our authors answer the question with a resounding "yes." Florence Nightingale spoke of nursing as a "noble calling" and then went on to say that it is up to us to make it noble. That statement of hers has inspired my thinking for many years, and I continue to find it a source of inspiration amid the pressures of today's reality. According to Webster's Dictionary , a calling is "a strong inner impulse toward a particular course of action, sometimes accompanied by conviction of divine influence" ( Webster's II New College Dictionary, 2001, p. 158 ). Although Webster's mentions "divine influence," many nurses identify very pragmatic, grounded considerations when choosing their careers. You will read about the individual who became a nurse because she and her husband had lost their jobs and were living with their 6-year-old in the basement of her parents' home. She chose nursing for economic stability, and found later that it was indeed her calling. Some wanted a career that provided variety, and learned that nurses work all over the world in almost every sett ing where humans exist. An interesting thread through many of these stories of calling reports is the number of men and women who chose nursing as a second career. For some indeed it was an economic decision, but many others came to nursing from another field because they wanted a life work that had meaning. Second-career nurses frequently comment on a search for meaning as the reason they came into nursing. A self-employed 45-year-old grandmother spending every day in the hospital caring for her 4-year-old grandchild with leukemia says, "My heart began singing out, 'I want to be a nurse.'" She completed her nursing program in December 2007. Another theme is that people were told by friends or family members that they had the personality and character to be a good nurse, at a time in their lives when they were searching for a career direction. In this issue, Beth Beaty, managing editor of Creative Nursing for many years, tells the story of this publication: how it grew from being a newslett er called Primarily Nursing (in the 1980s) to a full-fledged Journal of Values, Issues, Experience & Collaboration, and now to our new, expanded publication, with Springer Publishing Company managing our layout, circulation, and marketing. We are delighted with the expansion and evolution of Creative Nursing and look forward to future conversations on important issues presented both in print and online. Ongoing regular features will include reviews of books, articles, or conferences; reports on nursing research; statistics made accessible; humor; and history. For example, in this issue there are reviews of two books related to the work of nursing, one an interesting historical document on the work of nursing at the beginning of the 20th century and the other a contemporary piece on the place work holds in our lives today. In addition, this inaugural issue includes an article by Michael Cohen , "Professional Communication and Teamwork," and an essay by Donna Wright entitled "Call Waiting," about how she views her calling to be a nurse. Each of our issues will contain information relating to new knowledge, dealing with research, study findings, evidence-based clinical practice issues, informatics, statistics, or simply new ideas to be shared. …

Marie Manthey interviews JoEllen Koerner, PbD, RN, FAAN, Vice President of Patient Care, Sioux Valley Hospital, Stoux Falls, South Dakota. Dr. Koerner, one of the most innovative nurse executives in the country today, shares her Ideas about the future direction of nursing, commenting on increasing challenges and energy requirements that are both exhilarating and exhausting.

Thousands of nurses are leaving corporate life and the bedside for the world of entrepreneurship. It is a healthy sign for the profession. Being in business is one of the best ways to learn about ultimate risk-taking, an experience woefully lacking in the world of hospital- or corporate-based nursing. There seems to be no way to soften the ultimate risk of embarking on a business, although each person can certainly learn what worked for others and what to avoid. In this article, I outline some of the key things that worked and did not work for me during my 20-year stint as a nurse entrepreneur.

How have nursing leadership roles been affected by organizational redesign? The authors discuss the results of a survey of more than 5000 nurse executives and managers. They highlight reasons and core features of redesign processes, changing roles, expanded responsibilities, learning needs, and impact on quality.