Messages of professional empowerment from the land of Oz.

In the movie adaptation of Baum's book, Dorothy's whole adventure was a dream. But the movie told only a part of the original story. In the print version, Oz was a real place to which Dorothy eventually relocated after 3 more visits; Dorothy moved to Oz permanently in the sixth book (of 13 books) and became a princess. In many ways, critical care professionals are all living in a modern healthcare version of the story of Oz-facing tornadoes, wandering fields of intense expectations, traveling indistinct paths, manipulating wizardly technology, and confronting new enemies. To survive and thrive, we must have brains, heart, and courage. Despite everything that is going on around them, critical care professionals continue to have a sense of mission, a vision of continual improvement and professionalism, and a code of ethics that transcends the complex environment swirling around us. We can begin by creating a personal vision that we wish to achieve. This vision is not an academic exercise but rather a compelling statement that anticipates tomorrow without neglecting today. This vision will require commitment, teamwork, and involvement to make it a reality. Like the end of the original story of Oz, the end of this story is just the beginning. . . . Click your heels together 3 times and say, "It's a new century for critical care nurses!"

Incorporating CARE into caring for families in crisis.

When patients and their families experience the crisis of sudden hospitalization, much energy is spent providing curative interventions and physical care, often with little time available to help the family deal with the crisis. Incorporating caring behaviors into the cadre of critical care interventions must be used to help patients and families deal with the crisis. Caring is a basic value of health care delivery and embodies a spiritual and metaphysical dimension concerned with preserving, protecting, and enhancing human dignity. Caring becomes even more important when one realizes that cure may not always be possible. Four basic behaviors form a foundation for the Humanistic CARE Model and include the interconnection and interrelation of communication, advocacy, reciprocity, and empathy. Finally, our caring actions affect each of the lives we touch. The knowledge that those actions make a difference in the lives of critically ill patients and their families provides us with the insight that we have succeeded in incorporating CARE into caring for families in crisis.

Mentoring: nurturing the critical care nurse.

Mentoring is an active process that is currently receiving widespread attention in education, in the corporate world, and increasingly in health care. Job satisfaction of the critical care nurse may be related to the fulfillment of personal needs and goals. The attainment of these needs and goals ultimately will lead to increased job productivity, which in turn will promote cost-effectiveness, an outcome cherished by management. Therefore, recognizing the worth of job satisfaction to the institution and the possibility that mentoring may have an effect on it among the professional staff may be a key to the future of improved health care and cost reduction in an increasingly specialized and technologic health care environment. Certainly, the nursing shortage is no longer news to the lay public or those of us engaged in the practice of nursing. In critical care that shortage is acutely apparent. Attrition of qualified critical care nurses is increasing and various solutions to the shortage have been proposed, some being met with more enthusiasm than others. A more basic solution might be to answer the question, "How can we maintain a high quality of patient care while promoting job satisfaction and instilling a sense of self-worth within the critical care nurse?" Critical care nurses need to play a pivotal role in nurturing and developing other critical care nurses as a means to retain those individuals. How can they do that effectively? Mentoring is one answer.

Families in crisis: making the critical difference.

As nurses, we are educated to care for the whole patient, to provide care for the body, mind, and spirit, and to improve the quality of life. When a patient has a crisis, his or her family is propelled into the crisis as well. Although critical care nurses have always participated in a caring manner by interacting with families of critically ill patients, nurses must be encouraged to actively seek ways in which to help these families. This article has provided guidelines and strategies for caring for families in crisis. The most effective way to care for family members in crisis is by demonstrating a conscientious concern for their loved one, that is, the patient. The knowledge that our nursing actions make a difference in the lives of family members gives us renewed insight into maintaining the care in critical care nursing.

Mentoring the novice clinical nurse specialist.

Mentoring can be a very important component in the personal and professional development of the clinical nurse specialist (CNS). Successful mentoring can be a highly productive, cost effective way to increase performance levels, develop leadership skills, improve morale, and increase self-esteem and value of both the mentor and mentee. This article will look at mentoring relationships and the mentoring process as they relate to the CNS.