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As the health care field moves into the 21st century, the discipline is moving into new forms of service and leadership. This article presents a view of nursing leadership from the vantage point of community. Values, beliefs, and the changing roles of nursing leadership in creation of new order are examined along with skills and capacities necessary to accomplish the task at hand.

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The authors describe the Healing Web, a partnership between nursing service and education that encourages the best use of nurses education clinical experience and personal competencies. Based on differentiated practice and education of nursing students in multi-level roles the Healing Web partnership is demonstrating at multiple institutions, that education and nursing service can work collaboratively to position the profession of nursing for maximum effectiveness in the 21st century.

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Radical reforms in the dynamic health care arena are calling all professionals to examine their role function and its relationship to emerging new structures and processes. This article places the essence of nursing as the foundation for care delivery redesign, strategically positioning differing RN roles to match the differing needs of clients across the care continuum.

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Science-based nursing practice is shaped and influenced through the lens of research. These findings are dependent upon the phenomenon being studied and the interpretation that is given to the information discovered. In the emerging postmodern era, nursing, along with every other science-based discipline, must explore its work through the lens of quantum physics, chaos theory, and ecofeminist principles. This broader world view will enlarge our definition of health, nursing, and healing. An expanding perception of our world and our work will lead to relevant and life-giving models for care and caring that will powerfully position nursing as an essential player in the changing health care field.

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Values are an integral part of human existence; they select the priorities we live by and shape our way of being in the world. Living outside our value system is exhausting because our inner and outer worlds are not congruent with one another. Organizations must provide a variety of work roles reflecting a range of value sets to integrate staff at differing stages of value development. Individuals must know and honor their own values by living authentic, courageous lives through making career choices that are congruent with their values while honoring the unique career choices of their colleagues. Values are related to skills, and through skill acquisition more complex values are acquired. Through the development of interpersonal, imaginal, and systems skills, individuals and organizations can expand their capacity for caring and innovation in holistic and life-giving ways.

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Activities surrounding mergers, acquisitions, and right-sizing are calling nursing leaders to make life-giving choices for both their organizations and themselves. Career decisions are intimately woven into the philosophical frame and personal reality of each leader. Some choose to move in vast spaces, which create a career that is broad and sweeping both geographically and experientially. Others stay in place and facilitate their place in the universe through stability and connection. This article examines a career and leadership experience of a nurse executive who has remained in one geographical space for her entire life. Opportunities and challenges of this career path are explored while life-giving strategies that create meaning and significance for self and others are identified.

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The search for community manifest in society today reflects the apparent alienation, unconnectedness, and superficiality of modern life. A group of nurses in education and service created a community filled with caring and trust that designed the Healing Web, a transformative model for nursing. The web was established to create partnerships that will transform the health care paradigm of society. By establishing and maintaining a healing community within nursing and the larger universe, wholistic and integrative life will be restored.

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This article describes the process for creating partnerships in nursing. It is Part II of the development of M-I-D-D-L-E-G-R-O-U-N-D, a model for the integration of nursing education and nursing service. Collaboration and community building are the activities that occur as nurses who are "Futuremakers" create the new partnership paradigm. Seven capacities (7 Cs) needed to develop these dynamic partnerships are defined. These capacities can advance caring and healing in nursing.

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This article describes the creation and implementation of a model to integrate nursing education and nursing service. This model for interinstitutional integration of professional nursing presents five areas for collaboration between service and education. Mythology, creativity, innovative planning, and systems theory are used to bring together two systems to form a new whole called M-I-D-D-L-E G-R-O-U-N-D.

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Historically, nurses with different levels of education have been used interchangeably in acute care hospitals. If nursing is going to be viewed as a preferred career choice and acute care hospitals are to retain staff, nurse administrators must provide a nursing practice model that differentiates scope of practice based on education. The authors discuss how they implemented a system of differentiated practice.

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