Getting on top of organizational change. Part 2. Trends in nursing service

Fundamental to all of the trends described in this article is the nurse executive's ability to influence organizational policy and planning. The value of nursing as a clinical practice discipline provides consistency in policy, planning, and goal achievement. Viewing nurses as salaried professionals, establishing organizational structures that foster professional behaviors, and achieving cost-effective quality care all depend on the top nurse executive's effective use of power. In the next and last section of this series, nursing in multihospital systems and corporate structures will be discussed, and these themes will be further developed in relation to corporate planning for change.