Oncology educators, administrators, clinicians, and researchers are committed to excellence in providing evidence-based care and leadership, in developing new knowledge that can be used to improve care outcomes and care systems, and to excellence in influencing healthcare policy that will benefit all who are affected by cancer. Commitment is an admirable quality-it is, after all, a pledge to a positive course of action. Our commitment to patients and their families, to team members and care settings, and to care excellence, prevention, cure, and advocacy is unmistakably strong in oncology. But commitment without a plan that both guides and inspires could put us at risk of working very hard to improve care and care outcomes with only contained success that is limited to an immediate situation. Commitment that does not extend beyond a pressing immediate situation risks personal and professional disappointment or a sense of work and dreams unfinished despite best intentions and much personal effort. Instead, we need a well-articulated, longer-term plan beyond "this patient," "this study," "this role," or "this project"-a plan that has real meaning and inner significance for us.

Because we are vulnerable to best intentions specific to an immediate or short-term purpose that may not be embedded in a longer-term plan, we could particularly benefit from a formal process of declaring our legacy in oncology. Declaring a legacy in oncology can be at the level of each of us as individuals and at the level of groups of us such as a legacy declared by a team, a department, or an entire system of cancer care for a nation. The act of declaring a legacy begins almost immediately to provide benefit in terms of guiding our efforts.

A declaration of each person's individual legacy in oncology is an explicit statement of a plan to achieve "that which is better" in oncology, and the something better is of personal and professional importance to the person making the declaration verbally and in writing. This articulated plan is an individual's resolve to pursue a committed direction in order to achieve one or more highly valued end points. It is more than "doing good works" as the legacy seeks to make a lasting positive change in the state of what is. In this way, the declaration becomes a guide to achieving what we have proclaimed to be our legacy. A legacy in oncology is what we are determined to make better by our focused efforts. A legacy is more rewarding than either mission statement or strategic plan or even the combination of these two. A legacy is not what our patients, teammates, colleagues, or our students expect us to give-rather it is what we want to give to them based on our interpretation of our interactions with these groups about what needs to be better; it is about what inspires us most regarding these identified needs. An individual's legacy does not replace or compete with other patient, family, team, or system priorities and may in fact be quite complementary to those. A legacy may be about how we want to be professionally remembered.

Although a legacy is declared, it is not completely within the control of the individual or the team or group making the declaration. However, a key value of declaring the legacy is the inherent act of reflecting on one's life or career purpose and priorities. The act of declaring thoughtfully combines purpose, priorities, values, and strategies. Once the declaration is made, returning regularly to review, revise, and update the legacy is central to maintaining the focus and perspective on the status of the efforts and focus. Regularly revisiting the declared legacy also reaffirms our efforts.

Giving at the individual, team, or system level always requires a plan. A declared legacy is having a plan that inspires and sustains our efforts. We have a much better chance of giving what we seek to give and of making our "something better" if we have declared our legacy.

Our very best,

-Pamela S. Hinds, PhD, RN, FAAN

Department of Nursing Research and Quality Outcomes Children's National Medical CenterWashington, DC;

School of Medicine & Health Sciences

Department of Pediatrics

The George Washington University

Washington, DC

-Eileen P. Engh, MSN, RN-BC, CPN

-Susan Keller, MLS

-Katherine Patterson Kelly, PhD, RN

-Marlene A. Lee, MSN, RN

-Johanna Menard, BSN, RN, CPN

-Renee Roberts-Turner, DHA, MSN, RN, CPHQ

Department of Nursing Research and Quality Outcomes

Children's National Medical Center

Washington, DC