Businesspeak is the new language of health care. Insurance, pharmaceutical, hospital and long-term care industries are focusing on "market segmentation," "controlling capitated dollars," "public-private partnerships," "branding health care," "cost-quality trade-offs," and "quarterly earnings." The intervention wizards of heath care are designing high-tech, speedy, and costly procedures to replace and rejuvenate worn out body parts long subjected to the combined forces of genetics and life style. Third-party payers and managed care companies are monitoring and controlling who gets what care in a country of health care "haves" and "have nots." Amidst the corporatization, technological innovation, and bloated promises of health care, nursing's service ethic grows stronger and stronger. Evidence of this ethic is springing up across the country as nurses establish practices in underserved areas, as they tend to the disenfranchised, and as they work with the forgotten of health care-the mentally ill, the elderly, family caregivers, and those with limited or no access to care.

To practice in arenas of care that others ignore or avoid is part of nursing's history. Against all odds, Florence Nightingale established a humane system of care for the foot soldier of the British Army. Lillian Wald established the Henry Street Settlement in New York City to care for the families of immigrants pouring into the United States in search of the American dream. The Kentucky Frontier nurses, traveling on horseback and delivering babies, cared for indigent families in the rural and mountainous terrain of the south. Today, more than 30 schools of nursing are operating federally funded health centers in underserved rural and urban areas of the country.

"Action" is the key word in the title of the issue. Nurses act on behalf of those in need. Often their cost analyses are unsophisticated, their sense of market dynamics is non-existent, and their work is underfunded and unrecognized except by those who are the subject of care. This issue is about the depth and breadth of nursing's service ethic, of its contemporary nurses' efforts on behalf of the homeless, the imprisoned, the demented, and the families who care for those sacrificed to health care's efficiencies.

Nursing has always been about service to those in need. The authors of this issue clearly explicate the re-emergence and strengthening of the service ethic through innovation in practice in every arena of care.