To the Editor:

I thank department editor Marilyn Schaffner for her words in the November/December 2003 column, "Leading the Way." I just picked it up to read today and it hit me like a ton of bricks. It came at a pivotal point in my day today as a manager of a gastrointestinal (GI) department. I had just finished sitting through a heart-wrenching "lay your insides on the table" GI physician meeting. Listening to 2 of my GI physicians say they will be leaving in a few months due to several issues, I left the meeting with a feeling of gloom.

We had worked so hard to improve access, implement a GI nurse triage process, increase productivity, expand an outreach practice, etc., but now everything was on the line to have to continue current practice with the pieces left. I wondered how I could keep a positive outlook. While I understood where these guys were, I have my staff to think about. What about our future?

In this time of cuts, bottom lines, productivity, and justifications, my vision is sometimes clouded in determining the right path. It is so easy to take the path of frustration; yet how easily an environment can be destroyed with blame, frustrations, and "what-went-wrong" attitudes. I have fought so hard to keep nursing a profession in my departments: not something you do for a physician, but rather something you are. I believe in GI nursing as we practice it today: taking accountability for our actions and growing in our knowledge base, working beside physicians. My vision for the future is one of collegiality and shared practice like Marilyn said: "Creating a vision that provides staff the hope of what can be."

I have just finished reading the Five Keys to Nursing Management. In the book, I came across excerpts and quotes from Elias Zerhkouni. Referring to "heart and passion for the future," Zerhkouni says great leaders lead with their hearts. They listen, guide, and empower their teams to move in new directions. It was a shot in the arm reading Marilyn's message today. Thank you!! She inspired me to keep on the path of my values. It reminds me of another quote from the great hockey star, Wayne Gretzke. When asked what made him the great success he is today, his answer was, "I never skated to where the puck was going, but always to where the puck would be."

Marilyn, thank you. Hope for the future and a better tomorrow,

Nancy Hammes, RN