[From a nursing care project to a medical-nursing care project. A group vision].

The hospital world, in constant development, is becoming more complex and reduces the possibility for the actors to have fixed landmarks. Changes affect the organization, the rhythms and the division of labour in the field of health. The idea of a project of medical nursing care would thus come to offer the possibility of acquiring a global culture, a factor of integration and management of diversity. The notion of collective performance, of putting in coherence skills and means at the service of the treated person would then be federative. The organization in pole which meets a will to replace the current vision of the hospital, which is very fragmented, by a more integrated conception, invites the professionals to cooperate. Management by process which would consist in crossing structuring in pole with the transverse processes of taking care of the patients invites to focus on inter phases. Furthermore, this organization multiplying exchanges and intelligence, by giving initiative to the ground, can allow the Director of the Care to be proactive. To work in network rather than in a pyramidal way is an opportunity. The quality of the cooperation among the actors being determining to move from a logic of territory to a logic of project.