A glimpse over the horizon: choosing our future.

There are three things this presentation sought to accomplish. First, it's not the health care system you grew up with any longer. Even if you wanted to keep it, it's already gone. And we need to join hands and mourn the loss. We nurses don't mourn well--we just mourn long. So we need to join hands and mourn the loss and cry deeply for 5 to 15 minutes. Or else we need to laugh until it's out. Then we can get on with the work of constructing our future. Second, I wanted to give you a picture of the different context in which we live ... from the industrial age to the new age ... so you have an idea of the different elements that make up the age into which we're going that no longer looks like the age that we're leaving. Third, I wanted you know what was in the winds: subscriber-based management of life health care, fixing the price for that health care in advance of providing it, and inexorably and painfully building that continuum of services, that will necessarily have to be in place in order to provide the service that we will need to provide in order to sustain health care in the country. That's the road that we are on, and it's a noisy road, but it's also an exciting road. There are not going to be major successes. There is going to be a whole series of small successes, and you're going to have to celebrate your successes as you go. We don't celebrate very well either. We celebrate small successes. You have to celebrate the journey. Remember that in the systems definition of success, success is as sufficient appropriate aggregation of sufficient error. Only when you've aggregated sufficient error do you have the measure of success. Honor error, honor the pain, take moments to celebrate the journey for whatever reason you have so that the journey has meaning. You are going to be a leader and on your shoulders is going to be the expectation of providing leadership. Something in the course of our time together or your time here at the conference, resonated with your own consciousness, your own thinking, your own journey, your own experience, and your own leadership. Margaret Wheatly said in her book, Leadership in the New Science, talking about quantum mechanics applied to leadership: "The change is like a ripple; it doesn't matter where you make change, it doesn't matter how large the ripple, it doesn't matter how isolated you may feel, if you make the change it creates a ripple that ultimately changes everything".