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Saving your career in the 21st century.

This article addresses the fundamental and dramatic changes that case managers must undergo internally to keep pace with a rapidly and radically changing work environment as we move into the next millennium. The work paradigm is transforming from a model of well-defined job descriptions and clearly articulated career ladders within organizations to a fluid workforce in which individuals must now view themselves as a mobile portfolio of skills responding to particular needs within organizations Hence, case managers must retool their thinking, unlearn old beliefs that hinder success, and learn to manage their careers as microbusinesses within their organizations. This new model is founded on self-responsibility, entrepreneurial aptitude, vision and personal empowerment. Taking charge of one's career and consciously directing it is a dramatic departure from the norm for most individuals. There is a widely held tendency in our culture to define ourselves by our job titles. This is both an antiquated and myopic view that needs to be discarded to succeed in the future. Health care is a dynamic and evolving industry that requires forward-thinking, flexible, solutions-oriented people. The time is upon case managers to undergo a personal renaissance to artfully position themselves for success in the next millennium.

Adaptation, Psychological↗

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Entrepreneurship↗

From advocacy to ambassadorship: physician participation in healthcare governance.

Increasingly, physician leaders are called upon to assume governance positions in healthcare organizations. These range from small group practices to integrated systems with a regional or even national presence. Yet the meaning of board membership and the skills required for effective contributions in the boardroom are often unclear. This article reviews the essential challenges to governance bodies in the healthcare field, and focuses particularly on the issue of ambassadorship--an often neglected but essential aspect of effective board participation.

Conflict of Interest↗

Some dilemmas of master's level nurse education.

Despite an increase in the growth of master's level provision for qualified nurses in the United Kingdom uncertainty exists regarding the characteristics of master's level performance in respect of professional practice. This paper presents selected findings from a multidisciplinary study that sought to examine the characteristics of master's level performance in health professional courses that had an expressed practice orientation. It focuses specifically on dilemmas nurse educators encountered in relation to British master's level nurse education. Following an initial pilot stage involving focus group interviews with separate groups of nurses, occupational therapists and physiotherapists, an interview agenda was developed to explore participants' perspectives of the characteristics of master's level performance. Individual in-depth interviews were undertaken with a purposive sample of 18 nurse educators drawn from eight universities in England. Interview transcripts were coded and thematically analysed. Six kinds of dilemma emerged from the interviews. These were breadth vs. depth in the conceptualization of master's level for nursing, relevance to practice vs. academic detachment, facilitating creative thinking vs. reinforcing rigidity, encouraging or suppressing different modes of critical thinking, postgraduate nurses as loyal change agents vs. the problem of well-qualified mavericks, and professional experience as facilitating or hindering master's level performance. These dilemmas raise important questions about course design and the role of stakeholders in determining curriculum content. Moreover, a pervasive tension between a utilitarian emphasis on the application and utility of knowledge on one hand, and aspirations to promote creativity and critical thinking which look to alternative possibilities on the other hand, suggests that nurse educators exercise a degree of conservatism in relation to master's level. It is concluded that this apparent quest to maintain a safe variant of the status quo as the best way of promoting the wellbeing of patients should be subject to profound questioning.

Attitude of Health Personnel↗