By Linda D. Urden, DNSc, RN, CNA-BC, FAAN, Executive Director, Nursing Quality, Education & Research, Palomar Pomerado Health, Escondido, CA; Clinical Professor, Coordinator, Executive Nurse Leader Tract, University of San Diego, San Diego, CA, USA; Kathleen M. Stacy, MS, RN, CNS, CCRN, Nurse Manager/Critical Care Clinical Nurse Specialist, Intermediate Care Unit, Palomar Medical Center, Escondido, CA; Adjunct Faculty Member, School of Nursing, College of Health and Human Services, San Diego State University, San Diego, CA, USA and Mary E. Lough, RN, MS, CNS, CCRN, Clinical Nurse Specialist, Medical/Surgical/Trauma ICU, Stanford University Hospital and Clinics, Stanford, CA; Associate Clinical Professor, Department of Physciological Nursing, University of California, San Francisco, CA, USA.