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  1. Fitzpatrick, Mary Jo MS, RN, CPHQ, CNAA
  2. McElroy, Mary Jo MS, RN, CNAA
  3. DeWoody, Suzanne MS, RN,C, CNA


In an increasingly complex healthcare environment, the discipline of nursing is difficult to define. Although a designated "department of nursing" may be absent on the organizational chart, the functional elements of the discipline remain. Nursing leaders will benefit from a framework to define and operationalize the core elements of nursing. The authors offer a five-phase methodology to enable the creation of a strong nursing organization in the face of mergers, service lines, and complex reporting structures.