This issue's continuing education unit feature consists of a primer regarding pay-for-performance initiatives that are important for the nurse manager. As healthcare reimbursement dollars shrink and healthcare costs rise, it is important for all nurse managers to be aware of such payment systems in order to be full participants in system discussions about their adoption and implementation. Also in this issue is an interesting ethics column discussion regarding a patient's wish to go home and the potential conflicts that this may raise among staff members. Our Conversations in Ethics column this issue focus on the dilemmas present in a zero tolerance drug and alcohol policy. As always, we welcome your comments and questions. E-mail me at [email protected].