Nurse executives are leading in a time of unprecedented change. Not only are organizations currently inundated with change, but all indications are that the pace of change will continue to accelerate. Multifaceted developments in the technological, political, financial, professional, scientific, and social realms are rapidly redefining the nature of healthcare and healthcare delivery. Nurse executives need to examine the scope and nature of the change we are facing during this period of turmoil and ambiguity, in order to develop effective strategies for leading organizations and the profession into the future.