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As a holistic nurse and director or clinical working in a community hospital in Atlantic City, New Jersey, I am seeing first hand the impact this current situation is having on my colleages, our patients, area employers such as casinos, our hospital and health care in general. Our organization, AtlantiCare Regional Medical Center is financially strong as they were wise enough to invest during the boom economic years and have good reserves, however, many of our staff members are being affected because their significant others are getting laid off, some of them of course are on the verge of losing their homes, etc. Moreover, as the number of people losing their jobs increases they will also loose their health benefits and that will put a strain in our already taxed health care system. Our hospital already provides an increased amount of services to the uninsured in our community and gets reimbursed by Charity Care - which the program itself seems to be on the verge of collapse. We are preparing ourselves to see an increase patient population and doing more with less. This of course can add more stress to already stressed out health care providers.

So when I look for inspiration during these tough times, I am reminded on Florence Nightingale, the founder of modern nursing - Nightingale channeled her work to support hospital reforms and the need for educated, centered and grounded nurses who could provide better management of the hispital environment. She was not afraid to speak her truth to those in powerful positions. She saw beyond roles and addressed inequities in the system whenever it threatened the well being of her patients or those in lesser circumstances. I am sure she had her fair share of friends, enemies and friendnemies. Fast forward 100 years later and we find ourselves in our present circumstances.

The economic, political, and health care crisis that we are currently experiencing is once again a call to action. It is an opportunity for us to understand the realities around us and to rally together to do something radically different. Before us is the possibility of using this current crisis as an opportunity to unite, collaborate and to empower ourselves, and others, to actually get our health care system to work. Embracing an uncertain future, we need to support leaders, who are inspired, courageous and effective. We need to renew the energy of our healthcare workers who are burnt out and apathetic in our hospitals and clinical practices. If we point them to an inner compass that renews their passion, there is hope for real solutions and inspired creativity. All that we need is already there, in the currency of our collective, and it only needs to be tapped into.

Nightingale was able to transform the health care delivery of her era and beyond by looking at the healing process from a whole person perspective. She also saw nursing as sacred work; she believed that every person who is drawn to ease the pain and suffering of another is an instrument of genuine healing, regardless of whether they are a healthcare professional or not. So Nightingale's vision is generic, applicable to everyone, regardless of his or her occupation or profession.

In today's highly specialized health care, we are often tempted to compartmentalize our lives, putting our professional interests in one corner and our spiritual concerns in another. Nightingale’s spiritual vision and her professional identity were seamlessly combined. As she put it, "My work is my must." Nightingale exemplifies a degree of courage and fearlessness that is rare in any era. She shows that it is possible to honor our spiritual vision and integrate it with the highest standards of nursing practice - to "walk our talk." By her example, she invites each of us to find our meaning and purpose - our own "must.”

Andrew Harvey an internationally renowned religious scholar and teacher states that when the deepest and most grounded spiritual vision is married to a practical and pragmatic drive to transform all existing political, economic, social institutions, and I will add health care, a sacred force - the power of wisdom and love in action - is born. This force he defines as Sacred Activism.

Nurse theorist, Jean Watson in her Theory of Human Caring asserts that caring is a science and transpersonal caring relationships are foundational to our work. She defines caring as a moral ideal, rather than an action, that is necessary for the preservation of humanity. She explains how caring, as an ideal, benefits the person as well as the healthcare provider. She believes healthcare provides must cultivate sensitivity to self and others through self reflection, awareness and spiritual practice by cultivating lovingkindness, developing authentic caring relationships, being fully present, attending to basic needs with caring consciousness, engaging in the artistry of caring-healing practices, and ministering to the spiritual needs of the person by maintaining human dignity and nurturing the soul.

Amid the challenges we face in our nation, indeed the world - - it is easy to be overwhelmed by a sense of futility and hopelessness. As a nurse, and a recent cancer patient, I challenge us to embrace this radical way of looking at these challenges – not as health care reform, but health care transformation from the inside out in the form of personal transformation and empowerment through an encounter and special attention to the heart - for "sacred" and "heart" reflect a common meaning – it can generate the hope, courage, and vision required for our troubled times. We need to be connected to a vision of action that is inspiring, hopeful and rooted in deep spiritual wisdom and compassion.

To thrive in the current healthcare culture, we must create environments that redefine health, foster personal connection, and celebrate human potentiality. These environments must reflect and sustain the values and behaviors that are congruent with caring and healing.

It is my believe that this transformational process is not esoteric, but is entirely organic. This sacred activism is counteractive to the naysayer and do-nothings who are part of our problems. It is important to realize that this message is not a matter of philosophy, but of survival.

And so in the words of Nightingale, ‘So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself.” Thank you.