RESUMO
The demands of today's busy health care environment, coupled with economic constraints, are challenging health organizations more than ever before. The quality of the care we deliver will be jeopardized unless we shift to a more proactive approach, in which we create change, rather than react to it. The systems that will prevail and the individuals who make up those systems will develop the necessary skills, resources, and psychological stamina to succeed in the future. This will be accomplished through attention to people, for it is through people that all change occurs. Second-generation CNSs with advanced skills in process consultation, systems diagnosis, and human relations can assist in the achievement of these goals. The success of the CNS and the benefits to the nursing organization may be strongly influenced by nurse executives who embrace the concept of organization development, choose a skilled CNS for this purpose, and adequately prepare the organization for the utilization of this invaluable resource.