It has been said that timing is everything. In our daily lives, we constantly make decisions-when to speak, when to listen, when to keep silent and when to act. I believe the turmoil in the health care environment opens the door not just for nurses to act, but also for collective action.

It is time for health care providers to unite and seek reforms in our health care system that support and protect the American public. Doing so will require an operational change in how we approach issues large and small.

In September, in response to the Institute of Medicine report "To Err is Human," the national advisory councils that represent physicians, the Council on Graduate Medical Education, and nurses, the National Advisory Council on Nurse Education and Practice, came together to identify ways that health professionals can improve patient safety.

The councils met in Washington, listened to a panel of experts and made policy recommendations in the spirit of professional colleagueship and concern for public welfare. The full report is available from the Health Resources and Services Administration at www.hrsa.gov.

Implementing the councils' recommendations will require leadership, risk-taking, courage and the commitment of all levels of the nursing and medical professions to work together, respect each other and realize that we are our own and our patients' best allies in the fast-paced health care environment.

When the councils decided to meet, many said that they would not agree on anything.

The opposite was true. True concern for the needs of people replaced everything else.

As nurses, we have the power to change the dynamics of our own professional relationships to improve patient safety. I challenge each of you to take the first step. The rewards to clients, and also to us, will be immeasurable.