ical–surgical unit who would have been in a critical care unit ten years ago. We are now sending patients home in 1 to 3 days whom we previously would have kept in the hospital another 5 to 10 days. Procedures that required a 3- to 5-day hospital stay in the past are now being performed in day surgery or outpatient facilities. A variety of factors have led to this situation, including advances in technology; advent of the use of diagnosis related groups (DRGs) for patient billing; managed care insurance plans; prospective payment insurance plans, capitated payment insurance plans; movement from acute care to longer term care settings such as home health, nursing homes, and rehabilitation units; and, most importantly, the desire to contain the rapidly rising costs of health care. These problems, which together have been labeled the “quicker, sicker” phenomenon, in combination with a national shortage of registered nurses, have created a situation in which the contact time a professional nurse has with a patient is being cut to a minimum. Given this set of circumstances, if care planning is not done there is no doubt that gaps will exist in the nursing care given to a patient. Such care will be incomplete, inconsistent, unsafe, and certainly not of high quality, which will result in an increase in negative outcomes.