A classic research-based text in nursing practice and education, this newly revised second edition explains, through first-hand accounts of the hard-earned experiential wisdom of expert nurses, the clinical reasoning skills necessary for top-tier nursing in acute and critical settings. It provides not only the most current knowledge and practice innovations, but also reflects the authors' vast experience using the first edition in practice and educational settings. This updated edition includes new interviews from acute care, critical care, perioperative nurses, and more. Attention is paid to current IOM and nursing guidelines for systems approaches to patient safety, with education and leadership implications described throughout. It is an essential resource for undergraduate and graduate nursing educators, students, administrators, and managers seeking to improve systems of care and leadership in clinical practice. - Publisher.