Adapting to sweeping changes in health care organizations, senior nurse executives (SNEs) are redefining their roles—combining clinical skills, broad management understanding, and inspirational leadership to develop the skill set needed for success in today's unpredictable health care environment. Whether within the traditional organization as senior executives or outside it as individual small business owners, many SNEs are demonstrating creative, entrepreneurial leadership skills. CEOs value these but also emphasize the need for greater business and financial expertise from the SNE.