We are told constantly that health care is a business and that nursing should follow more business-like principles. As a health service or hospital is indeed a multi-million dollar organisation that needs to be well managed, there are no arguments from me on that score. If we are in business however, then let us be absolutely clear about the nature of our business as nurses. We are in the transformation business and the 'making a difference' business. Nurses don't just make the tea and coffee they make decisions. We need to appreciate the importance of processes and structures, but more importantly, we need a laser focus and a near-reverence for tangible and valued outcomes that improve patients' experiences.