We stand on the threshold of the next great revolution in medical practice. The restructuring of healthcare delivery has resulted in a shift from the traditional provider-controlled, fee-for-service model to a new paradigm organized around integrated healthcare networks that provide consolidated services across the continuum of care. Although oncology nurses are positioned to be at the forefront of this revolution, we must acquire new skills and develop innovative ways of thinking. The question for the future of oncology nursing is not whether our profession will continue to survive but rather how it will evolve and adapt to lead changes in the healthcare environment.