Every day felt like a Monday morning. A rainy one. That's the only way to describe the dark mood that hung in the ORs and hallways of Good Samaritan Hospital in Cincinnati, Ohio. Surgical managers didn't communicate with hospital administration, veteran nurses played power trips, new hires came and went faster than fast-tracked patients and we were better at turning over staff than rooms. Our department had a 50-percent vacancy rate and the hospital continued to downsize nurses in an effort to crawl out of the $48 million hole it was in.