Managing essential IV information and applying technology to patient care are essential aspects that I consider very important to my practice. My nursing skills and technology are put to the test every day as I work. New technology, changing procedures, and new equipment are essential to working in the cardiac catheterization laboratory. You have to adapt and change every day to keep up and stay educated. New physicians join, and we must learn their technical styles and equipment needs while maintaining exceptional patient care. Essential II's core organizational and systems leadership for quality care and patient safety is also an essential aspect that all nurses deal with on a daily basis. “Leadership skills are needed that emphasize ethical and critical decision making, establishing and maintaining effective working relationships, utilizing mutually respectful communication and collaboration within interprofessional teams, coordinating care, delegating, and developing problem resolution strategies. conflicts.” (American Association of Colleges) of Nursing, 2008, p. 13) This essential course begins on the first day of orientation and ends on the day the nurse retires. The importance of ethical decisions, critical decisions and respectful communication cannot be stressed enough. Whether speaking to an injured family member or a fellow staff member, you should always look at quality