[Excerpt] These experiences made us realize that we had underestimated the significance of cultural issues in the relationship between nursing and the external public world. Whereas we once thought that nursing could become significantly more visible by using more or less generic public relations techniques, we now believe that communication considerations specific to nursing must be addressed. Our metaphors also changed over time. Initially we thought in terms of the “invisibility” and “visibility” of nursing. Now we strongly feel the operative terms are “silence” and voice.” That is why we call this book From Silence to Voice and why we focus, in this edition, on moving beyond a “virtue script” that idealizes nursing toward messages that accurately depict nursing and its importance in health care.