1. Inpatient treatment programs operating in the managed care environment must clearly articulate their treatment outcomes and the processes of care that are connected to these outcomes. 2. The work of inpatient psychiatric nurses can be organized and articulated through the therapeutic processes of the Four S Model: Safety, Structure, Support, and Symptom Management. 3. Nurses are vital contributors to the inpatient treatment process, but will be marginalized if they are unable to articulate how their interventions contribute to the positive treatment outcomes.