An ICU nurse reveals how private equity ownership leads to preventable deaths and negligence in hospitals.

Winner of the AJN Book of the Year Award by the American Journal of Nursing in the History and Public Policy Category

In a country where health care is increasingly driven by profit, Margin over Mission exposes the dire consequences of corporate ownership in hospitals. James Kelly, an ICU nurse with over two decades of experience, narrates a gripping account of his final year at Lovelace Women's Hospital in Albuquerque, New Mexico—a year marred by preventable deaths, administrative changes, and the heartbreaking loss of a once-mission-driven institution to the clutches of Wall Street.

Kelly's poignant narrative takes readers on an emotional journey through the corridors of a hospital that once stood for community and care but became overshadowed by the relentless pursuit of profit. Through detailed anecdotes and critical analysis, Kelly reveals the stark reality of a health care system compromised by private equity, where decisions prioritize profit margins over the mission of saving lives.

Kelly's unique perspective as an ICU nurse provides an insider's look into how private equity is wreaking havoc in hospitals around the country. His story is also a powerful tribute to the countless health care workers who struggle to maintain their integrity and compassion in an increasingly inhumane system that prioritizes money over people.