In the USA, as in many countries of the world, nurses are the largest group of health professionals. It is estimated that there are over three million nurses employed across a wide variety of settings including hospitals, clinics, public health, and community-based facilities such as schools and senior care settings. Nurses are also employed as leaders, educators, and scientists and often lead employee health and health and wellness initiatives within the business sector.Unlike like many other western countries, the USA has not had a national health insurance system that assures citizens access to health care. Federal health care programs have been limited to seniors (Medicare), low income and persons with disabilities (Medicaid), and veterans who are eligible to receive care through systems operated by the Veteran's Administration. While the USA has achieved unparalleled health care advances and has access to very modern facilities and the most advanced technology in the world significant health disparities exist and the USA ranks fairly low among industrialized nations in mortality and morbidity. The recently passed legislation, the Affordable Care Act, that provided broader access to health care is presently under siege politically. This creates enormous anxiety within the US population as people fear that they will lose their health care coverage.In 2008, The Robert Wood Johnson Foundation (RWJF) in collaboration with the Institute of Medicine (IOM) launched a 2-year initiative on the Future of Nursing.The impetus for the initiative was the recognition that the nursing profession faced several challenges in fulfilling the promise of a reformed health care system