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Clearly, the future of nursing is heading for some significant changes. The Institute of Medicine (IOM) report, “The Future of Nursing: Leading Change, Advancing Health”, from 2011 highlights the changes facing the medical field, particularly related to nursing, and the obstacles we as nurses must face and overcome to continue to deliver effective, quality care to all patient populations. According to the IOM report, the passing of the Affordable Care Act (IOM report p. 21) will greatly affect the delivery of care, and nurses need to be ready to accept the challenges, “The ACA represents the broadest changes to the health care system since the 1965 creation of the Medicare and Medicaid programs and is expected to provide insurance coverage for an additional 32 million previously uninsured Americans. The need to improve the health care system is becoming increasingly evident as challenges related to both the quality and costs of care persist” (IOM report, p. 21). The key factors involved in nurses having the competency to meet the higher standards being set are based on: the transformation of nursing practice, the modification of nursing education, and the cultivation of nurses taking a more active leadership role.
Transforming nursing practice can occur several ways. The IOM report stresses the importance of this transformation to take place to improve care of the more diverse population of patients. It states that, “…the system must undergo and fundamental shift to provide patient-centered care; deliver more primary as opposed to specialty care; deliver more care in the community rather than the acute care setting; provide seamless care; enable all health professionals to practice to the full extent of their education , training, and competencies; and foster inter-professional collaboration” (IOM report p.86). With nurses being one of the most

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