As the leader of a philanthropy whose founder recognized early on the value of nurses to his own medical care and to healthcare writ large, I welcomed last year's Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, with great expectation. In the coming years, our nation's healthcare system will serve 32 million newly insured Americans as well as rapidly increasing numbers of seniors and people with chronic conditions. And it will do so in the context of changing models and settings for care delivery.