The Institute Of Medicine‘s 2010 report on the future of nursing, leading change, advancing health. Emphasis that nursing practiced should be transformed to be patient centered according to each patient unique need not considering what is convenient for the Nurse caring for the patient. The people of America devote efforts to provide quality and affordable healthcare to the people residing in the country. Nurses are the central part of the healthcare workforce with almost 3 million nurses working in different areas across the country. The changing condition in healthcare system and the new legislation to make the system more patients centered will place demand on the Nurses.(ACA,2010). In the aging population there will be increase in the need for palliative and long term care .The legislation has begun the process of redirecting the healthcare focus from specialty and acute care to chronic conditions; preventions of hospital acquired infections, prevention and wellness. Care patients receives should be culturally diversified and also should be accommodating to both the poor ,the rich , insured or uninsured ,every patient should be treated equal with respect and dignity regardless of the race or socioeconomic status. Nurses must be given the opportunity to maximize their nursing knowledge in their area of practice. That is to say that rules that will prevent this transformation such as regulatory hindrances to expanding nurse’s scope of practice, professional resistance to expand roles for nurses, outdated insurance policies, fragmentation of the healthcare system will have to be broken. In conclusion for these changes to be effective there should be the need for advance practice nurse, including their role in managing chronic disease, access to primary care and the regulatory barrier preventing them from taking this role. State legislature should require third party...