These are challenging times in which to be employed in healthcare. Unprecedented changes in the healthcare system are impacting care in all practice settings. These changes include financial pressures, uncertainty of the direction of healthcare reform, mandates from regulatory agencies to improve quality and patient safety, advancing technology, looming workforce shortages, and changes in the patient population. These changes can challenge resource allocation decisions and adversely affect the work environment. However, these forces can also create opportunities for nurses and the nursing profession. These opportunities include a greater voice for nursing in healthcare policy, expanded employment opportunities, and an enhanced image for nurses and the profession