The first key recommendation of RWJF-IOM report describes how state laws determines the limitations of various types of nurses by creating a system in which nurses does not practice according to their education and training but rather by its own state regulation. IOM’s recommendation to nurses is to practice to the full extent of their education and training. This recommendation is important because it will provide patient-centered, accessible and affordable care now and in the future to improved health outcomes (Tillett,2011), as well as to help new graduate nurses develop skills that are needed to build for safe environment and what needs to be improved. As a future nurse leader who will act as a catalyst between the patient and physician,
