This chapter addresses an influential aspect of leadership in nursing how it is perceived by others. The term “nurse” represents a wide range of roles, work experiences, and educational levels. Duke University Hospital (DUH), the flagship hospital of the Duke University Health System (DUHS), is a 924-bed tertiary care facility, and Kevin Sowers, serves as its president. The chapter highlights two recommendations salient to the issue of nursing leadership: expansion of opportunities for nurses to lead and diffuse collaborative improvements; and preparing and enabling nurses to lead change to advance health. The future is bright for nursing, with increasing roles and responsibility, particularly in leading and providing direct primary and advanced care. Health care cost is growing at unsustainable rates with challenges of providing access and achieving consistent quality of care. Modernizing nursing education and training to meet the emerging and complex needs also requires strong leadership as well as partnerships.