This chapter explains the seminal Institute of Medicine (IOM) report: The Future of Nursing (FoN): Leading Change, Advancing Health and the background organizations that wrote it. It demonstrates some key recommendations of FoN: Leading Change, Advancing Health report and its “fit” with Indian Country. The chapter differentiates between challenges in obtaining nursing education in Indian Country and those in dominant culture settings. The IOM’s effort with the Robert Wood Johnson Foundation (RWJF) on the FoN has been noticed by many, yet direct care nurses are largely unaware of the report. The chapter outlines the FoN recommendations into two groups: gaining education, practicing to its fullest scope, and pushing for more, including lifelong learning; and shaping policy, being at the table as full partners in health care redesign, and leading change. For American Indian/Alaska Native (AI/AN) nurses graduating from tribal colleges and universities (TCU), the majority will have an associate’s degree.