(Institute of Medicine [IOM], 2010a). The PPACA’s primary goals were to provide safe, quality, and affordable health care to every US citizen as well as to minimize the number Americans without insurance (Cherry & Jacob, 2016). According to the IOM (2010a) nurses played a fundamental role in developing the goals of the PPACA and are an essential component in meeting the requirements of the new act. Despite making up the largest sector of the health care workforce, the nursing profession faces multiple