The document discusses several future issues facing nursing and healthcare. It notes major demographic shifts in the US population along with changes to the healthcare system through the Affordable Care Act. Key challenges identified include chronic conditions, an aging population, health disparities, and limited English proficiency. Future nursing roles will focus on ensuring access to care, promoting high-quality outcomes, and developing competencies like critical thinking and cultural understanding. Nursing education must also prepare graduates to work across settings with these competencies.