This concepts course was developed for the instruction of nursing students in the BSN program. This course explores current issues in United States health care, including affordability, access, policy, reform, quality, and safety. The course provides an opportunity for students to assess the state of the United States health care system, determine changes needed in the U.S. health care system, including improving of the safety and quality care, and to explore how these changes can be best achieved. Students will apply knowledge of the U.S. health system in the role of the Registered Nurse and the Health Care Professional in leading change in optimizing patient care. Students will apply the concepts of resilience, ethics, advocacy, and leadership (REAL) to health care issue(s).