Health care reform has resulted in a unique opportunity for nursing to develop and expand its role in future health care environments. We discuss why we think nursing's time has come, as well as the forces in present health care environments that threaten nursing's progress. We have used modern evolutionary principles to elucidate seven key conditions required for nursing to survive and flourish in the new health care environments. These conditions include the need for nurses to: be relevant; be accountable; be visible; be innovators; have a global impact; retain their uniqueness, while functioning in multidisciplinary settings; and be exceptionally competent, while striving for excellence.