Changes in the health care system are threatening the independence and professionalism of health care providers. One such proposed policy change related to professional licensure is creating a specific challenge for the nursing profession. This article examines how the licensure challenge affects aspects of autonomy, independence, and integrity of the nursing profession with special emphasis on one group of nurses-that of nurse practitioners. The impact of the PEW Commission's study is analyzed as well as the concern for potential loss of individual licensure for nurses. Nursing groups have responded to the PEW Commission study to prevent such deregulation of the nursing profession.