Abstract
This article discusses two different types of nursing role currently being developed and highlights their impact on professional practice. One role type is concerned with meeting trusts' needs to reduce junior doctors' hours and costs, and includes specific aspects of medical practice. The second seeks to advance nursing practice and patient care. Both however; lack organization and clarity of definition. Developing the first type will not achieve the objectives of the second, even if the title of nurse practitioner is attached to the role. The nurse surgical assistant provides a lucid example of a role that is being medically defined, driven and supervised. Although individual nurses are clearly enjoying their new roles, the unique and valued characteristics of nursing are being threatened. This retrograde step should be viewed as unacceptable to the profession.

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