Confusion surrounds piecemeal changes in nurses' roles.

There has been a rapid increase in the number of so-called new roles in nursing. These have tended to develop in a random way. Consequently, titles are not a good indicator of what the role entails. The qualifications required to undertake a particular role are not clear and tend to be locally defined. This paper discusses the implications of this situation. Two subsequent articles will examine issues around patient consent, care provided by nurses in new roles and legality and accountability.