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Clarifying and defining nursing role developments.

The following factors have exacerbated the confusion over traditional nursing activities: the need to respond dynamically and flexibly to economic and national health targets; the pressure to reduce doctors' hours and to provide substitutes for the shortage of doctors; the ad hoc development of specialization in nursing, without any formal review or regulation by the UKCC; rapid and uncontrolled nursing role developments which have left nurses free to use whatever title they choose; the language and cultural clash over the way that certain titles from other countries, e.g. North America, have been used in the UK; and the confusion as to what the core terms ‘generalist’, ‘specialist’ and ‘advanced’ mean.