Extended and expanded role of a nurse, by giving this article author stressing the need for the registered nurse to exercise clinical judgement based on knowledge, maintain oversight, and be accountable, all in a context of professional and ethical regulation. Distinctions are drawn between professional nursing and nursing undertaken by other people. Based on the latest thinking on the nursing profession, with its emphasis on judgement, knowledge and responsibility, it is clear that mechanistic role extension is not the way forward for nurses.The terms role expansion and role development are deemed to be more organic and therefore acceptable, and appear to be used in parallel and interchangeably, often in the context of a movement towards ‘nurse-led care’, examples of which are discussed.