The boundaries of nursing in neonatal care, and the interface between the work of nursing and medical staff in delivering care, are changing The enhanced or expanding role of the neonatal nurse is not a universally accepted one If this professional development is to be widely accepted and implemented, some key issues will need to be addressed so that the changing role of the nurse and associated skill base are well founded As part of a large-scale national study of neonatal nursing in England, data were collected from nurses working in 24 different units Regional centres, subregional centres and district units from six widely separated health regions participated, and individual data were collected from 718 nurses (599 D-I grades and 119 A-C grades) While indicating that there is inter-unit variation in nursing practice, the results also show that many nurses are already in the process of changing their role in this acute specialty Nurses doing so are more likely to have a qualification in this specialty, though not all of them have A small number of nursery nurses and nursing auxiliaries were undertaking tasks that could be considered part of an expanded role The implications of the findings are discussed