Psychiatric nurses in the United Kingdom (UK) have begun to reattend to people with ‘serious and enduring mental illness’. At the same time research in the USA and UK has refocused much of its attention on neuroscientific theories and models of serious mental illness. Psychiatric nurses are being encouraged to consider the value of biomedical explanations of serious illness, such as schizophrenia, and to accomodate these theories and models in the practice of nursing. This paper will examine the challenge of the biomedical approach for the continued development of psychiatric nursing theory and practice. It is proposed that psychiatric nursing needs to develop further its own ‘proper focus’, if it is to survive as a key player in the health care field of the 21st century.