Abstract
■ The trigger for evolving change came from the change in junior doctor's working practices
■ Evolving nursing boundaries requires an evaluative and reflective approach to care delivery
■ Collaborative approaches, evidence based practice and effective outcomes are key responsibilities for Nurse Executives
■ Practice with accountability and lifelong learning are fundamental to advancing practice
■ Strategies for nursing practice must provide service time for educational study whilst maintaining required levels of clinical activity
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