Thanks Karen- I feel like I'm getting closer to the 'holy grail'..but then that may not even be in London, hey?! I know the USA has several Acute Care NPs but my time doesnt extend to a trip there unfortunately. and I'm working at developing a Critical Care NP position in our 8 bed Unit. We already undertake extended clinical practice with initiation of diagnostic testing and regulation of ventilation modes, for instance- forced on us due to the lack of a formal Intensive Care director. So I'm really hoping to liaise with a NP who works in acute care and discuss guidelines and role progress etc. I will be staying in Queensborough Terrace in London so not keen to travel too far from that area- only because I have to get back and my bush skills may not work so well in central London! Any ideas or names would be hugely appreciated. Cheers, Sue Clarebrough