Abstract
While the work of ambulatory nursing is increasingly complex, nurses have little specific preparation and support. Role confusion is prevalent, and nurses are often unable to articulate their roles. The authors present results of a survey that assessed practice patterns of registered nurses (RNs) in ambulatory care settings. They discuss how ambulatory RNs' perceptions that what they actually do in daily practice is disconnected from what they feel is important to do. Barriers to practice change are highlighted with recommendations that include working for effective practice design, building consensus about the scope of ambulatory RN practice, increasing education in academic and service settings, and enhancing support for delegation.