Aims The aim of this three-year study was to operationalise the role of a consultant nurse and, in so doing, facilitate the development of nurses and nursing for the purpose of providing better patient services.

Methodology Action research was used because it focuses on developing practitioners, developing practice and contributing to understanding both the phenomena being studied and the processes being used.

Results The role of leadership is recognised as key to bringing about cultural change, as is the use of approaches that clarify values and highlight the contradiction between espoused culture and culture in practice.

Conclusion The resulting culture had a positive impact on the unit in which the consultant nurse was based, on practitioners and their practice, and also on the trust. A number of factors, including transformational leadership, other facilitative processes, expertise in the practice of nursing, and other subroles of the consultant nurse were shown to be influential. This article explores the concept of organisational culture, and a second article to be published next week, discusses the consultant nurse outcomes.