This paper addresses the impact of health reform on registered psychiatric nursing practice. Over a nine-month period, seven focus groups were conducted with registered psychiatric nurses (RPNs; n = 33) from a variety of practice settings in south central regions of the province of Manitoba located in western Canada. Analysis of data collected from the focus groups are summarized according to the four probing questions utilized in this study, and are discussed in relation to: past registered psychiatric nursing, influential factors, future for registered psychiatric nursing, and proactive strategies. It is acknowledged that while reform has created an increase in the degree and level of independence for RPNs, findings suggest that some RPNs are concerned about insufficient preparation for these new and expanded roles, and all study participants are concerned about the current and future shortage of RPNs. Recommendations include commitment of sufficient funding and employer support for advanced education of RPNs as well as provision of additional funding for increases in the number of available seats for psychiatric nursing education, additional RPN faculty resources and a graduate education programme specifically designed for RPNs.