This paper reports on the conduct of study that investigated the experience of nurses working in a Cardiac Step Down Unit (CSDU). The study was undertaken in order to identify factors that inhibit the smooth running of the unit and impact upon patient care. Case study design was used to explore practices in the CSDU. Data collection strategies included focus groups, semi structured interviews, surveys, self-report, and observation of nursing activity. The case study approach enabled generation of data sets that illuminate the context, culture and working environment of the unit. It was found that the nursing care provided in the unit focussed on the provision of technology oriented rather than patient oriented care and that nurses experienced lack of role clarity about the care they provided. A number of recommendations that emerged from the study have since been implemented in practice and the effect of these changes are being evaluated in a follw up study.