This paper discusses how the Accident and Emergency Nursing Development Unit (NDU) in Dewsbury, UK, has developed the role of the emergency nurse practitioner. Each individual member of the Nursing Development Unit (NDU) contributed to this change in practice. Maintaining these contributions to practice development was as important as the practice itself. The NDU exists to support and facilitate a bottom-up approach. This paper will discuss the whole development process and will not therefore include all the details and results from what was a 2-year process.