Patient empowerment and patient and public involvement are a focus for NHS policy, with an emphasis on patient decision making and representation as core features of a patient-focused NHS. Patient empowerment and patient and public involvement imply a rebalancing of power in the nurse-patient relationship. In reality this is complicated by wider issues of power and control in a complex health service influenced by professional agendas, healthcare leadership, government targets and a developing business culture. Despite these ideological and organisational constraints, there are many ways in which nurses can support aspects of individual patient empowerment and patient and public involvement.