This paper represents some of the findings from a study of expatriate nurses working in developing countries. The aim of the study was to identify the value orientations of Western nurses and to suggest to what extent those values influenced practice. A values clarification exercise was carried out and classified within Kluckholin and Strodbeck's values orientation continuum (1961, Variations in Value Orientations. Row Paterson & Co., New York). Western nurses saw themselves as knowing what was right for others. They were essentially activists seeking to 'do' many things focusing on individuals while at the same time working towards community planning. Western nurses although powerless to alter the values of the system within which they worked were able to initiate change. The ability to adapt and reconstruct individual value systems in response to working in a cross-cultural situation influenced the effectiveness of the nurse in pratice.