Using 150 (+) video-taped Hong Kong nurse-client genetic counseling encounters, this paper exemplifies that the discursive processes associated with the nurses' identity constructions are intricate, overlaying and sometimes paradoxical as the nurses fulfill the (occasionally) opponent norms and prospects of their own, their clients, and their institution. They handle these tensions by relying on the classic roles allocated to nurses in these encounters like information supplier and adviser, and by generating the novel roles of codecision maker and cultural agent/moderator.