The role of the specialist in community nursing: perceptions of specialist and district nurses.

We investigated the management of specialist nurses and how district and specialist nurses perceived themselves and each other, in terms of responsibility, autonomy, skills and training, communication, role conflicts and job satisfaction. All locality and neighbourhood nurse managers, all specialist nurses, and all district and community staff nurses in one Health Authority were interviewed and surveyed. There was little disagreement about the role of the specialist nurse. District nurses were largely positive about specialist nurses, but the area of "hands-on" care was difficult for both groups of nurses. Communication between district and specialist nurses needed to be improved. Both specialist nurses and their managers believed that specialists were inappropriately managed.