Abstract
The impact of specialist nurses on the skill retention, expertise and job satisfaction of ‘generalist’ nurses, and of course on patient experience and outcome, continues to be the subject of comment (Castledine 2002, Wright 2002). We explore here the specific issue of the increasing number of specialist cardiac care unit (CCU) nurses being placed in A&E departments in England in response to professional and policy drivers to reduce delays in treating acute myocardial infarction (MI).