It is difficult to pinpoint the date when specialisation in British nursing practice began. Ever since the Nightingale era, nursing has been divided into certain categories, e.g. mental illness, subnormality and infectious diseases. In the early 1980s, I carried out research to identify clinical nurse specialists in England and Wales, as defined by themselves and area health authorities. The study also aimed to compare their present development with that of clinical nurse specialists in other countries, particularly the USA (Castledine, 1982).