To investigate the current work and role of the clinical nurse specialist. Twenty semi-structured interviews were undertaken with clinical nurse specialists and analysed using the constant comparative approach of grounded theory. The clinical nurse specialists (CNSs) in this study identified the communicator-carer role as their key remit. This was perceived as being extremely effective and unique as well as providing the CNS with his or her main source of job satisfaction. Nonetheless, intrinsic desires and external demands create a considerable workload that therefore needs to be prioritised. In addition, the legitimacy of certain demands needs to be challenged to ensure appropriate demands are met and relevant opportunities realised. The pivotal role of the CNS might be under threat as it fails to fulfill its original extensive remit, specifically that of undertaking research.