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This paper presents a qualitative study exploring the influences that drive clinical decision making among a small group of junior rheumatology nurses.A qualitative, descriptive design was chosen. Semi-structured interviews were used with a purposive sample of six junior staff nurses from two inpatient rheumatology wards in a large teaching hospital in the North of England. The interviews were audiotaped and transcribed using Burnard's (1991) thematic content analysis.The findings demonstrate four distinct themes which influence clinical decision making including professional development, patient-focused care, working in a specialty and rheumatology nursing. Development of experiential knowledge alongside access to specialized information and expert practitioners was also influential in informing decisions.