This study investigated the perception of influence and decision making among mid-level community-based nurses. Respondents were nurses and nurse leaders in public health nursing, home nursing, and nursing in nursing homes in the municipality. Nurses in three nursing services located within each municipality's Community Health Service in 72 municipalities were surveyed or interviewed. The results show that the leaders of the nursing service and nurses in the three services are regarded as having influence, and in fact, possess more influence on the decision process than the administrative leaders and political management. There are great differences in the perception of decision making among the leaders of the nursing service and nurses in the three services. The leader of the health visiting service has less influence on decision making than the leader of the nursing home, while the health visitor has more influence on decision making and autonomy in professional work than the nurse in the nursing home. These differences might be explained by contextual factors such as tradition, gender, and work process.