Background: The frequency of inter-hospital transport (IHT) of intensive care patients is increasing and research shows that adverse events related to transportation are common. When transporting a critical care patient a specialist nurse often accompanies. In this complex health care environment, according to the laws, patient safe care should be conducted. Research shows that specialist nurses who accompanies IHT experiences insecurity associated to not having an overall control of the care of the patient. There are a limited number of scientific publications of specialist nurses' experiences and management of patient safety in these situations and it seems relevant to examine how specialist nurses proceed.Purpose: The purpose of this study was to describe the specialist nurses' experiences and management of patient safety associated to terrestrial inter-hospital transport of intensive care patients. Method: A qualitative method with inductive approach. Data collection was conducted through 15individual semi-structured interviews. Collected data were analyzed using qualitative content analysis. Results: The results revealed four main categories and twelve subcategories. The four main categories were: Clear and targeted communication is a basic requirement for patient safety., Knowledge of and adherence to routines provides equivalent patient safety., The skills of the Working Group on IHT should be composed correspondingly to the patient's care needs., The working environment can be an asset or a threat. Conclusion: To work in an environment that did not belong to routine and sometimes in a combination with unknown staff made the specialist nurses experience the mission as a solo work where patient safety was depending on his/her past experiences and expertise. Implication: An effort to achieve equivalent safe care requires a comprehensive plan for IHT and to work towards national guidelines for IHT. Since it is a rare work it means a small volume of patients per specialist nurse and year performing IHT. Work performed less frequently by a larger number can be compensated with team training and regular follow-ups.