Being first at the scene of an accident might involve a great emotional stress for paramedics. The environment can be chaotic and the nurse has a responsibility to make a correct assessment of the victims. The ambulance service use different concepts as a tool for events and accidents. The ambulance service in the north has been trained in Pre-hospital health care management that can be used from everyday happenings to major disasters. The aim of the study was to describe nurses’ experiences of pre-hospital health care management. The study had a qualitative approach and data were collected through two focus groups at two ambulance stations in Västernorrland, Sweden. The analysis resulted in three main categories and nine subcategories. The results show that pre-hospital health care management facilitates work at the accident site and make it more structured. The concept is considered to be designed for larger accidents and defects in minor accidents. The Ambulance incident commander role is perceived as a great role with a lot to keep track of and a lot should be done in a short time while the role of Medical incident commander is considered to be more natural when it is more similar to the daily work which assesses and prioritizing patients. The concept is practiced too little and it takes practice to allow staff to feel confident in their roles. More research on the use and experience of the PS-concept by personnel on a disaster site is needed to give input for further improvement of the concept.