Ward sisters' views of the effect of NHS changes.

The role of the ward sister or charge nurse has long been acknowledged as being central to the provision of high-quality patient care. Health service reforms since the 1980s have led to greater managerial responsibility for ward sisters and charge nurses, who are often now known as ward managers. This paper reports on a study carried out in one hospital which described how 15 charge nurses and ward sisters saw their roles in the light of recent changes. While the informants spoke of areas of their jobs with which they were satisfied, such as control over financial resources, there were also areas of concern. These included the pace of change and the sense of isolation that they experienced. The ward sister's responses are described and recommendations for practice outlined.