The new ward manager: an evaluation of the changing role of the charge nurse.

Changes in health service policy and in the structure of nursing have made charge nurses into ward managers with the autonomy and power to improve the quality and effectiveness of patient care. In a climate where clinical effectiveness and quality of care are seen as central to the provision of appropriate health care, this study explores the experiences of one National Health Service trust in implementing this change in the charge nurse's role, and in doing so highlights the importance of effective change management. Nurse managers were interviewed and all ward-based G grade (range A-I) charge nurses within the trust were sent a questionnaire to ascertain: the level of satisfaction with the way the changes had been introduced; whether they were in favour of the changes; and if they had sufficient time, knowledge, resources, preparation and support to enable them to undertake their new role. A random sample of charge nurses were also interviewed. It was found that the majority of charge nurses (61%) were in favour of the development of their role, believing it to be both inevitable and necessary. However, many felt that the change process had been managed ineffectively. There had been insufficient consultation during the change process, preparation and support were perceived as inadequate, the roles of the various protagonists were often unclear, and the lack of supernumerary status led to role conflict and confusion. As a consequence the new ward managers were often unable to fulfil the true potential of this demanding but exciting role.