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Abstract
Background The nursing profession is being directed by the government to modernise alongside the NHS as an organisation (DoH 2000). The role of ward sister/charge nurse has taken the brunt of increasing managerialisation and the reduction in junior doctors' hours. This article examines how the role has developed and explores future opportunities.
Conclusion The ward sister/charge nurse role is pivotal to the modernisation of the NHS. However, unless the role, responsibilities and expectations of these experienced nurses are clearly defined, the position may cease to be a promotional aspiration of junior nurses. The negative consequences of this for standards of patient care and recruitment and retention of staff are likely to be significant.
Key words
* Modernisation
* Nursing: role
* Staff: recruitment and turnover
These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
THE NHS PLAN (DoH 2000) describes the government's strategic direction for the NHS over the next ten years. The principal tenet of this document is that the current problems the NHS is experiencing are located in its 1948 genesis, thus the service requires modernisation. The document states that rigid professional role delineation can result in poor responsiveness to patients' needs, while unnecessary bureaucracy places the requirements of the institution ahead of those of patients. In the NHS Plan, England's chief nursing officer lists ten key roles for nursing that break down some old boundaries between the clinical professions (DoH 2000).
The national nursing strategy, Making a Difference (DoH 1999), highlights social change, technological advances, epidemiological factors and increasing public expectations as factors that contribute to the need for NHS modernisation. Making a Difference (DoH 1999) outlines a commitment to strengthening nursing leadership and makes specific reference to the pivotal role of ward sisters and charge nurses, acknowledging that the role is sometimes undervalued and does not always attract the recognition it deserves. The document states that ward sisters and charge nurses: '...are the backbone of the NHS and the hub of the wider clinical team'. Chapter ten of the strategy describes how nurses, midwives and health visitors can begin to work in new ways, for example nurse-led intermediate care. However, although the ward sister or...