Analysis
NURSING MANAGEMENTApril 2009 | Volume 16 | Number 16
The role of ward sisters and charge
nurses is to be reviewed to tackle pay
discrepancies, ease caseloads and allow
them to supervise clinical practice.
The review by the rCN is to follow
the publication last month by the college
of Breaking Down Barriers, Driving up
Standards: The role of the ward sister and
charge nurse. This document examines
current roles, best practice and areas
where more support is needed and lists
several activities undertaken by the rCN
to promote the ward sister and charge
nurse role (see box).
Offering leadership
The report demonstrates that ward sisters
and charge nurses are prevented from
offering the leadership that is required
of them because their clinical caseloads
are too high, they have too little authority
over ward environments and they have too
much paperwork to do.
rCN general secretary Peter Carter said:
`one example featured in the report shows
the problems that arise when nurses are
not given the necessary authority to lead on
their ward. Nurses on one ward had to buy
their own batteries for medical equipment
because they did not have the authority to
get them delivered through the hospital
system. This is not an effective way for
a ward to be run, and there are few other
industries where this kind of thing would
be tolerated.
`Talented nurses should be free to lead
and to nurse, and good nurses should be
encouraged to take a career route where
they can lead, educate and oversee care
as ward sisters.'
Dr Carter said that ward sisters are
also involved, wrongly, in too many
human resource activities such as putting
together interview panels and writing job
advertisements.
According to the rCN report, ward
sisters and charge nurses should supervise
nursing on all shifts, rather than take on
heavy clinical caseloads. Many also report
a lack of formal preparation and skills
development to ensure that they and
aspiring ward sisters are fit for the job.
The report also claims that patients want
to know who is in charge of ward areas
and that these people have the necessary
authority to deliver good care.
The rCN recommends that all ward
sisters have supervisory roles so that
they can: fulfil their ward leadership
responsibilities, supervise clinical care,
oversee and maintain nursing care
standards, teach clinical practice and
procedures, be role models for good
professional practice and behaviours,
oversee ward environments, and be highly
visible as nurse leaders on wards. It also
suggests that ward sisters and charge nurses
should be given titles that convey clearly
their identities as nurse leaders of wards.
Nurse directors are urged to review the
remit of ward sisters and charge nurses
to ensure that they have appropriate
authority to deal with key issues, such as
ward cleanliness and nutrition, and the
appropriate administrative, housekeeping,
and human resources support.
Ward sister role under scrutiny
Nick lipley reports on how the ward sister and charge nurse
role is to be reviewed following an rCN study
Activities to promote ward sister and charge nurse role
According to Breaking Down Barriers, Driving up Standards, the RCN:
Will support nurse directors to promote discussion and a strategy to recognise the
importance of the ward sister and charge nurse role in providing high-quality care.
Will compile a factsheet with details of high-quality research into the importance of
the ward sister and charge nurse role.
Expects all staff who match the ward sister and charge nurse profile to receive at least
the salary of band 7 staff.
Pictured left: ward sister Samantha Philpott
at the Heart Hospital
DavidGee

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