Nurses as managers: between a professional rock and an HRM hard place?

This paper aims to give some insight into the role of nurses as managers in the British National Health Service (NHS). Concentrating on the role of line and middle management i.e. ward and clinical nurse managers, it is shown how attempts are made to cultivate nurse managers as major change agents in a time of cultural transformation for the NHS. This role has been greeted by senior nurses with mixed feelings: enthusiasm for introducing quality-led initiatives but also ambivalence towards fully embracing a management identity. Nurses have proved themselves to be competent middle managers throughout the history of the hospital service (Bradhsaw 1995). Nevertheless, many of the contradictions they now face could be attributed to a lack of investment in management training and development in the context of a period of major reform for the British public services.