Ward sisters and charge nurses face new and different pressures in a changing health service. This year’s RCN Congress will call for a national development programme forward managers. Here, the authors describe how, using a ‘think tank’, workshops and a seminar, one trust identified the obstacles to good nursing practice and developed positive ways of overcoming them

The qualities of the ward sister have long been recognised as pivotal to the provision and promotion of good patient care and ward management. Literature from both the US and the UK has identified nurse managers and ward sisters as key individuals within the entire health care organisation (Cameron-Buccheri and Ocier1996). A finding of many studies is the ward sister's ability to create a ward learning environment and act as a role model for staff (Orton 1981. Pembrey 1980,Roberts 1993).