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Sisters to take control of wards in Wales

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Ward sisters and charge nurses in Wales are to take control of cleaning and care under new powers announced for ward managers.

Over 30 recommendations, drawn up by a ministerial task force headed by RCN Wales, have been ratified by health minister for Wales Edwina Hart.

The group had urged the minister to give ward managers powers to improve hospital care as a priority last May.

According to the group’s report, Free to Lead, Free to Care, published last week, ward sisters and charge nurses will oversee their own domestic staff as well as newly appointed ward housekeepers.

They will also take responsibility for delegating cleaning tasks to HCAs, and will be able to demand help from rapid response cleaning teams and technical hygienists, who will be experts in cleaning clinical equipment.

Additionally, until all hospital wards in Wales are single sex, ward managers will decide where male and female patients should be placed within wards.

By the end of the year, all nurses will be given new uniforms as part of an all-Wales dress code to help patients distinguish between levels of nurse from sister to student. Moreover, although the idea hinges on a cost analysis, uniforms could be washed in-house and changing rooms provided for nurses by 2010.

A training programme to address managerial skills and standards of care will be mandatory for all ward managers by the same year, the report said.

Fluid charts and nutrition pathways will be provided to all ward managers by the end of this year.

RCN Wales interim director Richard Jones said: ‘I think this is superb and it is something that has been done from the ward up. Sisters have been very much involved and, when people are involved, that is when success occurs.

‘It gives them back the power to manage their wards, which makes the patient experience more positive, and allows nurses to look after their patients with dignity.

‘One of the most important factors is that they will be in charge of the domestic staff, which will make a real difference and will allow them to manage like they did years ago,’ he added.

Rosemary Kennedy, chief nursing officer for Wales, said: ‘The most important thing is the minister is making it clear that trust boards, from the chief executive down, must recognise the role of the sister.

‘It is about giving them the support to make difficult decisions. Once they are in that position we will find all of the other things, like cleanliness, nutrition and hydration, will all follow.’

What will happen and when:


  • All wards will have domestic staff and a housekeeper, managed by the ward manager

  • Ward managers will decide where patients are placed on a ward, with men and women on mixed wards in separate areas

  • They will take responsibility for delegating cleaning tasks to HCAs

By the end of the year

  • All ward managers will have access to a nutrition pathway and a fluid chart

  • They will have a national forum

  • There will be a dress code and a new uniform

  • Ward managers will have a mandatory training programme

By 2009

  • Ward managers will be supervised by the director of nursing, and new ward managers will have a six-month preceptorship

By 2010

  • All ward managers should have been completed mandatory training

  • Changing facilities will be set up at hospitals

Marie Williams, ward sister on Steffen Ward at West Wales General Hospital in Carmarthen, is a proud nurse.

A conversation she had with health minister for Wales Edwina Hart, when she visited the hospital in 2007, played a part in the minister’s announcement of proposals to empower ward managers during a further visit to the hospital last week.

Ms Williams told Ms Hart about the daily challenges of the health service and what more could be done to support ward sisters and charge nurses in order to improve patient care.

‘It is really good to know that nurses are being listened to and that our voice is increasingly stronger,’ she said. ‘We are on the frontline every day and therefore have a huge impact on the patient experience.’

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