<p>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.</p> <p>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.</p>