The future of nurse management.

organisation contin. ue to take its toll on many nurse managers the question arises: What of the future for nurse managers? Shrinking resources in real terms and attempts at introducing private contractors to run the support services means that the NHS we all know is about to undergo a transformation. So what does the future hold? Nurse managers will have less resources and an increased demand for more nurses. Nurse staffing formulae 'will be less helpful than knowing the actual minimum numbers of nurses required and available as matched against the money allocated and whether it is sufficient to achieve a reasonable standard of care. Scarcity of money will cause a total review of the services to be made and fundamental questions will be raised and will have to be answered. An extensive review will also have to made of the more expensive patient sennces such as dialysis. For instance, is the criteria sound which is used to place patients on a programme which possibly commits resources for several years? In some places the decision on criteria have been vague. This has to change. What comes out of this type of thinking is that eventually critical budgets have to be set for all medical specialities and development strictly controlled. Unfortunately, management cost restrictions do not allow us to employ the staff to produce the information. From this I under.stand that the days of total clinical freedom from the medical profession are numbered. Should this be so then what can be done for patients will have to be carefully matched with the resources that are made available. Nobody applauds that situation but this has already happened for many years in some specialities. If the number of hospital beds is restricted then only so much work can be undertaken. Choices have to be made which mean larger waiting lists and delays in treatment. What the future may hold is the partial or total closure of wards and departments because of the lack of money to provide