Australia.

Objective: Health systems throughout much of the world have been subject to 'reform ' in recent years as countries have attempted to contain the rapidly rising costs of health care. Changes to hospital structures (restructuring) have been an important part of these reforms. A significant impact of current approaches to restructuring is the loss of, or changes to, nursing management roles and functions. Setting: Australian hospitals Primary argument: Little evaluation has been undertaken to determine the impact of hospital structure and organisational restructuring on the nursing workforce. Conclusions: There is some indication that nurses have experienced a loss of key management positions, which may impact on their capacity to ensure that adequate and safe care is provided at the ward level