Happy with their lot or keen to move on? Janet Snell asked middle managers how they see their role and prospects

Irene Barr, deputy director of nursing at the Southern General Hospital trust, Glasgow 'In Scotland there's no shortage of management training for nurses.

From when I started as a staff nurse in the 1970s, right through to where I am now, I have always been sent off on management courses.

I did a diploma in management studies in 1987 when I was working as a nursing officer and could have gone on to do an MBA but chose not to. I have been very lucky to get support at all the units I've worked in throughout Glasgow and Lanarkshire. Here, my job is almost the same one I started with in the 1980s, but the job has developed as management has changed.

Working at this level is difficult and I've had to discipline people I used to work alongside. But as long as you make it clear it's a learning exercise rather than a punishment, then people understand it's your job.

You have to be kind and understanding and you have to work hard at maintaining your street credibility so that if it gets to the point of a disciplinary, people know there must be good reasons for it.

Nurses are excellent people managers. When I did my diploma, a lot of the non-nurses on the course, who were in the majority, had real difficulty when it came to organisational behaviour and how to deal with people. But the nurses sat back and wondered what their problem was, because that side of it is almost second nature to us.

I consider myself fairly ambitious, but I'm not really interested in going after a director of nursing job. I suppose if one came up I might apply for it.'

Clare Purnell, nurse manager, surgery department at Ipswich Hospital trust 'It can be difficult moving into management from a ward-based job, partly because there is so little formal training.

I was very fortunate to be able to shadow a long-standing member of staff who acted as nurse manager. But I didn't really know what the job was all about until I started. I was also lucky to move to a new trust for my first management role, so I didn't have to manage my former colleagues. But in other ways it made it harder because people didn't know me and I had to establish my clinical credibility.

I made a point of doing some shifts on the ward to show that I was still up to date, able to do the hands-on work and aware of the pressures the nurses were under. I still try and do one or two shifts a month because it's important to demonstrate you're keeping your clinical skills up to date.

I began as deputy service manager and I was made nurse manager following a reorganisation. I'm becoming more involved in the business management side which I find fascinating, though I knew little about it when I first started this job 18 months ago. Going into management wasn't always my ambition, but when I went into a specialist nurse role I missed managing people. If you have a management job that allows you to keep your hand in on the clinical side, that's the best of both worlds.

My role is still developing, and one good thing about the job is having a fairly free rein to shape it into what you want. There's scope for creativity in a way you don't really get on the ward when you're working to a set routine of doing the drugs, the lunches and the washes.

In a post like this, every day is very different and it's good to be able to learn more about the trust by getting involved in trust-wide groups and projects rather than just focusing on your specialty.

I haven't had any formal management training, but I did do an informal 10-day course covering recruitment and selection, risk management, finance and budgets. I think I would benefit from some formal training; it's just a question of finding the right programme.

My ambition is to learn more about the business side of things. My one frustration is the time it takes to get things done. Ideas have to go to various committees when really I'd like to get things moving.'

Judith Sweeting, Gwent Community Health trust head of district nursing services and a community manager for the unitary authority 'I think the hardest part for nurse managers is the letting go. You are managing colleagues that you used to have a lot of time for and you just can't be their mate any more. I've seen nurse managers who haven't been able to do that and their friends have been looked at by the other staff as the favourites. So it doesn't do anyone any good.

As you move up the ranks, you have to accept you're there to safeguard the public and the profession, and you can't do that if you have favourites. I think in middle management you are squeezed - those above you want you to deliver the service, those below tell you they are struggling to cope. Sometimes it feels all you do is react to problems - at this level, there's not an awful lot of positive feedback. The other issue is the difficulty of maintaining your clinical links; it can be quite a dilemma. If your career route is via general management, you come to do a management job and you are trained to do that. I don't think nurses are given enough preparation for taking on a management role. You are promoted and you're expected to take up the role and run with it. Some people sink, others swim.

Those with general management training are at a distinct advantage. I think you do need something of a ruthless streak to get to the top. I'm not suggesting nurses aren't capable of moving up, but I think they shed something in the process. As a nurse you've been trained to care for people and it's easy to start acting as the mother. If there's a problem, you always want to help, but managing people is a bit like having adolescent children - sometimes you just have to let them know you disapprove.

My ambitions don't lie in top management. I'm very happy being second in line in a section of a large organisation. I think I've found the right level for me.'

Marian Willmer, formerly quality development manager at Lewisham and Guy's trust, now a nursing lecturer (information management) at Brighton University 'When I was at Lewisham, I joined the trust's middle managers development forum, which was supposed to address some of the problems we faced. The trouble was we were a mixed bunch, ranging from people at senior admin level on about£22,000 up to managers at the other end of the spectrum earning£35,000 or more. So when we were told the forum was there to address our development needs, it didn't really ring true.

What did come over is how difficult middle management is and how much rubbish people at that level get thrown at them. Sometimes you feel that you can never win and it's hard to really achieve that much. It was easy to pick out those people on a career ladder, and the ones that had been promoted, because no one knew what to do with them.

When you come from a nursing background it's not always easy to plot a management career. I considered moving into personnel, but took a more junior general management role as administrative assistant to a chief executive. It was quite a culture shock coming straight from the wards, but I got on with it and thought I could work my way through the general management hierarchy.

But I found later, when I wanted to progress, that my lack of experience managing people counted against me. It was as if there was something magical about having managed people, which I'm not sure there is. I took an MBA, but then found that the fact I had one seemed to be viewed as a threat by managers who didn't. I might have continued my management career but the obstacles kept appearing, which was part of the reason I opted for an academic job.'