Aim To explore the challenges facing hospital nurse managers (HNMs) in selected hospitals in the Volta region of Ghana.

Method The study, which had an exploratory qualitative design, involved the recruitment of 12 HNMs from six public hospitals in the Volta region of Ghana. Purposive sampling was used and data were collected through semi-structured interviews. The conventional content analysis approach was adopted for data analysis.

Findings The study revealed several managerial challenges of being HNMs in performing their roles. These include: a lack of managerial preparedness, clear job descriptions and support; interference by other managers; and inadequate nursing staff and material resources. All these compromised the quality of nursing care. Participants found their role tedious and stressful, but also regard it as an opportunity to learn new ideas.

Conclusion HNMs face several challenges that negatively affect their performance. There is a need for succession planning, career development and mentoring programmes to strengthen HNMs’ leadership and management skills to help them provide high-quality nursing care.