The statement in this article is that nursing management is needed, however, rethinking is required. The traditional ways of organizing nursing practice have to be adjusted to the constantly changing conditions in health services. The purpose for nursing practice is to give the best contributions to the patients’ outcome. Today financial circumstances limit the efforts. This gives nursing leaders great challenges. They must despite of limitations take actions to ensure that an adequate nursing staff is available to protect patients and to improve the quality of care. The nursing leaders have to secure that nursing practice is evidencebased or based on best knowledge available. This requires nursing management and the need for competence as well as organizing and planning.