In the penultimate part of this series on issues in ward management facing charge nurses, George Castledine concentrates on the issue of accountability. The immensely powerful position of the charge nurse as arbitrator and co-ordinator of all health care given to the patient demands that helshe excercises this power responsibly and positively; hence, the crucial importance of accountability. The author explores this concept and also those of advocacy and conscientious objection. He concludes by suggesting that the ultimate area of accountability in nursing is the individual conscience of the practitioner and that in this may lie the key to the setting and maintenance of high standards of care.