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In the 1960s and 70s, the evolution of nurse management in French and British state hospitals was characterised by increasing specialisation and the development of a full career ladder. Since the 1990s, however, professional control over nursing staff and healthcare assistants has been eroded. The analysis shows the impact of New Public Management reforms on the definition and organisation of the category and the comparative framework highlights the effect of national healthcare policies, training and labour market systems on the evolution of the category. It also shows the strong individualisation of career pathways in Britain compared to France where a single career structure has been maintained. More generally, it is argued that nurse management is a relevant example of the impact of recent public policy changes on the status of professionalized occupations in the public sector.