sentences:  This 'changing skill mix' had the effect of increasing the managerial, medical and therapeutic work of nursing, and assigning bedside care to non-nursing staff.This grew out of 'total patient care' which involved nurses taking on additional clinical roles such as occupational therapy tasks, their work load increased accordingly.Nurses reported being concerned about qualitative differences in patient care that weren't being measured, as well as increased pressure and uncertainty due to extensive changes.