A number of organizations in recent times have undergone changes which have been motivated by the need to satisfy customer preferences. In the health sector, reforms were and still are motivated by the need to provide patient focused care thus organizing health services to meet patient needs and preferences; protecting patients rights, improving efficiency, the need for adopting new technology, reducing medical errors and minimizing overall total health cost. In Ghana however, reforms in the health sector had been motivated by the need to improve accessibility, reduce government cost and control and to improve efficiency of health care services in the country. Many studies in recent times have attempted to evaluate the impact of such reforms on health services management and organization and on how patient outcomes have been affected by these changes. This thesis attempted to investigate how one of such reforms, upgrading a clinic to a hospital, has affected the general competencies of nurses who stay at the post after the upgrade has been completed. The findings in this thesis suggest that most nurses maintained their previous positions after the upgrade. Some nurses had been promoted to higher levels of responsibilities which meant new job demands. This was resolved by the training and development of the skills necessary for performance. Secondly, the interviews showed that nurses workload had increased as a result of the upgrade and it was evident that nurses worked overtime and complained of lack of adequate health personnel at the hospital. All in all, the goal of the upgrade was achieved but new problems arose and uncertainties still linger in the minds of both nurses and management. Further exposition and a more robust assessment of the job demands and control model within this setting are warranted.