The care of critically ill children has received much attention in the past decade, and many of the recommendations from reports relating to the provision of paediatric intensive care have been addressed. In comparison, high dependency care has received less attention. This level of care is often provided on 'general' children's wards, yet its impact on nursing staff and care delivery have received little attention. This article presents a study which explores nurses' experiences of providing high dependency care on children's wards using focus groups. Following analysis, six categories emerged: definitions and perceptions of high dependency care; having a high dependency unit; problems in district general hospitals; the skills needed for high dependency care; team working; and staffing for high dependency care. These findings have implications for current clinical, managerial and educational practice and for future developments in the field of high dependency care for children.