The role and responsibilities of department heads, and the effects of changing conditions in higher education, are considered, and reference is made to the nursing education department. The department represents an organizational unit as well as an intellectual discipline, and the department head is expected to serve in four roles: leader, manager, scholar, and "first among equals," (i.e., a peer who is serving a limited term as head of the group). The department head is principally concerned with three areas of potential change: mission, faculty, and curriculum. The following areas are addressed: the department head's relation to collective bargaining, the rewards a department head either controls or influences, personal qualities and leadership qualities, future concerns affecting higher education, role ambiguity and stress, maintaining quality, and indicators of organizational vitality. Suggestions for new department heads, a bibliography, and a list of indicators of organizational vitality are included. (SW)