This study’s aim was to elucidate health-care staff experience of working on a lockedacute psychiatric ward. In many countries changes in health care has contributed tofewer beds available in inpatient care, and a concentration of patients with severepsychiatric conditions. This implies a changing work environment in acute psychiatriccare. Qualitative interviews with health-care staff (n = 10) were carried out on a wardfor patients with affective disorder and eating disorder in a Swedish hospital. Qualitativecontent analysis was used. Four themes were identified from the data: ‘undergoingchanges in care delivery’, ‘feeling a need for security and control’, ‘managing thedemands at work’ and ‘feeling a sense of responsibility’. This study adds to earlierresearch into how a sense of responsibility can place a significant burden on health-carestaff working on a locked psychiatric ward and also contribute to increased control ofpatients. This study also shows that relationships and power structures among healthcarestaff need to be addressed when organizational changes are made in care delivery.Further research is needed to reach a comprehensive understanding of care on lockedacute psychiatric wards, including a development of nursing and medicine as knowledgedomains in one common context.