A cost centre in a hospital setting is an identifiable department, for example a nursing care unit, which has been practically assigned an account number in the hospital accounting system. The purpose of a cost centre is to control clinical and administrative costs, as well as accumulated expenses by that identified department. A qualitative, descriptive, exploratory and contextual research design was used for this study. Homogenous purposive sampling was conducted from a population of 36 nurse managers appointed as cost centre managers. One focus group discussion comprising nine cost centre managers and 12 cost centre managers participated in unstructured one-on-one interviews until data saturation was reached. Data were analysed qualitatively using Teschs’ open coding method. The findings revealed there are dominant stories of perceived constraints related to the role of a cost centre manager resulting in personal and professional suffering and a need for a decentralised cost centre management for enhancement of cost centre managers' knowledge and skills. It was recommended that a training programme for cost centre managers be conducted as a process/procedure during which information will be disseminated about cost centre management including problem solving in the team, business plan, business cost planning and overall accountability of people involved. The goal of the training programme should be to clarify roles and values, create a safe environment for cost centre managers and build trusting relationships among all role players.