Leadership in the nursing unit: relationships with nurses' well-being

The head nurse occupies an important position in the nursing unit Concerning leadership style, a distinction is traditionally made between consideration and initiating structure Sometimes a third style is distinguished as well, namely 'production-orientated' leadership In a study of 561 nurses from 16 general hospitals in The Netherlands, the influence of two leadership styles upon the reactions of nurses (job satisfaction, experienced meaningfulness, health complaints and absenteeism) to their work situations was examined, namely the styles of social (i e consideration) and instrumental leadership (a combination of the styles initiating structure and production-onentated) The separate effects of the two styles were studied, as well as the connection between combinations of leadership styles and reactions The results indicate that social leadership contributes positively to nurses' reactions to their job Instrumental leadership, on the other hand, leads to health complaints From the analyses of combinations of leadership styles it appears that nurses are most satisfied if the head nurse pays much attention to both dimensions of leadership For health complaints, a tendency in this directions is also found Finally, it becomes clear that nurses with a great need for autonomy prefer a different type of leadership from nurses with little need for autonomy     

Mental health intensive care: the nurses'experience and perceptions of a new unit

This paper describes a qualitative research study which explored the practices and views of nurses working on a new Mental Health Intensive Care Unit A review of the literature identified the main aspects of intensive care provision (1) physical security, (2) characteristics of the patient group, (3) staff-patient ratios, (4) therapeutic environment and (5) multi-agency involvement Twenty-one periods of participant observation helped form the questions for a semi structured in-depth tape recorded interview in which 11 out of a total of 16 trained nurses took part The information is categorized and the discussion is informed by observation of practice The nurses perceived the following as the main issues that the physical environment is inadequate for security, that the patient group appears to have the common characteristic of being unwanted in other clinical settings, that the staff-patient ratio is inadequate and that their vision of the nature of a therapeutic environment is vague     

Reduction in hospital stay of chronic schizophrenic patients after long-term clozapine treatment

The present study aimed to elucidate the effectiveness of clozapine treatment in reducing the disabling period of chronically ill schizophrenic patients by investigating their rehospitalization status. Of 232 schizophrenic patients with a history of clozapine use who were recruited from the clinic at Seoul National University Hospital, 117 were selected who had been followed up for more than 1 year with respect to rehospitalization. To obtain information about the period before the clozapine change, a chart review of these 117 patients was conducted. The number and length of hospitalizations of the patients significantly decreased after clozapine treatment compared to the same period before clozapine treatment. The hospital days per year of the patients were also decreased significantly after clozapine introduction. By analysing 38 patients who were followed up for more than 5 years, it was suggested that the decrease in the number and length of hospitalizations was substantially sustained for up to 5 years after clozapine treatment. This study showed that the number and length of hospitalizations are significantly decreased by long-term clozapine treatment and that this effect can positively affect the social outcome of schizophrenic patients.