This study was carried out to specify risk factors related medical errors and mistakes in working conditions of nurses. Data on the working conditions, job-related stresses, medical errors, and mistakes of 1,339 nurses in 6 teaching hospitals were collected using questionnaire. The logistic regression analysis was used to obtain quantitative relationship between risk factors related medical errors and working conditions. It was found that the stress factors of "over working time," "break time," "job demand," "job control," "job suitability," "job satisfaction," "physical stress," "mental stress," and "fatigue" were concerned with medical errors and mistakes. The result implied that the improvement of working conditions of nurses was needed and so that appropriate nurses staffing was discussed for keeping patient safety.

The aim of this study was to identify the actual conditions of difficulties for head nurses who train their staff nurses in China. The level of difficulties and necessary support were clarified. By using a self-devised questionnaire, data was collected for 202 head nurses from 4 hospitals affiliated to a Chinese medical college. According to the Gathering Method I applied, a selfregistering investigation was conducted.

Results: Among the difficulties faced by the nurse training, the categories were: ①Continuing Nursing Education, 66%; ②Education and Researching Abilities, 61% ; ③Impart Motivation, 46.5%. In this order, the ratio of difficulties was high. In the scoring rate (according to the mean value), the 3 items of highest rank were as follows. ①Enhancing the ability of nursing research (3.81±1.25); ②Ensuring teaching materials and instruments for nursing educational activities (3.75±1.31); and 3) Assuring a budget for nursing education (3.62±1.23). The 3 items of lowest rank were as follows. ①Setting themselves as an example for the nursing practices (1.21±0.65); ②Helping staff nurses to learn nursing techniques (1.35±0.67); and ③ Helping nurses to gain basic nursing knowledge ( 1.37±0.79).

In order to train staff nurses, the expectation of essential support was very high. One quarter (25.3%) of the head nurses hoped that they could obtain all of the support listed the above. The first 3 items among all essential supportive opportunities were listed sequentially. ① Increasing the opportunities for head nurses to study outside the hospital (4.79±0.58); ②Enhancing inhospital training of teaching skills (4.79±0.56); and ③Enhancing in-hospital training on nursing research methods (4.6±0.73). There was no correlation between difficulties and essential supports in spotting nurse talents.

The administrative method applied nowadays in the ward has not become well established yet. Therefore, it is very important to establish systematic education and management for Chinese head nurses on nurse training.

This study aimed to clarify what useful experiences for the middle nurse manager's growth are, and how they may learn from the experiences. For this study, we focused on middle nurse managers who, having demonstrated an ability to work in the medical environment, also displayed an ability to do so despite some extreme changes being made in modern Japanese medicine. The participants were eight middle nurse managers of four general hospitals. The data was obtained from semi-structured interviews that we analyzed using the qualitative induction method. As a result of the analysis, five main experiences and twenty-four concrete experiences have been presumed useful experiences for the growth of the middle nurse managers. The main experiences were ① systematic development of human resourses, ② encounter with hardships, ③ job challenges, ④ early manager experiences, and ⑤mentor's support.

The participants developed systematically first through organization, which then developed into nursing. After mastering the art of nursing, they then became managers. Through the process of developing systematically, first through human resources, they acquired many special abilities and challenged various areas. They encountered various hardships while doing so, one such being the lofty attitude they developed due to the improvement of their skills, and the conflict they found themselves in assuming a new role. As a result, they were able to obtain a valuable lesson, such as trying to look at themselves more objectively. In addition, four main experiences of the participants had been influenced strongly by mentors, and all participants had met their special mentors with whom they grew up as a leader.

A qualitative induction study was performed with the purpose of clarifying the characteristics of how nurses and physicians interact via their mutual conversations in the patient-care setting, including the thinking that lies behind their respective discourse. Data was collected by means of participant observation at nurse-physician conversation sites and via semi-structured interviews with nine nurses and nine physicians.

As results, the following were found in the nurse-physician discourse: "Cues for Action," "Cues for Reconsideration," "Acquisition of Information and Opinions," and "Provision of Information and Opinions."

As for "Cues for Action" and "Cues for Reconsideration," characteristics observed were that nurses question the opinions of physicians and use "cues" when intentionally offering information, thereby stimulating the development of the care process.

As for "Acquisition of Information and Opinions," and "Provision of Information and Opinions," characteristics observed were that more information, both in terms of quantities and kinds, is provided by nurses to physicians ─ especially observed was the provision by nurses of much information regarding changes in patients as well as concerning patient families during the course of the treatment. Also, in settings of conversations between nurses and physicians, in cases where there were differences in their respective opinions, there were not a few cases where, due to not providing verbally to the other party the thought processes supporting one's opinion, no development was seen in the mutual interaction process.

From the above results, it was thought that, for the formation of a collaborative relationship between nurses and physicians, it became clear that it is required to exchange "Cues for Action," "Cues for Reconsideration," after a nurse and a physician share the idea which care as a patient goal, or the view and background of a plan and both sides in everyday life by exchange of "Acquisition of Information and Opinions," and "Provision of Information and Opinions."

Also as conditions for the formation of a collaborative relationship, it was suggested that, on the side of nurses, there needs to be the ability to make clinical decisions on the basis of their specialty expertise, an understanding of patients including their families, and the ability to make clear and convincing communications, while on the side of physicians, there needs to be a deepening of their understanding of care and of the expertise of nursing, and cooperation via positive and clear expressions, including a conscious expression of information, opinions, policies, and intentions concerning care and treatment, etc.

The present study investigated the relationship between mentoring and the career outcomes of nurses with respect to mentor job positions. A questionnaire survey was administered to 780 non-management level nurses with nursing experience of 10 years or more using a mentoring scale consisting of subcategories "career function," "acceptance/approval function," "manager's behavioral function," and "emotional function," as well as a career outcome questionnaire consisting of subcategories "job satisfaction," "internal motivation," and "achievements." It was found that slightly less than 60% of subjects had a mentor. Subjects whose mentors were "nonmanagement level nurse," "chief nurse/assistant head nurse," and "head nurse," were categorized into 3 groups, and the relationship between mentoring and career outcome in these groups was analyzed. For subjects whose mentor was non-management level nurse, a relatively weak positive correlation was observed between 3 subcategories, except for "emotional function," in the mentoring scale, and all subcategories in the career outcome survey. In the group whose mentor was chief nurse or assistant head nurse, although a relatively weak positive correlation was observed between "career function" and "job satisfaction," no correlation was observed between any other subcategories. In the group whose mentor was head nurse, a relatively strong positive correlation was observed between all subcategories except for between "emotional function" and "job satisfaction." Significantly, Pearson product-moment correlation coefficients between "manager's behavioral function" and "achievements," and "manager's behavioral function" and "job satisfaction" were both above 0.5. Therefore, it was suggested that the mentoring function of head nurse were effective in advancing the career development of individual nurses.

The purpose of this study takes informed consent to be an innovation in nursing knowledge and seeks to clarify the relationship of its diffusion with present leadership types. The study was conducted between August 30, 2005 and September 15, 2005. We chose 1,148 nurses who agreed to participate in this study from three general hospitals approved by a third-party accreditation council. We employed the innovation adoption model of Rogers for the diffusion of informed consent in nursing care, and utilized the PM instructor behavior measurement scale according to Misumi's PM theory of leadership analysis. We compared the diffusion of informed consent with four leadership types. Results were as follows. The average age of subjects was 32.9±9.6 years, and clinical experience was 10.9±9.3 years. The diffusion of informed consent was 76.4% and prevalent. Regarding four leadership types, PM leadership type(strong P and M function) did better than pm type in promoting the innovation diffusion by knowledge, attitude, decision and practice. These findings suggest that it is important to strengthen both P function(Aim achievement performance) and M function(Group maintenance attitude) to facilitate the diffusion of informed consent in nursing care.