The objective of this study is to describe how nurses who had changed workplace for the first time assessed the significance of their experience of changing workplace when thinking back on and narrating the experience. We conducted a non-structured interview with two nurses who had the first change of workplace to a university hospital, at their own initiative, in the fourth year of clinical expe-rience; one from an acute care hospital and the other is from another university hospital. The analysis was performed based on phenomenology by focusing on the narratives. Both of the nurses stated that "it was different from what I had expected". The experience behind these statements made these nurses think about their expectations and what they had anticipated only when placed in situations different from their expectations. This awareness originated from the expectations they had harbored. The newly arising awareness that "it was different" clearly showed that they had performed their nursing duties without particularly thinking about what nursing practice involved. This newly arising awareness became an opportunity for them to redefine their styles and approach to the work, and required them to change their understanding of what nursing involves. They repeatedly assessed the significance of this "it was different" experience through the work in the new hospitals, comparing it with the experience in their former workplaces. The nurses were not aware of any clear time point for changing their approach to nursing, and the significance of the experience varied with the situations experienced by each.

The objective of this study was to assess the association between support from nursing managers and professional autonomy in nurses. The anonymous, self-administered questionnaire was given to 997 nurses. The survey items included the scale for social support from nursing managers (15 questions), the scale for relationships with nursing managers (20 questions), and the scale for professional auton-omy in nursing (47 questions), as well as general demographic questions. Of 997 nurses, 374 nurses (37.5%) responded to the survey. Of these, we excluded 73 nurses with missing data. Thus, 301 nurses were eligible for our analysis. A logistic regression analysis was used to estimate the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between social sup-port from nursing managers/relationships with nursing managers and professional autonomy in nurses. After adjustment for confounding factors such as years of experience and basic nursing education, social support from nursing managers was associated with professional autonomy in nurses [OR (95% CI): 1.17 (1.03 - 1.34)]. Additionally, after adjustment for confounding factors such as years of experi-ence and basic nursing education, relationships with nursing managers was associated with professional autonomy in nurses [OR (95% CI): 1.10 (1.03 - 1.18)]. Our findings suggest that support from nursing managers is positively associated with professional autonomy in nurses.

The purpose of this study was to describe the development and evaluation of a competency-based management program for nurse managers. We referred to "Competence at work" (Spencer & Spencer, 1993) and enrolled Japanese nurse managers in a program to assess areas of competency. This program was composed of eight modules based on competency clusters. Thirty-three subjects (1~5 years of managerial experience) participated in this program. We measured competency levels using a question-naire that we designed. Self-efficacy was measured with the General Self-Efficacy Scale which is 16-item scale designed by Sakano and Tojyo (1986). We distributed questionnaires before the program started and just after completion; 32 and 32, respectively, were collected. A module evaluation question-naire was distributed after each module to evaluate the program contents. All 33 participants completed each module evaluation.

A paired t-test was used to compare participants' competency level and self-efficacy. The mean score of competency was significantly higher after the program than before (2.87 vs. 2.76, p<.05). The mean score of self-efficacy was significantly higher after the program than before (9.65 vs. 8.71, p<.05). However, there was a cluster of cases where the mean score of competency was lower after the pro-gram, and there was one module which received a low rating for intelligibility and participant satisfaction.

Overall, the program effectively increased the competency levels of nurse managers. Some modules may require revision to improve contents or methods of presentation.

This study aimed to identify nurse managers' perception of and approaches to successful manage-ment. The participants were 9 nurse managers with more 5 years of experience as a nurse manager and who worked in general hospitals with more than 300 beds. Semi-structured interviews were conducted, which included questions on what conditions nurse managers considered crucial for successful opera-tions and how nurse managers strived to achieve these. We analyzed the data using the modified-grounded theory approach. Two categories of nurse managers' perception and five categories of nurse managers' approach were found to contribute to successful management. Nurse managers attempted to "understand nurses' personality", "adopt viewpoints other than one's own", and "enable nurses' inde-pendence" on a daily basis. Based on this information, they subsequently "carefully worked on opera-tional plans for the unit". In addition, nurse managers strove to "create a work environment that encouraged discussion among nurses". Subsequently, nurse managers suggested operational plans to nurses, and attempted to "incorporate the nurses feedback into their management style". Nurse manag-ers took the initiative in "improving quality of patient care continuously". It was suggested that nurse managers consider units that maintain and provide consistent quality nursing to be successfully; thus they involved nurses in operational decision-making.

Objective: This study aimed to make basic data based on clarification of the status of the support to nurses with caring their children or after delivering by hospitals and its influences on continuation of their employment.

Methods: Study subjects were nurse managers in 339 hospitals with more than 200 beds in eight pre-fectures in Japan. Nurse managers responded to questionnaires anonymously. We investigated character-istics of hospitals and nurse managers, the status of workforce, and the support to nurses with caring their children or after delivering by hospitals. Mann-Whitney U test was used for analysis by SPSS.

Results: 122 questionnaires were returned and 110 questionnaires were analyzed. The rate of hospitals which adopt shortened office hours was 42.7% and lowered overwork was 36.4%. The rate of resigna-tion by delivery and caring their children of regular nurses per all regular nurses was 1.0±1.2% and per resigned nurses was 11.3±13.5%. However the rates of hospitals which adopt shortened office hours and lowered overwork were low, the rate of resignation by delivering and caring their children in the hospitals which adopted shortened office hours or lowered overwork was less significantly than which they did not adopt.

Conclusion: It is suggested that the support to nurses with caring their children or after delivering by hospitals as shortened office hours and lowered overwork influenced on continuation of their employment.