Objective：To clarify the effects of trust in nurse managers, organizational justice, support from nurse managers, and support from colleagues on the organizational commitment of mid-career nurses working at regular hospitals in Tokyo, which has a high rate of COVID-19 infection, and to find ways to strengthen the organizational commitment of mid-career nurses.

Methods：We conducted an anonymous self-administered questionnaire survey of 629 mid-career nurses working at general wards of 19 general hospitals with 200 or more beds in Tokyo. Using structural equation modeling, the survey investigated the effects of trust in one's immediate nurse manager; organizational justice, including procedural justice, distributive justice, interpersonal justice, and informational justice; support from one's immediate nurse manager; and support from colleagues on organizational commitment.

Results：Two hundred and forty-nine responses were received, of which 222 were valid (valid response rate, 32.1%). Results showed that organizational commitment was affected by "Procedural justice," "Distributive justice," and "Support from colleagues."

Conclusions：The organizational commitment of mid-career nurses might be improved by explaining the process of their role assignment and salary evaluation; by appropriately evaluating their contribution to work; and by creating an environment which encourages respect among colleagues.

Objective：The purpose of this study was to clarify the decision support provided by nurse practitioners (NPs) in scenarios where hospitalized patients are determining treatment policies.

Methods：The participants had at least 2 years of NP work experience in a ward. A semi-structured interview method was used for 6 NPs who agreed to participate. The data obtained were analyzed using a qualitative descriptive approach.

Results：Four categories were extracted: "Building relationships between patients and nurse practitioners (NPs) and eliciting patients' wishes", "Building relationships between families and nurse practitioners (NPs) and facilitating communication of wishes between patients and their families", "Identifying and proactively intervening in physical conditions of patients that impair decision-making", "Optimizing the medical team to accommodate patients' wishes".

Conclusions：The decision support role of nurse practitioners (NPs) was considered unique due to their membership in clinical departments and collaborative symptom management with physicians, which differs from typical nursing roles by allowing self-management of work time instead of working in shifts.

Discharge planning nurses collaborate with ward nurses to identify and prioritize patients who may face difficulties upon discharge. Despite their interventions, readmissions are not uncommon. This study aimed to examine the reality of readmissions among patients with orthopedic disorders and explore the high readmission rates and causes. There were 150 readmission cases out of 7.798 patients (1.9%), discharge planning nurses intervened in 33 cases (22.0%). The most common underlying condition was "assistance required for activities of daily living (physical)" with 125 cases (83.3%). The most prevalent disorder was "lumbar spinal stenosis" with 41 cases (27.3%). Based on these findings, the tendency for readmissions in patients with orthopedic disorders has become apparent. The challenge ahead is to establish a mechanism where discharge planning nurses can intervene early for patients who correspond to high readmission rates and evaluate whether this approach can reduce readmission rates.