Mental exhaustion among hospital nurses, particularly among novice nurses, is an important problem in Japan, being assumed to be a reason for early resignation. Difficulty in relationship with colleagues is one of important correlates with their job stress, although few researchers have focused on the self-expression attitude of senior nurses toward novice nurses. In the present study, the authors developed a vignette that a novice nurse is just making an error in a clinical setting, and also the Scale for Assertion of Clinical Nurse (SAN) based on assertion theory. These tools were applied to a self-administered questionnaire survey for 736 senior hospital nurses, for the purpose of investigating the possible association of their self-expression attitude with age, marital status, and job class. Out of the subjects, responses for 424 (57.6%) were analyzed.
SAN consists of three scales, Assertion scale, Non-assertion scale, and Aggression scale. The former two scales exhibited sufficient internal consistency, although the last scale did not. Factor construct validity and criterion-referred validity for three scales were confirmed, in reference with the responses to the vignette. Future works to improve their reliability and to confirm their validity are warranted.
The responses to the vignette and SAN showed that those aged 40 or above, and those engaged with administrative work were significantly assertive, respectively, while young nurses and staff nurses were significantly non-assertive. These results suggest that the more experiences they have in work and personal life, the more assertive they get toward novice nurses, although this can not be concluded from the present cross sectionaldata.
Although the above observation can not be generalized at once, this includes important suggestion. Because it is possible that relatively young nurses can not be assertion model for novice nurses, hesitating to point out problems among novice nurses; however, the young nurses engaged for 1-4 years are usually nominated for preceptors to novice nurses in actual hospitals of Japan. Assertion training therefore seems to be needed for these young preceptors to assertively express themselves toward novice nurses. For this purpose, self-rating tools such as SAN may be useful.

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