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The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients.

Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis.

In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards.

Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty.

All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies.

To the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.

Drawing on the conservation of resources (COR) theory, this study aims to assess the moderating effect of the psychological contract (PC) type (relational, transactional and balanced) on the relationship between psychological contract breach (PCB) and organizational citizenship behaviours (OCBs).

The authors administered a survey to a sample of 159 nurses working in a large public hospital. To analyse the survey data, the authors used partial least squares with SmartPLS v.3.3, a variance-based structural equation modelling technique that combines principal component analysis, path analysis and regression analysis.

This study shows that nurses counteract the loss of resources following a PCB by investing more in stronger interpersonal relationships with co-workers and patients as a way to recuperate from resource loss and gain social resources. In addition, the moderating effect of the PC type reinforces the relationship between a PCB and OCB in a way that relational and balanced PC types support OCB-I positively but negatively OCB-O. Furthermore, the transactional PC does not reinforce negatively the link between PCB and OCB-I, and the negative interacting effect on the PCB and OCB-O link is only partially supported.

The study findings are grounded on a cross-sectional research design and a convenience sampling strategy.

The results highlight the relevance of human resources management practices centred on employee involvement and participatory supervision styles for ensuring OCB display at the workplace.

The results add new evidence to COR theory by highlighting the importance of social resources as a mitigator in the relationship between nurses’ PCB and OCB towards co-workers and patients (OCB-I). Hence, the OCB-I display will vary in function of the target and the moderating effect of PC type (relational, balanced or transactional).

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Research with vulnerable groups is crucial to get their input into public policy design that will directly impact on them. However, there are many methodological and ethical challenges involved in encouraging participation from groups with a wide range of intellectual, cognitive and physical capacities while ensuring that the rights and well-being of participants are protected. Rather than exploring ethical theories, this chapter is a case study describing the practical ethical considerations that were involved in designing and holding a series of focus groups with adult health and social care service users from vulnerable cohorts. It is based on a series of focus groups which the Institute of Public Health (IPH) held with specified cohorts as part of a policy development process on adult safeguarding for the Department of Health (DOH) in Ireland. The four cohorts were people with intellectual disability, cognitive impairments, significant mental health challenges and nursing home residents. This chapter does not describe the findings of the focus groups but outlines the ethical and methodological considerations that arose in designing and conducting this research, and the practical ethical safeguards employed to mitigate risk and comply with Irish and EU General Data Protection Regulation (GDPR) legislation governing health research. It outlines the ethical issues around protecting confidentiality and using incentives to encourage participation, how individuals' capacity to give informed consent was maximized, the risk-assessment and mitigation procedures used to prevent harms arising and the measures put in place to provide follow-up emotional support to participants.

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses’ intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses’ intentions to pursue formal leadership roles.

Healthcare workers are considered to be the most vulnerable to face mental health. Therefore, this paper aims to examine how negative leadership (despotic leadership) affects employees' psychological distress. Specifically, the authors investigated bullying behavior as mediating mechanism and hostile attribution bias as boundary condition that trigger psychological distress.

The authors collected data from 252 nurses and their immediate supervisors (as a coping strategy for common method bias) through “Google Forms” from various public and private hospitals.

The authors applied structural equation modeling and noted that despotic leadership positively affects employees' psychological distress through bullying behavior. In addition, hostile attribution bias is identified as an important factor in amplifying the effect of bullying behavior on psychological distress.

The authors collected data from high-power distance culture where negative leadership is more prevalent as compared to low-power distance culture. Their findings suggest management to discourage self-centered leaders (despotic) and employees with negative personality traits (hostile attribution bias) as these affect their mental health.

Drawing upon conservation of resources theory, this study is the first of its kind that has investigated how and when despotic leadership affects employees' psychological distress. In addition, the authors also highlighted the importance of negative personality traits (hostile attribution bias) that can amplify the association between bullying behavior and psychological distress.

This paper aims to critically compare the impact and preparedness for practice of two types of mental health nurse training in the UK. One being a hospital-based apprenticeship model from the 1980s; the other a university-based and more academically focussed approach from this millennium.

This autoethnographic reflective commentary describes and reviews the effectiveness of two training curricula for Registered Mental Nurse (RMN) training. The first being the certificate-level 1983 syllabus of the UK Central Council for Nursing, Midwifery and Health Visiting, which was replaced in the late 1990s by diploma and degree-level Project 2000 training of the General Nursing Council. Using a reflective narrative approach to describe the lived experience of two qualified nurses, it compares, reviews and critiques both initiatives.

The author/researchers found both benefits and negatives inherent in each model. These were grouped into five key headings, which are a sense of belonging/identity; exposure to clinical practice; differences in training modality; development of clinical management skills and clinical preparedness; and academic merit. The older curriculum lacked an academic or research base, whereas the more recent approach encouraged and enhanced this element. However, with regard to preparing the clinician/registered nurse to feel confident in addressing a range of clinical and managerial challenges, the older style training seems to deliver better outcomes. They conclude that a move towards a “middle ground” between the two models may be of benefit to future RMN preparation.

This study reports on the experience of two registered nurses. Therefore, the sample size is small. However, autoethnography is acknowledged as an effective means of delivering qualitative research; in addition, the authors access and use material from the wider literature to triangulate and critique their approach. This paper adds to the literature but also allows for duplication by others to further test the findings.

This type of study provides an opportunity for others to review, compare and contrast nursing or other multi-discipline changes in training/curriculum. The research method is one that is transferable and can be used within areas of practice, which have resource limitations. It provides an opportunity to replicate it in other services or jurisdictions.

Nursing in the UK has experienced significant change over the past four decades. For RMNs, the move from hospitals into the community has been transformational. In addition, the influence of higher academic standards and the influence of the recent pandemic have challenged the profession and individuals within it. This study demonstrates positive and negative elements of the dilemma faced by nurses and offers a further contribution to this area.

There are a number of academic papers, media stories, statutory reports and guidance that explore the impact of changes within nurse training. This paper uses a first person autoethnographic study of the impact and effectiveness of these changes at a human level, the nurse on the ground. It uses the ward medicine keys as the vehicle to represent the huge responsibility that newly qualified nurses must face; this is not widely represented elsewhere in the literature!

This study aims to investigate to role of empowering leadership and psychological empowerment on nurses' work engagement and affective commitment.

Self-administered questionnaire data from 231 nurses working in a university hospital in Saudi Arabia were analysed using a cross-sectional research design using structural equation modelling (SEM) to assess the relationship between empowering leadership (EL), affective commitment (AC) and work engagement (WE) while testing for the mediating role of psychological empowerment (PE).

SEM analysis demonstrated that EL significantly relates to AC. AC similarly significantly relates to WE. Further, the results showed that PE substantially mediates the relationship between EL and WE. There is no significant direct relationship found between EL and WE.

The study findings are essential for nursing managers. They illustrate that nurses become more committed to their organisation and, in return, more engaged with their work when they receive EL. Therefore, nursing managers could train their leaders to practice EL as increased WE has been found to result in other positive work attitudes such as reduced turnover intention.

This study corroborates the relationships between EL, AC and WE, as well as the mediating role of PE. However, this research is unique as the long-established relationship between EL and WE was not supported. It shows that the propositions of leader-member exchange theory may not hold for unique non-Western contexts, in this case, Saudi Arabia.

The study aims to investigate how pregnant and nursing mothers’ stories have been neglected in writing about gender, security and spaces.

The study chronicles Agogo Traditional Area’s pregnant and nursing mothers’ resistance and survival in this conflicted environment. The author used photo voices in a participatory photography design to give conflict-area women a voice. Interviews and observations supported this. Pregnant and nursing mothers were sampled using the purposive and snowball sampling techniques. The data analysis considered narrative analysis, photographic and inductive approaches.

The findings highlighted how these mothers in vicious settings experienced healthcare access and problems, societal issues including gender dynamics, food insecurity, and emotional and psychological well-being.

The findings in this study expand the socio-cultural narratives of pregnant and nursing mothers in violent spaces.

This study examines the social organizational structure of one early childhood education (ECE) center in Finland and the relationship between this structure and the roles and the responsibilities of the members of the organization.

The research is a qualitative case study with ethnographic features. Its variables for content analysis are based on Henry Mintzberg's theory of organizational design.

The study's results show that the organizational structure of the ECE center follows the organizational configuration of a Professional bureaucracy and that the multiprofessional teams follow the configuration of a Simple structure. The structures for centralization and decentralization are suitable for a professional bureaucracy, but the roles of the members of the organization and the processes for shared decision-making lack clarification. The shortage of qualified ECE teachers disrupts the function of the organization and the work of ECE leaders.

The educational background of subjects may have affected the findings.

The study uses Henry Mintzberg's organizational structure theory to evaluate how and why power is distributed and activities are coordinated at the ECE center. The results also show what parts of the organization pose challenges that most commonly disrupt the organization's operations. With these findings, it is possible to expand the understanding of roles and responsibilities in the currently reforming ECE environment and what ECE centers need to function effectively. The study is part of a larger research project and will be continued to examine the leadership culture of the ECE center.