| Summary: | The aim of this study was to investigate the relationship between the perceived stress in qualified nursing staff and the satisfaction of students with the clinical learning environment. The study consisted of three distinct phases. The initial phase was based on informal interviews with students (N=54) and qualified staff (N=23). Data collected from these interviews was used to develop and design three tools. The latter formed the basis of the second phase of the study - a quantitative survey. Respondents in this phase were pre registration students (N=162) from one school of nursing, and qualified staff (N = 105) from two district hospitals in the south of England. The final phase of the study was carried out using a grounded theory approach. Findings from phase two provided the focus areas for this phase of the study. A total of 13 qualified staff and 18 students were interviewed. Collection of data for the three phases spanned a two and a half year period. The overall findings, based on the results from all three phases of the study, suggest that satisfaction for students and stress in qualified staff is derived from the atmosphere in, and the organisation of, the working enyironment.These two aspects were unified by the style of leadership employed in the clinical learning areas. A participative leadership style, which employed an individualised approach to patient care, increased the satisfaction of students and qualified staff, and was associated with reduced staff turnover, sickness and absenteeism. Good social support and social integration strategies existed for nursing staff working in this area. Conversely there was much dissatisfaction of qualified staff and students in areas where authoritarian leadership styles were employed. There was an increase in staff turnover,sickness and absentee rates. Consequently a large percentage of bank/agency staff were employed. Recommendations include the need for training in participative leadership styles for all clinical managers, and the assurance of individualised patient care in clinical areas where students are allocated. Alongside this there is a need to monitor student satisfaction and qualified staff stress and job satisfaction on a regular basis.
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