Decoding Nursing Job Demands: A Multicenter Cross-Sectional Descriptive Study Assessing Nursing Workload in Hospital Medical-Surgical Wards.

Background: Nursing workload is largely studied but poorly explored under physical, mental, and emotional dimensions. Currently, only a limited number of variables have been linked to nursing workload and work contexts. Purpose: The study aimed to investigate whether it is feasible to identify variables that consistently correlate with nursing workload and others that are specific to the context. Methods: We employed a descriptive correlational analysis and a cross-sectional design. Data were collected through a survey distributed to registered nurses working across Italy, at the conclusion of randomly assigned morning or afternoon shifts. Results: We received 456 surveys from 195 shifts, collected from nurses in four public and two private hospitals. Commonly associated variables with nursing workload dimensions included patient complexity of care, admission/discharge or transfer, informing patients/relatives, contacting physicians, and unscheduled activities. Variables categorized as setting-specific were patient isolation and specialties, nurse-to-patient ratio, adequacy of staff in the shift, peer collaboration, healthcare documentation, educating others, and medical urgency. Conclusions: In summary, certain variables consistently correlate with nursing workload across settings, while others are specific to the context of care. It is imperative for nurses and nurse managers to measure the nursing workload in various dimensions, enabling the prompt implementation of improvement actions.

Factors Influencing Generation Z Bachelor of Nursing Students' Decision to Choose Nursing as a Career: A Pilot Study.

Introduction: Despite nurses representing the largest healthcare professional group, the number is not enough for global health coverage. Understanding Generation Z students' intrinsic and extrinsic motivations, internal and external influences, and beliefs in choosing nursing education is crucial. This knowledge empowers universities to enhance nursing program enrollment through targeted promotion and recruitment strategies. Objective: The aim was to understand why Italian students of Generation Z choose the Nursing Degree Course. Methods: In this pilot study, a cross-sectional design was used. A survey with closed and open answers analyzing demographics, opinions, and motivations among new enrolled nursing students was administered on the first day of the Bachelor of Nursing Degree course. Descriptive statistics were used. Quantitative data were analyzed with Chi-square and ANOVA tests and qualitative data underwent content analysis and coding. Correlation analysis explored relationships between qualitative and quantitative results. Results: Forty first-year students (85% female, average age 22) completed the questionnaire. The choice of the degree pathway, as the first or second option, is influenced by intrinsic and extrinsic motivations, the student's opinions, and family and social influences. Significant positive and negative associations were evidenced. Negative factors affecting choice included location and the responsibility for nursing care, while positive factors included role models, family advice, passion, curiosity for healthcare, the desire to help others, and family influences on decision-making. Conclusions: Among Italian generation Z students, the choice of the nursing degree pathway is influenced by social models, family advice, passion, the desire to help others, and curiosity. Universities should be more proactive in their recruitment and promotion efforts, transforming these events into vibrant meeting points for professionals from diverse nursing specialties. They should also implement robust information policies that highlight career possibilities spanning clinical practice, management, education, and research areas within the field.

Self-Perceived Clinical Competence of Nurses in Different Working Experiences: A Cross-Sectional Study.

BACKGROUND: Competence is an essential concept for measuring nurses' performance in terms of effectiveness and quality. To this end, our analysis highlighted the process of acquiring competencies, their self-evaluation into clinical practice, and how their proficiency levels change throughout the nursing career. In detail, this research explored nurses' perceived level of competence and the factors that influence it in different contexts. METHODS: A cross-sectional survey using a structured questionnaire to assess the nursing participants' perception of their competencies in different clinical settings was accomplished. RESULTS: A descriptive and bivariate analysis was performed on 431 nurses. Most respondents assessed their level of competence to be higher than their roles required. The Kruskal-Wallis test confirmed that nursing experience was a relevant factor influencing nursing competencies. CONCLUSIONS: We suggest improving the competence of practicing nurses, using experience as a measurable effect of their development.

Assessment of the Psychometric Characteristics of the Italian Version of the Nurse Manager Actions Scale.

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses' autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items' scalability as well as the scale's validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar-Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar-Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage.

Quality of life of critical care nurses and impact on anxiety, depression, stress, burnout and sleep quality: A cross-sectional study.

OBJECTIVES: To investigate how anxiety, depression, stress, burnout, and sleep quality impact on Quality of life of critical care nurses. BACKGROUND: Several studies reported that critical care nurses are exposed to a high risk of anxiety, depression, burnout, stress, and sleep quality, but we do not know the impact of critical care nurses. DESIGN: A cross-sectional study. METHODS: We have included all critical care nurses working in the intensive care unit for at least six months. Data were collected from December 1, 2021, to March 18, 2022. We evaluated the critical care nurses using the Depression Anxiety Stress Scale (DASS), Maslach Burnout Inventory scale, Pittsburgh Sleep Quality Index and Nurse Quality of Life. The primary endpoint is Quality of Life. Associations were tested using multivariate modelling. RESULTS: A total of 140 critical care nurses were included. Multivariate regression showed the relation between emotional QoL and emotional exhaustion and DASS total score [OR = 0.14; 95% CI (0.03-0.73); p = 0.019 and OR = 3.64; 95% CI (1.07-12.32); p = 0.038, respectively]. Personal accomplishment and DASS total score have a direct relationship on quality of work-life [OR = 0.21; 95% CI (0.05-0.82); p = 0.024 and OR = 4.18; 95% CI (1.01-17.33); p = 0.049, respectively]. CONCLUSIONS: The physical quality of life is not optimal in critical care nurses, while burnout and the DASS score directly impact the emotional and work-life quality of life. IMPLICATIONS FOR CLINICAL PRACTICE: Our research has highlighted the importance of detecting the quality of life of critical care nurses. The nurses should take proper care of their health by adopting the right health behaviours to create correct work conditions and increase the quality of care for critically ill patients.

Continuing Education through the Campus Game: A Sustainable Gamification Project to Improve Doctors' and Nurses' Knowledge of Quality and Clinical Risk Management.

The COVID-19 disease has dramatically changed lives worldwide, including education. This is a challenge for traditional learning. In fact, the European Higher Education Area poses the challenge of boosting the quality of teaching through active methodologies supported by digital pedagogy. Gamification is one of these tools and it has considerable attention in the healthcare literature. We aimed to create a game in the Campus Bio-Medico University Hospital Foundation in order to offer continuing education on Quality and Clinical Risk procedures to our staff. The 2021 "Campus Game" (178 players) introduced the "Badge Challenge" (Team Building, Procedures, and Security) and 73 questions. The leaderboard of every single match was posted in some of the hospital's strategic areas and also published online on the company intranet to ensure engagement and competitiveness. Gamification has spontaneously promoted teamworking and a virtuous process of multiprofessional education. We found that, during the Campus Game, there was a 4.9% increase in access to the intranet page containing information on Quality and Patient Safety and an 8% increase in access to the Hospital Policies and Procedures. In the near future, we wish to expand this game, involving hospitals with similar types of activity and levels of attention to quality and safety issues, and also to enhance the network of partners and the principles of Q&S management itself.

Psychometric Properties of the Italian Version of the Leader Member Exchange Scale (LMX-7): A Validation Study.

For decades, scholars have studied leader-member exchange (LMX) relationships to understand and explain the effects of leadership on follower attitudes and performance outcomes within work settings. One available instrument to measure these aspects is the LMX-7 scale. This measurement has been widely used in empirical studies, but its psychometric properties have been poorly explored. The aim of this study was to test the psychometric characteristics (content, structural and construct validity, and reliability) of the Italian version of the LMX-7 scale and to support its cultural adaptation. We used a cross-sectional multi-center design. The forward-backward translation process was used to develop the Italian version of the scale. The scale was administered through an online survey to 837 nurses and nurse managers working in different settings. The factorial structure was tested using both exploratory and confirmatory factor analyses (EFA and CFA), and reliability was evaluated using Cronbach's alpha. For the construct validity, we used hypothesis testing and differentiation by known groups. The Italian version of the LMX-7 scale presented one dimension. All the psychometric tests performed confirmed its validity and suggested its usefulness for future research.

Nurse-Patient Communication and Relationship When Wearing Personal Protective Equipment: Nurses' Experience in a COVID-19 Ward.

Little is known about which communication strategies nurses carried out and whether the nurse-patient relationship has been altered due to the mandated use of personal protective equipment during the COVID-19 pandemic. This study describes how nurse-patient communication and relationships took place from the point of view of nurses engaged in caring for patients with COVID-19. A qualitative descriptive study design following COREQ guidelines was conducted. Semi-structured telephone interviews with nurses working in the COVID ward of an Italian university hospital were performed between September 2020 and June 2021. Ten nurses were recruited using convenience sampling. One overarching theme, three main themes, and nine sub-themes were identified. The overarching theme 'The in-out relationship: 'in here and out there' and 'inside me and out of me' included the main themes 'A closed system different from normal', 'Uncovering meaningful human gestures', and 'A deep experience to live''. The relational nature of nursing-where 'me and you' and the context are the main elements-leads nurses to find new ways of interacting and communicating with patients, even in a new situation that has never been experienced. Enhancing human gestures, thinking about new contexts of care, and educating new generations to maintain human-to-human interaction, regardless of the context of care, are the directives to be explored for creating the future of nursing care.

Evaluation of Standard Precautions Compliance Instruments: A Systematic Review Using COSMIN Methodology.

BACKGROUND: Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals' compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. METHODS: We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. RESULTS: Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. CONCLUSIONS: The available instruments that measure healthcare professionals' compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.

Cultural Adaptation and Psychometric Properties of the Trust Me Scale-Italian Version: A Validation Study.

BACKGROUND: The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust Me Scale for use in Italian-speaking populations in nurses and nurse managers. METHODS: The translation process involved methodological steps of collaborative and iterative translation with cultural adaptation. The validation process included a cross-sectional study enrolling a convenience sample of 683 nurses and 188 nurse managers who completed the Italian version of the Trust Me Scale and measures of intention to leave, satisfaction, and organizational commitment. RESULTS: Item 5 was removed for poor factor loading, and items 11 and 13 were removed following an a priori strategy focused on deleting items with correlations between residual variables different than expected based on theoretical expectations derived from previous research. The final model fit well to sample statistics with a three-factor structure (harmony, reliability, and concern) and 13 items. A multiple-indicator multiple-cause model showed a measurement invariance between nurses and nurse coordinators. Construct validity was also supported by the evidence that the measured domains of trust align with the theoretical expectations and are related to the intention to leave, job satisfaction, and organizational commitment. Each dimension showed adequate scale reliability. CONCLUSIONS: The Italian version of the Trust Me Scale is a valid and reliable instrument to measure trust in nurses and nurse managers in Italian-speaking contexts. It can be used for research in nursing and leadership and evaluation of interventions aimed at improving trust in healthcare contexts.

Appraisal and Evaluation of the Learning Environment Instruments of the Student Nurse: A Systematic Review Using COSMIN Methodology.

BACKGROUND: Nursing education consists of theory and practice, and student nurses' perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools. METHODS: We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC. RESULTS: In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools. CONCLUSION: Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments' external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties.

Psychometric Characteristics of the Self-Care of Chronic Illness Inventory in Older Adults Living in a Middle-Income Country.

Chronic illness requires numerous treatments and self-care is essential in the care process. Evaluation of self-care behaviors facilitates the identification of patients' needs and optimizes education and care processes. This study aimed to test the psychometric characteristics (validity, reliability, and measurement error) of the Albanian version of the Self-Care of Chronic Illness Inventory (SC-CII). Patients with multiple chronic conditions and caregivers were recruited in outpatient clinics in Albania. The patients completed the SC-CII, which includes three scales: self-care maintenance, self-care monitoring, and self-care management. Factorial validity was tested for each scale, with confirmatory factor analysis. Reliability was evaluated with the composite coefficient, Cronbach's alpha, and the global reliability index for multidimensional scales. The construct validity was tested using hypothesis testing and known differences between groups. The measurement error was tested to assess responsiveness to changes. The self-care maintenance and self-care monitoring scales showed a unidimensional factorial structure, while the self-care management scale showed a bidimensional structure. Reliability estimates were adequate for all reliability coefficients. Construct validity was supported. The measurement error was adequate. The Albanian version of the SC-CII shows good psychometric properties in the Albanian sample.

Nurses' Organization of Work and Its Relation to Workload in Medical Surgical Units: A Cross-Sectional Observational Multi-Center Study.

INTRODUCTION: Work contexts can affect nurses' work and work outcomes. Work context factors of nurses, patients, or workflow can modulate nurses' organization of work and determine increased workloads. AIM: The aim of this research was to analyze relationships between factors regarding the patient, the nurse, workflow, and nurses' work organization, to investigate whether work organization is related to physical, mental, and emotional workloads, and to explore whether one dimension of workload influences the other dimensions. METHODS: We used a cross-sectional design based on the Job Demand-Resources theory. We asked registered nurses, working in nine medical-surgical wards across three hospitals in Italy, to self-report on work organization and workloads regarding randomized shifts over three consecutive weeks. Four scales from the QEEW 2.0 questionnaire were used on an online survey for data collection. multivariable linear regressions with structural equation modelling were tested. The study was approved by the three local Ethics Committees. RESULTS: We received 334 questionnaires regarding 125 shifts worked. Patient complexity (ß = 0.347), patient specialties (ß = 0.127), adequacy of staffing (ß = -0.204), collaboration with colleagues (ß = -0.155), unscheduled activities (ß = 0.213), supply search (ß = 0.141), and documentation (ß = 0.221) significantly influenced nurses' work organization. Nurses' work organization was significantly related to physical, mental, and emotional nursing workloads. CONCLUSIONS: the patient, the nurse, and workflow aspects influence nurses' work organization and workloads. Healthcare organizations, managers, and nurses should explore work settings to identify work turbulences early and implement strategies to improve nursing work conditions and workloads.

Effectiveness of transitional care interventions in patients with serious illness and their caregivers: a systematic review protocol.

OBJECTIVE: The objective of this review is to evaluate the effectiveness of transitional care interventions for seriously ill patients and their caregivers. INTRODUCTION: Seriously ill patients and their caregivers may have complex health and social care needs that require services from numerous providers across multiple sectors. Transitional care interventions have been designed to enhance a collaborative approach among providers to facilitate the care transition process. However, the effectiveness of transitional care interventions for seriously ill patients and their caregivers, and the effects of such interventions on their outcomes, remain unclear. INCLUSION CRITERIA: Randomized controlled trials with adult patients (≥18 years old) with serious illness and their caregivers involved in transitional care programs will be considered for inclusion. The patients' outcomes will include mortality and/or survival, symptoms (eg, pain, nausea), and health-related quality of life. The caregivers' outcomes will include caregiver burden, preparedness, and well-being. METHODS: The JBI methodology for systematic reviews of effectiveness will be followed. The search strategy will aim to locate published and unpublished studies. Electronic databases, including PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, will be systematically searched from 2003 to the present. Studies in English, Italian, Spanish, French, and German will be included. Critical appraisal and data extraction will be conducted using standardized tools. Quantitative data will be pooled in statistical meta-analysis or, if statistical pooling is not possible, the findings will be reported narratively. Certainty of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022319848.

Chronic Non-cancer Pain Management in a Tertiary Pain Clinic Network: a Retrospective Study.

INTRODUCTION: Chronic pain is a distressing condition that should be treated in specialized pain clinics. Pain clinics offer a holistic, evidence-based approach, including pharmacological, complementary, and invasive treatments. This study aimed to provide preliminary information regarding chronic pain treatments and identify reasons for accessing an important hub-spoke pain clinic network. METHODS: A retrospective multicenter cross-sectional study was carried out. A total of 1606 patients' records were included. Patients were selected from the 26 pain clinics of a single region in Italy. Univariate and multivariate logistic regression models were used. RESULTS: Multivariate models showed that the use of opioids were considered effective for severe or moderate pain [odds ratio (OR) 0.41; 95% 0.33-0.51], while the use of invasive treatments (OR 2.45; 95% 1.95-3.06) and the use of complementary therapy (OR 1.87; 95% 1.38-2.51) were associated with severe or moderate pain. Overall, age, sex, nonsteroidal anti-inflammatory drugs (NSAID) use, a combination of NSAIDs, complementary therapies, and a combination of opioids and invasive treatments did not seem to be significantly associated with the nature of pain. Multivariate models confirmed that clinical parameters such as the nature of pain, multi-diagnosis, more than one site of pain, treatments, and general practitioner, but not the severity of pain and use of invasive treatments, had an impact on the choice of a pain clinic. CONCLUSION: Opioids are useful in managing moderate or severe chronic pain. Multimodal approaches are used for the management of chronic pain. Moreover, it is not clear how patients are addressed to access different pain clinics (spoke versus hub) networks. More widespread adoption is needed for an interdisciplinary approach to managing chronic pain and adopting guideline recommendations, and rigorous research is required to provide more substantial evidence and support clinical practice.

What determines physical, mental and emotional workloads on nurses? A cross-sectional study.

AIM: This study aimed to identify determinants of physical, mental and emotional nursing workloads. BACKGROUND: Workload has a physical, mental and emotional dimension. It influences employees' well-being and quality of care. Nevertheless, studies of specific predictors for each dimension of nurses' workload are scarce. METHODS: We used a cross-sectional prospective design based on the Job Demand-Resources theory. We asked nurses to describe workload perceived at the end of every shift over three consecutive weeks. Data were gathered from two academic hospitals, in seven medical-surgical wards. We received 259 responses and tested 2 multivariate regression models. RESULTS: Physical workload was predicted from all variables tested; mental workload was determined by patient complexity or isolation, adequacy of nurse staffing and skill-mix, and unscheduled activities; and emotional workload was predicted by all variables except adequacy of staffing and other people's education. CONCLUSIONS: Patient, nurse and workflow aspects influenced nurse's shift workload differently for each specific dimension. IMPLICATIONS FOR NURSING MANAGEMENT: Measurement and definition of predictors of workload in the work environment are essential. Recognizing the determinants of specific dimensions of workload facilitates identification of the most appropriate interventions to improve nurses' well-being in health care settings.

Adult oncology patients' experiences of living with a central venous catheter: a systematic review and meta-synthesis.

BACKGROUND: The incidence of cancer is increasing globally, and a greater number of patients will receive treatments though central vascular access devices (CVADs). Only a few qualitative studies describe the experience of adult oncology patients living with CVADs, and no systematic review of literature has been published on this topic. We therefore aimed to systematically synthesize the evidence of the qualitative studies on the experience of adult oncology patients with CVADs to report the implications of living with this device, and to inform healthcare professionals (HCPs) about problematic aspects of care for this population. METHODS: A comprehensive literature review was conducted on PUBMED, MEDLINE, SCOPUS, COCHRANE, and WEB OF SCIENCE, and was updated on May 25, 2021. Nine studies fulfilled the inclusion criteria. The evidence was synthesized using the meta-aggregation approach proposed by the Joanna Briggs Institute. RESULTS: Four themes emerged: During catheter implantation oncology patients typically experience reluctance, apprehension and acceptance; The nature of the information, knowledge transmission and HCPs' competence all influence the patient's confidence; How the presence of a catheter impacts the patient's daily life, their self-perception and their social behavior; The catheter is a symbol of disease, a friend that helps prevent problems, and its removal is perceived as physical and psychological liberation. CONCLUSION: This systematic review evidenced some problematic aspects related to patient information, education and device management, and gaps in nursing skills on handling the device. The results of this review should be used as a framework for improvement interventions.

Defining nursing workload predictors: A pilot study.

AIM: To explore predictors of perceived nursing workload in relation to patients, nurses and workflow. BACKGROUND: Nursing workload is important to health care organisations. It determines nurses' well-being and quality of care. Nevertheless, its predictors are barely studied. METHODS: A cross-sectional prospective design based on the complex adaptive systems theory was used. An online survey asked nurses to describe perceived workload at the end of every shift. Data were gathered from five medical-surgical wards over three consecutive weeks. We received 205 completed surveys and tested multivariate regression models. RESULTS: Patient acuity, staffing resources, patient transfers, documentation, patient isolation, unscheduled activities and patient specialties were significant in predicting perceived workload. Nurse-to-patient ratio proved not to be a predictor of workload. CONCLUSIONS: This study significantly contributed to literature by identifying some workload predictors. Complexity of patient care, staffing adequacy and some workflow aspects were prominent in determining the shift workload among nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Our findings provide valuable information for top and middle hospital management, as well as for policymakers. Identification of predictors and measurement of workload are essential for optimizing staff resources, workflow processes and work environment. Future research should focus on the appraisal of more determinants.

The Role of the Leader on the nurses perception of work well-being.

BACKGROUND: Work well-being can affect performance and quality of care. Previous literature described the influence of leadership styles on nurse turnover, job satisfaction, attitudes and behaviours. There is a need to explore more nurses' perception of their leaders and related effects in the work environment. AIM: The aim of this study was to explore relationships between nurses' inspiration by the leader and nurses perceptions of work pleasure, work problems, and teamwork satisfaction. METHODS: This was a cross-sectional pilot study based on the theory of social exchange (Gouldner, 1960). We administered some of QEEW instrument scales to nurses working in five medical-surgical wards of a hospital. Simple linear regression analysis were performed. RESULTS: We received 81 completed questionnaires. The inspiration by the leader showed to be an antecedent of work pleasure (R2=26%), work problems (R2=30%), and teamwork satisfaction (R2=28%). CONCLUSIONS: An inspiring leadership was associated with nurse perceptions of reduced work problems, and increased teamwork satisfaction and work pleasure. The role of the leader and the use of an appropriate leadership style is therefore essential to increase levels of well-being in nurses. Future studies with a larger sample are needed to confirm our findings. NURSING IMPLICATIONS: Our results suggest that leadership style has a prediction effect on perceived nurse well-being. Moreover, leadership style has an impact on work climate and interdisciplinary teamwork. Therefore, chief executives should invest energies in leadership training and continuing education in order to develop among ward manager's effective leadership competencies.