A study was conducted at the Department of Neuropsychiatry, Osaka Medical College between June 1 and October 31, 1991. The study evaluated the stress level of the nursing staff in the department using a questionnaire, and intervention was taken in improving problem areas in order to alleviate the stress level. The department has 56 beds and an outpatient unit. The nursing staff comprises of 16 state registered nurses and 4 assistant nurses with prefectural registration. The nurses play multiple roles and some areas of their work are not clearly defined. They have a heavy workload with high demand, yet their control over their work is limited. This problem is inherent in medical school hospitals as the nurses, in addition to their clinical work, take an active part in teaching student nurses as well as in assisting junior physicians with limited experience. The results of the questionnaire showed that the key problem areas were poor intepersonal communication, lack of influence in decision-making, and an inefficient hierarchal system. These factors gave the staff a feeling of helplessness, contributing to the high stress level. In order to reduce the stress, informal meetings were held to encourage staff members to share their ideas regardless of their position. Ward physicians were encouraged to be more precise in their instructions and to provide opportunities for the nursing staff to discuss problems. As a result, the overall atmosphere at the workplace improved. A seemingly well-functioning team of professionals, when investigated, reveals that there are many problematic issues. In a hierarchal system, there inherently is some resentment within the team. However, better intradepartmental communication reduces such resentment and contribute to the reduction of stress
