In the first of this series of monographs on patient care in general hospitals an attempt was made to picture the anxiety, frustration, boredom, and loneliness that are concomitants of hospitalization for many patients.¹ Perhaps the most frequent criticism of the hospital is its coldness and impersonal atmosphere, with its lack of consideration for the patient as an individual human being. Various relatively simple changes in the use of the physical and social environment of the hospital were suggested as possible means for alleviating some of the boredom and sense of aloneness, and for reducing the sharp difference between the...

A recently published book,Personnel: The Human Problems of Management,emphasizes by its very title the current focus of attention of many writers who are interesting themselves in how management and labor can work together more effectively.¹ In the rapidly growing literature consideration is increasingly devoted to the psychosocial needs of employees, as predicated on the basis of social science theory and an expanding body of experimental studies. Regardless of differences in the particular behavioral concepts selected for major attention, there is general consensus that more than the economic needs of personnel must receive careful notice from management if an...

Earlier reference was made to the potential importance of the worker’s immediate peer group in his quest for social approval and a sense of significance in what he is doing. The peer group offers him not only this support but so much more that it becomes essential to include informal membership in such a group as a psychosocial requirement for most employees.¹

Small work groups, furthermore, are of major importance to the organizational design and the on-going program of an institution, and must be examined from that perspective, too. Consequently, this chapter is devoted exclusively to the subject of small...

The preceding chapter has attempted to demonstrate the significance of interpersonal relations as manifested through what they can accomplish in providing psychological support to the members of face-to-face groups, and in exerting pressure on the institution even when the groups are not backed by unions or vigorous professional associations. Ever since Harry Stack Sullivan developed the psychiatric theory of interpersonal relations, it has found increasing favor among psychiatrists and social scientists, not only in its application to situations between therapist and individual patient but as a method capable of producing changes in group attitudes and behavior. It has been made...

Communication is seriously impeded, we noted earlier, by the organizational structure of the hospital and its resulting social system. Here further attention must be given to this problem that every large hospital, like most complex industries and business enterprises, finds a very serious one. Communication is, in fact, of paramount importance since coordination of patient care depends upon it. When no fewer than twenty-three different occupational status groups can be counted on a typical ward or unit,¹ one gets some realization of the amount of communication needed and of how easily failure to achieve coordination of service can occur.

But...

Review of earlier experiments in motivation led psychologists to formulate the hypothesis, success = motivation X aptitude. Subsequent experiments appeared to demonstrate that motivation is even more important than had been assumed. Hence they have restated the hypothesis to read, success = motivation² X aptitude. Obviously, in any efforts to maximize the use of the human resources of the hospital in behalf of better patient care, the question of the level of staff motivation becomes one of paramount importance.

Hospitals are, of course, well aware of this fact but they have tended to rely predominantly upon the hope that improvement...

In these two final chapters an attempt will be made, in part through summarizing some of what has already been said, to present suggestions about ways in which psychological support of staff might be strengthened in the hope that greater competence, self-confidence, and incentive would be reflected in larger interest and understanding of patients. The suggestions have been drawn from the literature of the health services, reports about and observations of recent undertakings in many hospitals, social science concepts, and experimental studies and theoretical conclusions concerning industrial and business management that seem to have relevance for hospital administration.

Some of...

Interesting work, a sense of accomplishment, and recognition from colleagues and those in higher positions have been referred to as highly important factors in motivation. The question of how these prerequisites can be made available must now receive more direct attention. Before positive methods can be explored, however, roadblocks that first need to be removed in order to make the positive steps possible or effective, require examination.

Some insight into the nature of these roadblocks, as applied to nursing at least, has been provided by the writer’s annual workshop on patient care attended by nurses in supervisory, administrative, and faculty...