Objective. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics. Methods. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire. Results. Nursing managers showed a low degree of burnout, which was similar to that of medical managers. Most of them had a low level of emotional exhaustion and a low level of depersonalization, while personal accomplishment was contrasted. Only 2.3% had a high degree of burnout. These findings challenge the hypothesis of high stress being associated with high burnout, as nursing managers can be supposed to have a highly demanding job due to their intermediary position within the hospital hierarchy. Variations of burnout by personal, work-related, and organizational characteristics mainly concerned emotional exhaustion. Conclusion. Though nursing managers face a highly demanding job, they may benefit from resources (including coping strategies and empowerment) which help counterbalance job stress. Unequal distribution of resources may play a central role when facing burnout.

The predictable shortage of nursing staff, in Switzerland as in the rest of Europe, continues to highlight a recurring problem for public health policy. The issue here is not just questions about the care and treatment of patients or the quality of such care, but also about the conditions necessary for adequate staff recruitment and the long-term professional engagement of health care personnel. Training in nursing care at the Universities of Applied Science of Western Switzerland is also indirectly concerned by rationalisation measures currently in force in the public Activé par Editorial Manager® et Preprint Manager® appartenant à Aries Systems Corporation health sector. The training context affords a valuable opportunity for assessing the tensions between two types of logic : that of professionalisation based on the rationality of economics, and that of professionality, understood as the construction of the subject in his/her professional activity. The results of our research demonstrate the existence of fields of tension, encountered by students, between their process of professionalisation and their emerging professionality, tensions that also impact on the other pillars of professionalisation that are engagement, motivation and recognition. This qualitative study was based on biographical interviews, analysis of portfolios, professional projects and internship reports (evaluation of skills and competences by professionals), with an original cohort of 43 bachelor of nursing students in their third year of training in Switzerland and Belgium.

Les nouveaux modes de gestion mis en place depuis quelques années dans les institutions hospitalières ont modifié en profondeur l’organisation de ces dernières. Nombreux sont les écrits qui décrivent certaines conséquences sur le domaine de la communication plus spécifiquement. Par cette étude nous avons cherché à comprendre quel était l’impact concret des nouveaux modes de gestion sur la communication au niveau des cadres, mais également des équipes soignantes et ce, en termes de satisfaction et/ou de stress. Cette étude de deux ans a été menée auprès de 900 cadres dans des hôpitaux de Suisse romande en utilisant une méthodologie mixte. Une première phase de questionnaires a permis de mettre en évidence les éléments problématiques, tandis qu’une seconde phase organisée sous forme d’entretiens de groupe dans chacun des hôpitaux, a eu comme objectif une meilleure compréhension des liens entre management et communication. Nous nous basons ici sur cette dernière phase qualitative, particulièrement significative en termes de résultats. Ceux-ci montrent en effet, une importance capitale accordée à la communication par les acteurs du soin, en même temps qu’une dévalorisation croissante du temps dévolu aux échanges, tant entre les pairs qu’avec le patient. Il en découle une frustration qui n’est pas sans conséquences tant au niveau de la prise en charge des patients que des institutions elles-mêmes. Il s’agit, au moyen de ces résultats, de prendre conscience de tous les niveaux impliqués dans la dynamique communicationnelle et des atouts majeurs qu’une bonne dynamique peut favoriser, ou à contrario des problèmes graves qui peuvent découler d’une gestion qui n’accorde pas l’importance voulue à cette dimension de la communication, présente dans l’ensemble de l’institution hospitalière.

Résumé La question de la confiance est au coeur du fonctionnement de nos sociétés hypermodernes. Une recherche-action collaborative conduite avec six services hospitaliers, relative à l’impact de l’Éducation thérapeutique du patient (ETP) sur les relations soignant-soigné, a permis d’explorer le sens et l’utilité de la confiance dans le processus de soins, à la fois pour les soignants et pour le malade. Selon cette étude, il apparaît que la gestion des risques pour la santé du malade ne saurait se réduire à la seule expertise technique, mais inclut des sphères plus subjectives. En prenant en compte la situation du malade hors hôpital, médecins et soignants côtoient des environnements non maitrisés où les interactions entre malade, environnement humain et soignants deviennent essentielles, et où des relations de confiance sont à construire dans une visée d’efficacité thérapeutique.

was first defined in the 1950s by the psychologist Hans Selye and is characterised by a high psychological and physical burden, which can become a problem when an individual's resources are no longer able to compensate for the burden and re-establish balance. The resources that an individual uses to manage activates compensatory mechanisms to help it respond to these demands. If the stress lasts, however, the body's resources begin to be depleted and can no longer fully meet its needsa process of exhaustion begins and the stress becomes detrimental to the individual's health.This understanding of stress leads to two potential types of action to stem the phenomenon. The first strategy involves attempting to do something about the actual cause of the stress, i.e. the context or the specific elements that result in the overload of demands that create the stress: workload, emotional weight, financial problems, and so on. The second strategy, on the other hand, focuses on the individual and his or her capacity to respond to stress in a positive manner, i.e. by mobilising the relevant resources. The research presented here uses Demerouti's Job Demand-Resources Model (JD-R Model) to understand the dynamics of what happens with these resources. We attempt to show how S. Hobfoll's thoughts on resources provide an valuable complement to Demerouti's model with respect to identifying all the various facets of the complex problem of stress. This will be particularly interesting in a management system that is itself a powerful generator of stress. REVIEW ARTICLE

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