A nursing theory for nursing leadership.

For many years nursing practice has found its foundations in nursing theory. A review of theorists such as D. E. Orem, C. Roy, B. Neumen, V. Henderson, M. E. Rogers and others reveals a focus on the management of patient care, not leadership. This has provided most nurses with a solid foundation in 'management', but little in terms of 'leadership.' In more recent years, theories such as the Deming Management Method, Managers as Developer Model, Shared Governance and Transactional Leadership have been introduced, none of which are nursing theories. This article discusses the conceptualized differences between management and leadership theory arguing that there is a difference between 'leadership and management'. A leadership theory is proposed utilizing Ida J. Orlando's model for nursing. This theory provides a nursing foundation for nursing leaders to utilize both in the management of patient care and in leadership.

Interaction of expectancy and the pharmacological effects of d-amphetamine: subjective effects and self-administration.

The study examined the effects of expectation on the subjective effects and oral self-administration of 15 mg d-amphetamine (AMP) and placebo in 40 volunteers who reported no prior use of stimulants other than caffeine. A balanced placebo design was used to create four groups: told Placebo/got Placebo (P/P), told Placebo/got Stimulant (P/S), told Stimulant/got Placebo (S/P), told Stimulant/got Stimulant (S/S). There were three sessions. On one session (INFO), participants received a capsule containing AMP or placebo and were given information about the contents of the capsule according to the balanced placebo design. On another session (NO INFO), participants received no information about the capsule's contents and were given placebo. On the final session, participants were allowed to choose either the INFO or NO INFO capsule. Participants came to the laboratory to ingest their capsules, and then returned to their normal environments where they completed subjective effects questionnaires every 2 h for 8 h. Expectancies influenced the subjective effects reported during the INFO session, regardless of whether subjects actually received AMP or placebo: subjects who expected a stimulant had higher ratings of "feel drug" and "like drug". The pharmacological effects of AMP were also evident on the INFO sessions: AMP produced its prototypic subjective effects regardless of subjects' expectancies. Significant interactions between drug and expectancy were obtained on self-report measures of anxiety and arousal: anxiety was higher for groups who received substances that did not match their expectations (P/S and S/P) and arousal increased most in volunteers who expected placebo but received stimulant. Choice of drug was determined primarily by pharmacology: participants who received AMP on the INFO session usually chose that capsule, regardless of information about its identity (P/S: 8/10; S/S: 9/10). In contrast, participants who received placebo on the INFO session chose this capsule at chance levels, regardless of information about its identity (S/P: 3/10; P/P: 6/10). Thus, expectancy influenced some of the subjective effects of AMP and placebo, but the pharmacological effects of the AMP were instrumental in determining whether volunteers would self-administer the drug.

Implementing the Performance Based Development System (PBDS) at Naval Medical Center San Diego.

Competency-based performance development is an educational tool that assesses the knowledge and skill base of an RN to enable staff development personnel to formulate orientation and training specific to that individual's learning needs. Theoretically, competency-based performance development is a time-efficient method for orientation. Recent healthcare reform, budgetary constraints, and downsizing have also affected the military. The stimulus, rationale, and obstacles experienced in implementation of this program in the military are common to all staff development educators.