SUMMARYThe methodology and part of the results of an in-depth observational study of four psychogeriatric hospitals are described, focusing on the quality of care received by patients and how this was affected by the level of job satisfaction among nurses. In all four hospitals two wards were selected for intensive study over a period of 4 5 months each. Quality of care was studied through standardized recording of staff's feeding, toileting and bathing of a stratified sample of patients. The findings point to a very strong relationship between job satisfaction and quality of patient care. Staff and patients in high-satisfaction (HS\ wards proved more likely to initiate a conversation or other interaction. HS staff also offered patients more choice, independence, personal attention, supervision, information and privacy, and were more likely to converse with patients during feeding, toileting and bathing. Toileting and bathing appeared especially sensitive to these effects. Despite these differences, HS staff took no longer to feed, toilet or bathe their patients. These relationships are suggested to be mainly attributable to management practices, particularly at ward level, which influence both job satisfaction and quality of patient care.

Same/next day discharge can be performed safely in appropriately selected patients. Although this will be achieved in a minority of patients (21.7% in this study using an early discharge pathway) it has potential for resource and cost savings. © 2015 Wiley Periodicals, Inc.

This paper begins by reviewing the small number of studies of staff nurses' work satisfaction. Subsequently, an examination is made of the differences in work satisfaction between staff nurses and other grades of nursing staff in psychogeriatric wards in National Health Service hospitals in Scotland. These data are part of a larger study into work satisfaction and the quality of care in these settings. Significant differences in satisfaction at work are identified between the staff nurse group and the other grades taken as a whole. Analysis of the components of job satisfaction suggests that these differences arise from: first, the experience of the work itself; second, the quality of the supervision which takes place; and third, the assessment of hospital policies, such as the transfer of staff to other wards.

In this short essay it is argued that recent criticisms portraying the activist environmental movement as overly pessimistic are valid and that the communication of this pessimism to the public at large has been largely counterproductive to the objectives of environmentalists. It is argued that, in contrast to historic assumptions of a 'progress paradigm' that epitomized the widely held optimism of the past, the shock tactics and pessimistic media campaigns employed by the activist environmental movement, and the media that capitalizes upon those campaigns, have contributed to the creation of a figurative hopeless age.The key characterization of the hopeless age is the widely held assumption that the future will be worse than the present and that the lives of future generations will be diminished relative to our own. It is argued that the creation of this social-psychological phenomenon is counterproductive to the aims of the environmental movement and that the restoration of a collective vision and message of hope would be far more productive. Lastly, some reasons for a hopeful outlook are suggested.

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