Under the health-care insurance system in Taiwan, hospital management has not only to challenge the impacts of the post-SARS era, but also has to conquer the system change brought about by the National Health-Insurance Bureau. By global budget and various quality-control indicators, the hospital confronts pressure on restriction measures, including, on the one hand, reducing manpower, while on the other, pushing remaining employees to achieve more. The nursing department, comprising the highest percentage of faculty in the hospital, cannot but burden itself by accepting more duties. A ward nursing unit (WNU) therefore, has taken on the fundamental role of attaining the goals set by the hospital. This review is concerned with how the WNU functions and what kind of relationships exist between head nurses and staff nurses. An approach was adopted of exploring the impact of transactional leadership and trust on Organizational-Citizenship Behavior (OCB) between head nurse and staff nurses, with the aim of clarifying the present situation and proposing some suggestions for future modifications.
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