• Eric R Wright, Beverly Linde, N Leela Rau, Mathew Gayman, and Theresa Viggiano.
• Department of Sociology, Indiana University-Purdue University Indianapolis, Cavanaugh Hall 303, 425 University Boulevard, Indianapolis, IN 46202-5140, USA. ewright@iupui.edu
• J Emerg Nurs. 2003 Aug 1;29(4):314-21.

IntroductionDuring the past 3 decades, the number of patients with serious mental health problems seeking care in general hospital emergency departments has increased exponentially, with special clinical challenges. This study examines the effect of organizational climate--the subjective perceptions of staff regarding the work environment--on ED staff members' attitudes toward patients with mental health problems, as well as the effect on the clinical care of these patients.MethodsThe data for this study came from a written survey of 109 emergency nurses and other clinical staff employed in a general public hospital emergency department in a midwestern city (response rate = 67.9%).ResultsThe findings indicate that the emergency nurses and other clinical staff who view their working conditions positively report having more frequent contact and providing a greater variety of interventions to patients with psychiatric problems. Staff members who believed that their clinical work roles and expectations are poorly defined were those least likely to interact with this patient population.DiscussionThe findings indicate that organizational processes seem to have an impact on the delivery of clinical care, as well as caregivers' attitudes about this patient population. This finding underlines the importance of addressing organizational climate in emergency departments as part of an effort to improve the quality of care for patients with mental health problems.

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