164 student nurses were randomly assigned to 1 of 4 ward types such that 2 factors-type of nursing (medical/surgical) and sex of patients-were systematically varied with counterbalancing of order effects. Self-reported levels of affective symptoms and perceptions of the work environment, together with independent data on sickness/absence, performance, and the objective work environment, were recorded over the 2 ward periods. Within-Ss analyses showed significant differences between medical and surgical wards in affective symptoms and in perceived and objective measures of the work environment. Male and female wards differed primarily in perceived environment, work satisfaction, and performance. Analysis of the main effects, with control for covariance, indicated that the perceived work environment contributed to the observed differences in affective distress between medical and surgical wards while mitigating differences between male and female wards. (45 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).