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BY YEAR 2020, THE SIZE OF THE registered nurse (RN) workforce is forecast to be nearly 20% below the projected requirements (Buerhaus, Staiger, & Auerbach, 2000). The severity of the current shortage, albeit somewhat eased from years past, is expected to reach as many as 800,000 RNs by 2020 (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2006; U.S Department of Health and Human Services, 2002). The health care work environment as a source of overwork and stress has been implicated in the nursing shortage (Institute of Medicine [IOM], 2003). Because stress-related illness contributes to rising health care costs and disability (Bruhn, Chesney, & Slacido, 1995), creating a healthy work environment is a priority for maintaining an adequate nurse workforce. Nurse managers play an integral role in creating the health care work environment and in modeling the way for staff nurses. Minimizing nurse manager stress and enhancing nurse manager coping behaviors are consistent with retaining both nurse managers and staff nurses.
The nursing shortage literature explores stress and coping in the staff nurse role, but literature related to nurse manager subjects is sparse. The U.S. studies primarily focus on the "old" head nurse role prior to the re-engineering of the health care industry that took place in the mid 1990s. Given the increasing complexity of today's health care work environment and the significant nursing shortage, understanding the impact of the nurse manager role expansion following re-engineering and the related impact of these changes on individuals in this role is crucial to maintaining an adequate nursing workforce over the next 10 to 15 years.
Background and Significance
The nursing profession is in the midst of one of the most crippling nursing shortages in its history. Researchers estimate that by year 2020, the available RN workforce will fall 20% below projected requirements (Buerhaus et al., 2000) and this deficit will result in a shortfall of as many as 800,000 RNs (Buerhaus et al., 2006). Although growth of the hospital nursing shortage appears to have temporarily slowed down, an actual shortage of nurses still exists (Buerhaus, Staiger & Auerbach, 2003).
According to the Health Resources and Services Administration, a division of the U.S. Department of Health and Human Services (2000), 8.4% of the 2.7 million U.S. RNs are employed in...