The effects of hospital restructuring that included layoffs on individual nurses who remained employed: a systematic review of impact

The study purpose was to assess the evidence on the effects of hospital restructuring that included layoffs, on nurses who remained employed, using a systematic review of the research literature to contribute to policy formation. Papers addressing research, hospital restructuring resulting in layoffs, effects on nurses, and a stated relationship between the independent and dependent variables were included. Data were extracted and the quality of each study was assessed. The final group of included studies had 22 empirical papers. The main effects were significant decreases in job satisfaction, professional efficacy, ability to provide quality care, physical and emotional health, and increases in turnover, and disruption to healthcare team relationships. Nurses with fewer years of experience or who experienced multiple episodes of restructuring experienced greater effects. Other findings remain inconclusive. Further research is required to determine if these effects are temporal or can be mitigated by individual or organizational strategies.