Nurse staffing and nursing performance: A review and synthesis of the relevent literature

This paper presents the results of an extensive literature review of quantitative and qualitative studies that relate the internal work environment to nurse withdrawal behavior and nurse performance. A model depicting the interrelationships and descriptive tables are developed on the basis of this review. Studies indicate a “vicious spiral to the bottom” whereby cuts in nurse staffing result in a negative work environment characterized by work overload, poor nurse physical and mental health, and low job satisfaction. This environment, in turn, increases nurse withdrawal behavior and adversely affects nurse performance. Implications for public policy, management and future research are discussed.