Understaffing as a Two‐Dimensional Phenomenon: A Cross‐Sectional Study of Hospital Nurses' Manpower and Expertise Understaffing

ABSTRACT Aim(s) To examine whether manpower and expertise understaffing are distinct, and whether they relate similarly to nursing stressors, burnout, job satisfaction and intentions to turnover. Design A cross‐sectional survey of hospital nurses nested within units was used. Methods The sample included 402 nurses. Nurses provided ratings of the study's variables using validated self‐report measures. The data were analysed both as multilevel and single‐level data. Results Manpower and expertise understaffing contributed unique explained variance to all of the examined outcomes. Nurses within the same units experience different understaffing levels. Expertise understaffing emerged as a significantly stronger predictor than manpower understaffing for three of the six of the outcome variables (illegitimate tasks, job satisfaction and turnover intentions). Conclusion Manpower and expertise understaffing are distinct, and both are associated with nurse outcomes. Reporting Method We have adhered to the STROBE guideline for cross‐sectional studies. Implications for the Profession and/or Patient Care Considering both manpower and expertise understaffing to maintain proper staffing levels in nursing units is crucial. Patient or Public Contribution A Director of Patient Care Services from the hospital where the study was conducted is a member of the research team. This member contributed to designing and conducting the study as well as interpreting the results.