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Abstract:
A new emphasis on primary and preventive care is hailed as long overdue by many in nursing. One effect of this paradigm shift, however, is being experienced in many hospitals. Acute-care facilities are rearranging services ("restructuring"), consolidating programs and eliminating large numbers of staff ("downsizing") in an effort to position themselves securely for the future. Downsizing can be devastating to those who lose jobs, so nurse managers and administrators can play a key role in planning the downsizing process sensitively. Whenever possible, loss of a traditional job should be balanced by the offer of a new opportunity within the healthcare system.