Are nurse managers ready for the current challenges of healthcare?

In a study at four teaching hospitals, nurse managers rated themselves most competent in activities related to the management of their unit, and believed these activities were most important. Nurse managers lacked some of the skills and knowledge needed to relate to the larger organization and external environment, activities that they rated as less important. Selection, education, and development efforts should be targeted to newly important roles and skills for which nurse managers have little preparation.