“…The evidence thus far reveals that Italy has nurse concerning PTNR compared with other European countries. What is of particular concern is that unlike other countries such as Greece, where there is one of the highest PTNR worldwide with substantial effects identified (Aiken et al., 2012) resulting from substantial under resourcing due to ongoing fiscal measures to address economic crisis (Timmins, Parissopoulos, Plakas, & Fouka, 2017); Italy has the third largest economy in Europe and the 8th largest GDP in the world (Giardi, 2019). As such, one would expect a nursing workforce that is comparable with similar or lesser economies such as Norway (average 5.4 PTNR, Aiken et al., 2012) which has almost double the PTNR found reported in Italy.…”