“…25). Literature trends discussed in the 1990s by McGinnis and Donner (1997, pg.25) on the subject of nurse managers have resulted in four areas of focus: (1) the increase complexity and multifaceted nature of the nurse manager role (Baxter, 1993;Duchemin et al, 1994;Duffield, 1994;Mark, 1994;Mintzberg, 1994;Porter-O'Grady, 1995); (2) the influence of the nurse manager on the hospital environment (Evans, 1994;Horvath et al, 1994;Nakata & Saylor, 1994); (3) specific competencies that comprise the nurse manager role (Carroll & Adams, 1994;Chase, 1994, Dreisbach, 1994Duffield, 1992Duffield, , 1994Duffield et al, 1994); and , (4) management education and development (Evans, 1994;Henninger et al, 1994;Reimer et al, 1994;Spence Laschinger & Shamian, 1994;Sullivan et al, 1994). Similar trends have continued in addition to literature related to nurse manager impact on outcomes in the last decade (Shortell, Zimmerman, Rousseau, Giles, Wagner, Draper, et al, 1994;Ten Haaf, 2007).…”