[This paper is a commentary on Workplace Empowerment as a Predictor of Nurse Burnout in Restructured Healthcare Settings by Heather K. Spence Laschinger, Joan Finegan, Judith Shamian and Piotr Wilk.]

Why is it necessary to add more excellent literature to a problem that is already well documented and understood but not acted upon? This is the fundamental question I am left with after reviewing the article by Laschinger, Finegan, Shamian and Wilk.

The question is not a criticism of the paper or the authors but, rather, a lament at the lack of systematic response to what we all know is a ticking time bomb for our healthcare system. The growing shortage and disaffection of nurses, arguably our most critical healthcare providers, must be addressed.

The authors add to the analysis in an important way with their study design and attention to statistical thoroughness. Their longitudinal approach is an important step forward, as is their validation for nursing of findings in other work settings.

However, stripped of these important features, the article again points to the need to change how we structure our work settings and support our caregivers or we risk accelerating very dangerous trends. Still, there is a huge chasm between knowing and doing.

In this regard, the section "Discussion and Managerial Implications" is most enlightening, because the authors point out a number of logical and clear methods to positively address both structural and psychological empowerment. However, as this section is read, one can easily see many barriers to these actions. Too small budgets, too little time and lack of long-term attention are but a few of the very real pressures preventing the system from generating effective responses. Still, for the attentive and long-term leaders who understand that the health of our system and its capability to meet the needs of our citizens is directly tied to the care of our caregivers, this article will reassure you that you are on the right track, or will hopefully stimulate you to begin the journey.

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