An increasing number of hospitals, in the pursuit of goals related to both efficiency and effectiveness, are implementing reorganization schemes that frequently involve downsizing, decentralization, or some combination of downsizing and decentralization (Barrett, 1995, p. 24). Among health care professionals, nurses tend to be those most frequently displaced by the contemporary downsizing and decentralization strategies (Suderman, 1995, p. 7). This research examines some of the more important effects on the practice of nursing of the implementation of downsizing and decentralization schemes by hospitals.