Abstract
PURPOSE: The Future of Nursing 2020-2030 consensus report recommends that: "Nurses attend to their own self-care and help to ensure that nurse well-being is addressed in educational and employment settings through the implementation of evidence-based strategies".1(p357) We interviewed nurse leaders in our health system to assess knowledge and beliefs about factors influencing nurse well-being, the impact of well-being on practice environments, how leaders influence well-being, awareness and utilization of existing well-being resources, resource gaps, barriers to nurses embedding well-being at work, and their interest in well-being-focused leadership competency development.
METHODS: The first author conducted 53 semi-structured interviews with all CNO's and Magnet coordinators, and leaders CNO's identified as being: "key partners in work to support a positive practice environment and nurse well-being". Snowball sampling identified additional influencers. Respondents comprised 42 nurse leaders and 11 inter-professional partners. Interviews were recorded and transcribed. Both authors contributed to the thematic analysis.
RESULTS: All leaders described well-being as physical and emotional. Some added spiritual well-being, or meaningful work. Most said well-being included having balance and control in their personal and professional lives. Consequences of compromised organizational well-being included exhaustion, turnover, absenteeism, compromised team cohesion, decreased willingness to help others, impatience, fixed or uncompromising thinking, decreased capacity to flex, adapt or problem-solve, and a sense of hopelessness. Before a probe for: "downstream consequences of compromised well-being" few leaders mentioned impacts on care quality, safety, or patient experience. Once probed, several provided examples of these impacts. Respondents believed enhanced nurse well-being would improve retention, role satisfaction, engagement, productivity, team cohesion, collaboration, clinical reasoning, flexibility, willingness to try new things, and patient experience and outcomes. When asked how leaders influence well-being, almost all framed their answer inter-personally. Most mentioned presence, and more than half mentioned role-modeling; only 18 provided specific behavioral examples. The described attributes of leaders who support well-being included relational, trust-building and inspirational behaviors consistent with transformational and authentic leadership styles, and current well-being leadership evidence (2-3). Few mentioned organizational-level influence such as workflow review, break policies, flexible scheduling, strategic prioritization, or organizational investment. Awareness of well-being resources varied; most cited mental and emotional health support services. All leaders considered embedding well-being practices at work important, but cited several barriers to feasibility and frontline nurse acceptance. The main concerns across all hospitals were time and staffing constraints, and nurses' beliefs about the incompatibility of integrating well-being into clinical practice. Two-thirds of nurse leaders and half the inter-professional leaders described the nursing culture of selfless service to patients as a key barrier to adoption. All expressed interest in enhancing well-being knowledge and skills personally, and within their organization.
CONCLUSION: While leaders recognized the impact of nurse well-being on the practice environment, and expressed interest in influencing it, their knowledge of evidence-based well-being strategies appeared limited. All expressed interest in enhancing well-being-focused leadership competency. They suggested that challenging the belief that integrating well-being practices at work is incompatible with safe patient care is essential for successful implementation of unit-level well-being strategies.
Notes
References:
1. National Academies of Sciences, Engineering, and Medicine. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: National Academies Press; 2021
2. Wei H, King A, Jiang Y, Sewell KA, Lake DM. The impact of nurse leadership styles on nurse burnout: a systematic literature review. Nurse Lead. 2020;18(5):439-450.
3. Shanafelt T, Trockel M, Rodriguez A, Logan D. Wellness-Centered Leadership: equipping health care leaders to cultivate physician well-being and professional fulfillment. Acad Med. 2021;96(5):641-651.
Sigma Membership
Nu Beta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Nurse Leaders, Well-being, Self-care
Recommended Citation
Cumpsty-Fowler, Carolyn J. and O'Rourke, Lynnsey, "Nurse Leaders’ Perceptions of the Benefits of, and Barriers to, Embedding Nurse Well-Being at Work" (2025). Creating Healthy Work Environments (CHWE). 8.
https://www.sigmarepository.org/chwe/2023/presentations_2023/8
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Austin, Texas, USA and Virtual
Conference Year
2023
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-10-14
Nurse Leaders’ Perceptions of the Benefits of, and Barriers to, Embedding Nurse Well-Being at Work
Austin, Texas, USA and Virtual
PURPOSE: The Future of Nursing 2020-2030 consensus report recommends that: "Nurses attend to their own self-care and help to ensure that nurse well-being is addressed in educational and employment settings through the implementation of evidence-based strategies".1(p357) We interviewed nurse leaders in our health system to assess knowledge and beliefs about factors influencing nurse well-being, the impact of well-being on practice environments, how leaders influence well-being, awareness and utilization of existing well-being resources, resource gaps, barriers to nurses embedding well-being at work, and their interest in well-being-focused leadership competency development.
METHODS: The first author conducted 53 semi-structured interviews with all CNO's and Magnet coordinators, and leaders CNO's identified as being: "key partners in work to support a positive practice environment and nurse well-being". Snowball sampling identified additional influencers. Respondents comprised 42 nurse leaders and 11 inter-professional partners. Interviews were recorded and transcribed. Both authors contributed to the thematic analysis.
RESULTS: All leaders described well-being as physical and emotional. Some added spiritual well-being, or meaningful work. Most said well-being included having balance and control in their personal and professional lives. Consequences of compromised organizational well-being included exhaustion, turnover, absenteeism, compromised team cohesion, decreased willingness to help others, impatience, fixed or uncompromising thinking, decreased capacity to flex, adapt or problem-solve, and a sense of hopelessness. Before a probe for: "downstream consequences of compromised well-being" few leaders mentioned impacts on care quality, safety, or patient experience. Once probed, several provided examples of these impacts. Respondents believed enhanced nurse well-being would improve retention, role satisfaction, engagement, productivity, team cohesion, collaboration, clinical reasoning, flexibility, willingness to try new things, and patient experience and outcomes. When asked how leaders influence well-being, almost all framed their answer inter-personally. Most mentioned presence, and more than half mentioned role-modeling; only 18 provided specific behavioral examples. The described attributes of leaders who support well-being included relational, trust-building and inspirational behaviors consistent with transformational and authentic leadership styles, and current well-being leadership evidence (2-3). Few mentioned organizational-level influence such as workflow review, break policies, flexible scheduling, strategic prioritization, or organizational investment. Awareness of well-being resources varied; most cited mental and emotional health support services. All leaders considered embedding well-being practices at work important, but cited several barriers to feasibility and frontline nurse acceptance. The main concerns across all hospitals were time and staffing constraints, and nurses' beliefs about the incompatibility of integrating well-being into clinical practice. Two-thirds of nurse leaders and half the inter-professional leaders described the nursing culture of selfless service to patients as a key barrier to adoption. All expressed interest in enhancing well-being knowledge and skills personally, and within their organization.
CONCLUSION: While leaders recognized the impact of nurse well-being on the practice environment, and expressed interest in influencing it, their knowledge of evidence-based well-being strategies appeared limited. All expressed interest in enhancing well-being-focused leadership competency. They suggested that challenging the belief that integrating well-being practices at work is incompatible with safe patient care is essential for successful implementation of unit-level well-being strategies.
Description
Summary: Frontline nurse leaders can influence the adoption of well-being practices at work. This presentation describes lessons learned in our health system’s baseline well-being-focused leadership assessment. We will discuss leaders’ current knowledge and beliefs, perceived opportunities and barriers, and implications for future adoption of evidence-based well-being strategies.