Other Titles

Nurse Leader Stress and Creating Retention Environments [Title Slide]

Abstract

Nurse leaders are a health care group that has been provided limited support to manage stress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. An education project targeted to frontline managers in critical access hospitals was provided in an effort to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A nursing theory to guide the foundation of the education was required to provide structure to the work. A combination of Dr. Jean Watson’s Theory of Caring and Dr. Marilyn Ray’s theory of bureaucratic caring provided the foundation for this work. The participant group included seven nurse leaders from four critical access hospitals in the central United States. Although this was a small focus group, the findings have implications for all care delivery locations. The tool to measure improvements in leader knowledge was an amalgamation of existing, validated stress-identification and job-related questionnaires. Data were analyzed using descriptive statistics. The overall stress score changed from an average of 51% to 19%. Another significant finding was the likelihood of nurse leaders continuing in their position or looking for promotion in leadership increased from 28% to 43%. The implications for positive social change are that a short education program supporting leader development can have significant impact on leader retention. The focus on creating a culture to retain nurse leaders will ensure a strong leadership pipeline. Strong and resilient nurse leaders will create a foundation to ensure that frontline care givers have the support and leadership to build care units where nurses and others want to work.

Notes

References:   Barnett, P., Barnett, M., Borgueta, E., Moreno, J. V., & Watson, J. (2021). COVID-19: An organizational-theory-guided holistic self-caring and resilience project. Journal of Holistic Nursing, 39(4), 325–335. https://doi.org/10.1177/08980101211007007

Bernard, N. (2019). Resilience and professional joy: A toolkit for nurse leaders. Nurse Leader, 17(1), 43–48. https://doi.org/10.1016/j.mnl.2018.09.007

Brzozowski, S., Rainbow, J. G., Pinekenstein, B., Knudsen, É. A., & Steege, L. (2018, September). Exploration of relationships among individual and organizational characteristics, nurse leader fatigue, and turnover intention. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 62(1), 627–631. https://doi.org/10.1177/1541931218621143

Cockerham, M., Kang, D. H., Howe, R., Weimer, S., Boss, L., & Kamat, S. R. (2018). Stress and cortisol as predictors of fatigue in medical/surgical nurses and nurse leaders: A biobehavioral approach. Journal of Nursing Education and Practice, 8(5), 76–83. https://doi.org/10.5430/jnep.v8n5p76

Cummings, G. G., Lee, S., Tate, K., Penconek, T., Micaroni, S. P., Paananen, T., & Chatterjee, G. E. (2021). The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. International Journal of Nursing Studies, 115, https://doi.org/10.1016/j.ijnurstu.2020.103842

Dimino, K., Learmonth, A. E., & Fajardo, C. C. (2021). Nurse managers leading the way: Reenvisioning stress to maintain healthy work environments. Critical Care Nurse, 41(5), 52–58. https://doi.org/10.4037/ccn2021463

Heiss, K., & Clifton, M. (2019, June). The unmeasured quality metric: Burn out and the second victim syndrome in healthcare. Seminars in Pediatric Surgery, 28(3), 189–194. https://doi.org/10.1053/j.sempedsurg.2019.04.011

Martin, E., & Warshawsky, N. (2017). Guiding principles for creating value and meaning for the next generation of nurse leaders. JONA: The Journal of Nursing Administration, 47(9), 418–420. https://doi.org/10.1097/NNA.0000000000000507

Description

An education program for nurse leaders. This education will help to identify stress indicators and risk factors. This will help to reduce burnout in real time to improve retention of frontline leaders.

Author Details

Rebecca S. Hawkins, DNP, MBA/MSN, RN

Sigma Membership

Pi Nu

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Nursing Leaders, Nurse Leaders, Nursing Leaders -- Psychosocial Factors, Personnel Retention, Occupations Stress, Mental Fatigue, Burnout, Professional Burnout

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

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. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-02-20

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Managing Nurse Leader Stress to Promote Leader Retention

Washington, DC, USA

Nurse leaders are a health care group that has been provided limited support to manage stress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. An education project targeted to frontline managers in critical access hospitals was provided in an effort to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A nursing theory to guide the foundation of the education was required to provide structure to the work. A combination of Dr. Jean Watson’s Theory of Caring and Dr. Marilyn Ray’s theory of bureaucratic caring provided the foundation for this work. The participant group included seven nurse leaders from four critical access hospitals in the central United States. Although this was a small focus group, the findings have implications for all care delivery locations. The tool to measure improvements in leader knowledge was an amalgamation of existing, validated stress-identification and job-related questionnaires. Data were analyzed using descriptive statistics. The overall stress score changed from an average of 51% to 19%. Another significant finding was the likelihood of nurse leaders continuing in their position or looking for promotion in leadership increased from 28% to 43%. The implications for positive social change are that a short education program supporting leader development can have significant impact on leader retention. The focus on creating a culture to retain nurse leaders will ensure a strong leadership pipeline. Strong and resilient nurse leaders will create a foundation to ensure that frontline care givers have the support and leadership to build care units where nurses and others want to work.