Abstract

In the post-COVID-19 landscape, many nurses report feeling abandoned (5), undervalued (6), and inadequately supported (2,3). As such, it is incumbent for organizational leaders to take action to support nursing staff and implement strategies that foster healthy work environments and promote nurses’ well-being. A potentially overlooked contributing factor is toxic positivity. While this phenomenon appears to be present in nursing, it remains underexplored. The purpose of this presentation is: (a) to provide an overview of the concept of toxic positivity, (b) to explore its potential impacts on patient care outcomes, and (c) to discuss strategies nurse leaders can employ to move away from toxic positivity and create supportive, healthy work environments.

A concept analysis of toxic positivity using Schatzman’s dimensional analysis method was conducted, revealing a multi-dimensional concept applicable across various settings, including the nursing workforce. Toxic positivity, defined as a process in which givers—either intentionally or unintentionally—deny or disregard another person’s negative emotions or experiences through misplaced positivity (7), may contribute to burnout, diminished well-being, job dissatisfaction, and retention challenges. The salient dimension of toxic positivity is Emotional Suppression, which, when compounded by other relevant dimensions and sub-dimensions, may lead to psychological distress and decreased well-being among recipients. These negative outcomes can, in turn, affect patient care quality and outcomes (4), making toxic positivity a significant concern for nursing leaders. Given the identified consequences, nurse leaders should develop a heightened awareness of the presence of toxic positivity within their organizations.

The findings from this concept analysis align with long-standing issues in the nursing workforce. Nurse leaders should focus on identifying toxic positivity, learning how to avoid it, and educating staff on healthy coping strategies. Instead of promoting dismissive positivity, leaders should adopt trauma-informed care practices, provide adequate resources, foster open communication channels, and actively address nurse burnout (1). These leadership strategies, coupled with system-level interventions, can help create and sustain work environments that shift the focus from harmful emotional suppression to healthy acknowledgment and meaningful support for the nursing workforce.

Notes

A potentially overlooked factor impacting the nursing work environment is toxic positivity, an underexamined phenomenon in nursing where individuals dismiss others’ negative emotions through misplaced optimism. A concept analysis revealed a multi-dimensional concept with consequences that may affect patient outcomes. Nurse leaders should raise awareness of this issue, adopt trauma-informed practices, and promote healthier work environments through open communication and adequate resources.

Description

(1) Harris, S. R., Amano, A., Winget, M., Skeff, K. M., & Brown-Johnson, C. G. (2024). Trauma-Informed Healthcare Leadership? Evidence and opportunities from interviews with leaders during COVID-19. BMC Health Services Research, 24(1), 515–515. https://doi.org/10.1186/s12913-024-10946-9

(2) Muir, K. J., Porat-Dahlerbruch, J., Nikpour, J., Leep-Lazar, K., & Lasater, K. B. (2024). Top 2 factors in nurses ending health care employment between 2018 and 2021. JAMA Network Open, 7(4), e244121–e244121. https://doi.org/10.1001/jamanetworkopen.2024.4121

(3) O'Hara, C. & Reid, M. (2024). The under 35 nursing workforce in 2022: Overworked, under supported, and burned out. Journal of Nursing Regulation. 15. 45-55. 10.1016/S2155-8256(24)00028-0.

(4) Pryor, S., Hanson, A., Chan, J., Brunner, H., Letourneau, R., & Menon, U. (2024). Nurse well-being and patient-specific outcomes: A scoping review. Journal of Nursing Care Quality. https://doi.org/10.1097/NCQ.0000000000000776

(5) Robinson, K. R., Gierach, M., Bartelt, S., Wolles, B., McClellan, C., Hodge, J., & Lovro, J. (2023). Battle of COVID-19: Frontline nurses feel abandoned during the pandemic. American Nurse Today, 18(3), 12–16. https://doi.org/10.51256/ANJ032312

(6) Tribby, K. V., & Isaacson, M. J. (2024). We’re not valued, we’re not heard: Voices of seasoned nurses in a rural state following the onset of COVID-19. Advances in Nursing Science, 47(3), 233–247. https://doi.org/10.1097/ANS.0000000000000490

(7) [Author]

Author Details

Hannah Grace Shipp, BSN RN CCRN SCRN PCCN; Katherine Christine Hall PhD, RN, MEDSURG-BC, CNE

Sigma Membership

Epsilon Sigma at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Toxic Positivity, Patient Care Outcomes, Nurse Leaders

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Phoenix, Arizona, USA

Conference Year

2025

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

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Overcoming Toxic Positivity: Leadership Strategies for Promoting Healthy Nursing Work Environments

Phoenix, Arizona, USA

In the post-COVID-19 landscape, many nurses report feeling abandoned (5), undervalued (6), and inadequately supported (2,3). As such, it is incumbent for organizational leaders to take action to support nursing staff and implement strategies that foster healthy work environments and promote nurses’ well-being. A potentially overlooked contributing factor is toxic positivity. While this phenomenon appears to be present in nursing, it remains underexplored. The purpose of this presentation is: (a) to provide an overview of the concept of toxic positivity, (b) to explore its potential impacts on patient care outcomes, and (c) to discuss strategies nurse leaders can employ to move away from toxic positivity and create supportive, healthy work environments.

A concept analysis of toxic positivity using Schatzman’s dimensional analysis method was conducted, revealing a multi-dimensional concept applicable across various settings, including the nursing workforce. Toxic positivity, defined as a process in which givers—either intentionally or unintentionally—deny or disregard another person’s negative emotions or experiences through misplaced positivity (7), may contribute to burnout, diminished well-being, job dissatisfaction, and retention challenges. The salient dimension of toxic positivity is Emotional Suppression, which, when compounded by other relevant dimensions and sub-dimensions, may lead to psychological distress and decreased well-being among recipients. These negative outcomes can, in turn, affect patient care quality and outcomes (4), making toxic positivity a significant concern for nursing leaders. Given the identified consequences, nurse leaders should develop a heightened awareness of the presence of toxic positivity within their organizations.

The findings from this concept analysis align with long-standing issues in the nursing workforce. Nurse leaders should focus on identifying toxic positivity, learning how to avoid it, and educating staff on healthy coping strategies. Instead of promoting dismissive positivity, leaders should adopt trauma-informed care practices, provide adequate resources, foster open communication channels, and actively address nurse burnout (1). These leadership strategies, coupled with system-level interventions, can help create and sustain work environments that shift the focus from harmful emotional suppression to healthy acknowledgment and meaningful support for the nursing workforce.