Dissertations & Theses (Open Access)

Date of Award

Spring 5-2019

Degree Name

Doctor of Philosophy in Nursing (PhD)


Joan C. Engebretson, DrPH

Second Advisor

Rebecca L. Casarez, PhD

Third Advisor

Christina Barss, PhD

Fourth Advisor

Deborah J. Jones, PhD


Background: Nurse leader sustainability is essential to organizational climate and patient care outcomes. The state of science of nurse leader sustainability is fragmented and warrants critical examination. Current research exists examining the impact of occupational stress among frontline nurses. However, research is scarce exploring occupational stress among nurse leaders.

Purpose: To narrow knowledge gaps by exploring perceptions of occupational stress among nurse leaders and their responses to stress.

Methods: A generic qualitative descriptive approach was used to explore perceptions of occupational stress among nurse leaders. The final sample consisted of 17 participants via purposive sampling. Thematic content analysis was used to categorize themes derived from the data. Data organization employed coding schemes to identify, label, and categorize concepts or themes. External validation via peer debriefing was used to ensure accurate interpretations.

Findings: Ten theme clusters subsumed under six emergent themes, “Always under pressure”; “Lack of work/life balance”; “My senior leadership does not support me”; “Fear”; My senior leadership does support me”; “Organizational commitment”.

Conclusion: Establishing and sustaining healthy work environments for the nurse leader generates a cascading effect on the organization. A heightened awareness of the elements that trigger occupational stress is a task that the organization must become astute to. It is imperative nurse leaders understand their response(s) to occupational stress directly impacts the organization, staff, and patient outcomes.


Nurse Leader, Nurse Manager, Occupational Stress, Job Stress, Well-being

Included in

Nursing Commons



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