Dissertations & Theses (Open Access)

Date of Award

Spring 5-2020

Degree Name

Doctor of Philosophy in Nursing (PhD)


Joan Engebretson PhD

Second Advisor

Melanie McEwen, PhD

Third Advisor

Chung-An Chen, PhD


Background: Nurse leaders are indispensable to the delivery of quality, patient-centered care. They are influential in the practice environment, contributing to front-line staff job satisfaction. They work to improve retention, turnover, organizational health, and patient outcomes. Yet, there is a dearth of research investigating the motivating factors that appeal to, encourage, discourage, and help retain nurse leaders in their roles. The forecast of a shortage of nurse leaders, along with the reluctance of nurses to assume leadership roles, is affecting healthcare organizations throughout the United States. An in-depth understanding of the underlying factors related to motivation that appeal to, encourage, discourage, and retain nurses in current leadership roles is needed for the development of recruitment strategies to mitigate the current and future shortage of nurse leaders.

Purpose: The aim of this study was to better understand the underlying perspectives related to the motivation factors that appeal to, encourage, discourage, and retain nurses in leadership roles.

Method: A descriptive qualitative approach, including semi-structured, audio-recorded individual interviews of 15 nurse leaders, was used to gain in-depth understanding of perspectives related to leadership motivation. Data were analyzed using a thematic content analysis approach.

Findings: Findings suggest that nurse leaders are driven by a mixture of intrinsic and extrinsic motivation factors early in their career. This shifts to become more focused on intrinsic motivation factors surrounding making a difference, connecting with others, and mentoring later on in their career. A thematic content analysis of the data was organized into a conceptual framework to help understand the processes which motivate nurses in leadership roles. Six main themes emerged from the data: Pathway into nursing, Motives for assuming leadership roles, Pathway into leadership roles, Transition into leadership roles, Challenges of leadership roles, and Motives for remaining in leadership roles. These themes provide insight into the motivation processes that appeal to, encourage, discourage, and retain nurse leaders in leadership roles.

Conclusion: Findings suggest that nurse leaders are driven by both intrinsic and extrinsic motivation factors throughout their career with the focus shifting later in their career to become more intrinsic motivation. Current nurse leaders should be encouraged to use this information to assist them as mentors and to create supportive mentoring relationships to develop the next generation of informal nurse leaders who can assume formal nurse leadership roles, thus creating a future pipeline of leaders to mitigate the nursing leader shortage.


nurse leader, motivation, transition, challenges

Included in

Nursing Commons



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