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Learning Objective 1: identify unique challenges nurse managers face trying to execute their daily practice roles.
Learning Objective 2: discuss structures and processes needed to better support both novice and experiences nurse managers in their roles.
Methods: This qualitative descriptive study determined what situations contribute to nurse manager stress, what coping strategies they utilize, and what health-related outcomes they report. A purposive sample of 21 nurse managers from three U.S. hospitals completed a 14-question interview incorporating the Critical Decision Method, a methodology that uses cognitive probes to illuminate novice to expert cognitive differences. Content analysis was completed, themes identified, and trustworthiness strategies addressed.
Results: Sources of stress related to people and resources, tasks/work volume, and high performance expectations. When comparing novice nurse managers with experienced nurse managers, the novices used predominantly emotion-focused coping strategies, a narrow repertoire of self-care strategies, and experienced negative psychological, physiological, and functional outcomes related to their coping efforts. Experienced nurse managers working as co-managers utilized mostly problem-focused coping strategies, reported a broad repertoire of self-care strategies, verbalized no negative health-related outcomes, and demonstrated high creativity levels.
Conclusion: Performance expectations for nurse managers practicing in acute care hospitals are complex and often unrealistic. Rising role expectations increase nurse manager stress, making coping more difficult, and potentially harming nurse manager and work environment outcomes. Findings from this study have implications for the nurse manager’s ability to create healthy work environments for practice, crucial structures needed for nurse retention and patient care quality/safety that necessitate individual and organizational strategies.