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Research Library

Aligning Theory and Evidence‑Based Practices to Enhance Human Flourishing in Nurse Executives

    • Published: 2017
    • Jim D'Alfonso
    • Ph.D. Dissertation, Doctor of Nursing Practice, University of San Francisco, September 2017.
    • Download the complete paper, click here.


Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n=12) was conducted, and the results for 12 matched pairs were statistically significant for improved personal and organizational indicators of stress over time, indicating improved vitality, engagement, and sustainability. Findings validated concerns regarding the prevalence of stress in the nurse executive group and demonstrated positive outcomes for key performance indicators that support personal wellbeing, resilience, retention, and success. One nurse executive identified she no longer felt like leaving the organization and nurse executive leader turnover has decreased measurably following the intervention. The relative low costs, positive outcomes, and flexible format of this program make it feasible to support spread and enculturation of improved stress management practices that benefit both employee and organization through existing orientation and ongoing professional development strategies.