Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Sandra P. Thomas

Committee Members

Martha Raile Alligood, Howard Pollio, Mitzi Davis


Fewer people are entering the profession of nursing. There is already a shortage of nurses, yet, many abandon the bedside for lucrative ways to practice their art and for respected positions less inhibited by bureaucratic initiatives. A significant percentage of nurses will soon retire, further diminishing the number of experienced caregivers.

Good nurses require great leaders. A primary goal of organizations is to retain and recruit effective nurse managers. This study provides insight to the needs of nurse managers and aspects that keep them from leaving their jobs. The purpose of this study was to gain a differentiated understanding of the nurse manager role, one that is multifaceted and challenging. Some might consider management as prestigious, even powerful, yet nurse managers reveal the contrary. They speak of frustration and job barriers. They feel isolated in an unsupportive work environment and overwhelmed by pressures of administration and demands of staff and patients. During this study, they ask, "'Why am I still here?" and provide the answer.

A phenomenological approach was used to interview eight nurse managers. From their language emerged a five-category thematic structure against a bureaucracy unconcerned with their challenges. The five categories included Organization, Administration, Nurse Manager, Nursing Staff, and Patients. The top category, Organization, had one major theme, Outdated Norms: A Good Old Boys' System. Administration also had one major theme, They: An Unsupportive Entity. The middle category, Nurse Manager, had four themes: (1) In the Middle: Bosses on Top and Bosses on the Bottom, (2) Being Separate: Feeling Alone, (3) So Unprepared: Forging My Own Trail, and (4) Why Am I Still Here, You Ask? The fourth category, Nursing Staff, consisted of three themes: (1) The Part I Like the Least: Counseling, (2) Bent Over Backwards: Staffing & Scheduling, and (3) Clock In, Clock Out: A Lack of Professionalism. At the bottom of the structure, Patients had one major theme, I Never Forget What It's Like to be a Nurse. In the midst of describing endless challenges, nurse managers unveiled their dedication to nursing and an undying commitment to their profession.

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Nursing Commons