All ETDs from UAB

Advisory Committee Chair

Larrell Wilkinson

Advisory Committee Members

Retta R Evans

Laura Talbott Forbes

Jenna Lachenaye

Jennan Phillips

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Education


The impending registered nursing shortage has been a critical concern within the healthcare industry for decades. One of the main causal factors of the nursing shortage is job dissatisfaction within the work environment, which results in increased registered nurse (RN) turnover (Erenstein & McCaffrey, 2007). Furthermore, job related stress has been found to be a significant barrier to nurse retention; however, a “healthy work environment” (HWE) can mediate adverse outcomes. HWEs are characterized by high levels of trust between workers and administration, respect for one another, effective communication and collaboration, and a climate of emotional as well as physical safety (Shirey, 2006), all vital to the healthcare industry (Cornett & O’Rourke, 2009). Several cross-sectional studies have suggested that quality RN work environments have a positive effect on nurse outcomes related to nurse retention (Aiken et al., 2011; Hasselhorn et al., 2006; Van Bogaert, Clarke, Roelant, Meulemans, & Van de Heyning, 2010). This mixed methods research design explored the relationships between the HWE, job related stress, perceived stress, resilience, and coping among RNs at a Magnet Hospital and Level IV Regional Neonatal Intensive Care Unit (RNICU) located in the Southeastern United States. Based on the data analysis of phases I and II, NICU RNs perceived their work environment as healthy and reported low levels of job related stress and average perceived levels of general stress. The data analysis revealed a significant inverse relationship between the NICU HWE and job related stress. Coping was also found to modify the relationship between job related stress and the NICU HWE. Although job related stress exists within hospital environments, HWEs can serve as a buffer against the effects of job related stress by offering employees a supportive environment to meet organizational expectations.

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