Degree Name

Doctor of Education in Leadership (Ed.D.)

Type of Paper/Work



John Holst

Second Advisor

Thomas L. Fish

Third Advisor

Alice Swan


The purpose of this grounded theory study was to provide nurse managers in two healthcare organizations with an opportunity to share their reflections on their leadership development and transition from staff nurse to nurse manager. This qualitative study provides analysis grounded in the data and themes from the interviews, developing theory, and recommendations, which should prove useful to the leaders in the agencies where the study was done.

Through 19 semi-structured interviews of current or previous nurse managers, the participants described what contributed to their leadership development and the challenges they encountered. In the category of contributors, the themes included identity and purpose, “Emotional Intelligence”, mental models of continuous learning, and a nurturing community. Challenges included the transition from staff to manager, learning from adversity, and the large scope and rapid pace of change.

The researcher conducted an analysis of the findings using the lenses of Symbolic Interactionism (SI) combined with Goffman’s (1959) dramaturgy and theatrical performance, and the four frames of Bolman and Deal (2008). There are definite front stage and back stage aspects to the leadership development of nurse managers. These theories help represent the complexity of the individual and organizational aspects of the leadership development of nurse managers. Additionally, a theory emerged that outlined the symbiotic forces which help nurses develop as leaders. These symbiotic forces include the hazardous terrain with the unpredictable and the unknown, as well as the tranquil waters of reflection, renewal, and support. The theory also describes the ripple effect of nurse managers as leaders in the organizational context. The study yielded significant implications and recommendations for nursing educators, nursing practice and the organization, nurse leaders, and future researchers.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This file may be slow to open due to its size. For best results, right-click and select "save as..."

Included in

Education Commons