Nurse Leader Well-Being in the United States: An Integrative Review

Background: Nurse leaders are essential to safe, high-quality patient care, yet they face significant challenges, including physical and emotional health issues, high stress, and poor work–life balance. These challenges may compromise their ability to lead effectively. A better understanding of how well-being can be promoted among nurse leaders and the knowledge gaps within this literature is needed. Methods: This integrative review was guided by Whittemore and Knafl’s five-step framework. Peer-reviewed articles were identified through PubMed, Scopus, and Academic Search Premier. Studies were screened using predefined inclusion and exclusion criteria and included if they examined well-being among hospital-based nurse leaders in the United States. Data were extracted and synthesized to identify common themes and gaps. Findings: Fifteen U.S. studies published between 2013 and 2023 met inclusion criteria. Nurse leader demographics, personal qualities, and workplace resources emerged as key facilitators for well-being. Gaps in knowledge extended across research methodology and well-being conceptualization and measurement. Conclusions: Future research should prioritize a greater emphasis on the relationship between leader well-being and patient outcomes, consistent measurement of well-being, with greater focus on organizational-level interventions. Strengthening nurse leader well-being may have important implications for workforce stability, leadership effectiveness, and patient care quality. Applications to Practice: These findings may inform strategies to strengthen nurse leader well-being, an essential foundation for effective leadership, workforce stability, improved patient care delivery, and healthier work environments.