VOLUME  1 | ISSUE 10 | JULY 2025

Addressing the Global Nurse Migration Crisis: Strategies for a Resilient and Equitable Healthcare Workforce

Maurice Joy G. Cudal, MSN, RN

  In recent years the movement of nurses across borders has surged, driven by unevenly distributed health-care infrastructure, appealing economic incentives, and, at times, fraught national climates. When nursing staff leave their home countries, the vacancies they create deepen existing deficits in patient care, especially in low-and middle-income settings (LMICs). The global struggle for skilled workers became painfully apparent during the COVID-19 pandemic, which exposed systemic weaknesses and placed unprecedented pressure on already fragile health and social-care teams (McPake et al., 2024).  

   According to the World Health Organization (WHO), low-and middle-income nations will confront a collective shortfall of roughly eleven million health workers by 2030 if current trends persist. This looming gap results not only from demographic growth and aging populations, but also from decades of underfunding in education, training and equitable workforce assignment. Compounding the problem is the persistent disconnect between curricula and the evolving health needs of communities. In response, policymakers and educators must therefore map international migration patterns, coordinate prudent investments, and strengthen retention strategies in regions facing the steepest scarcity of skilled personnel.

  The COVID-19 pandemic exposed serious weaknesses in the world’s ability to respond to large-scale health emergencies. Timmis et al. (2020) argue that closing these gaps depends on international benchmarking, solid funding, and well-planned preparedness measures. Future health systems must therefore learn to keep staff on the job, adapt quickly to sudden demands, and resume normal operation without long delays. Outside the clinic, the migration crisis adds another layer of difficulty, especially for nurses who have fled conflict zones or fragile environments. Along the road to safety, refugees, including healthcare workers, face heavy mental strain and a long list of unmet needs (Griswold et al., 2021). For these reasons, any lasting solution must combine clinical support with broader humanitarian aid, so displaced nurses can heal themselves and return to the vital work of saving lives.

  Building a skilled healthcare workforce not only fills service gaps but also supports wider economic growth and strengthens community resilience. The High-Level Commission on Health Employment and Economic Growth highlighted six investment areas—training local women and young people, expanding apprenticeship programs, linking pay to skill advancement, modernizing data systems, easing financial barriers, and matching education supply with proven job openings—that promise the highest return. Every step contributes to the goal of universal access for patients and builds an economy that values human capital. To counteract nurse attrition due to overseas recruitment, policymakers should introduce targeted retention packages tied to professional development and safe working environments.

  The persistent flow of migrant nurses directly reflects global inequality, political instability, and weak governance, issues underscored by Sustainable Development Goal 16. Sustained peace and credible institutions can reassure health professionals who otherwise flee conflict or predicted unrest, allowing community clinics and hospitals to function during emergencies. Equitable regulatory frameworks, transparent licensure procedures, and responsible recruitment codes nurture trust, encouraging qualified personnel to remain in-country and serve their populations. By linking sound migration policies to broader justice initiatives, nations can protect vulnerable workers, bolster local health systems, and advance the SDG agenda in tandem.

   The crisis also intersects Sustainable Development Goal 10, which seeks to reduce inequalities, and Goal 17, which calls for partnerships among nations. Both goals highlight the uneven spread of healthcare workers around the world and the pressing need for cooperative action. When nurses leave low-income countries for high-income ones, the people who remain are denied essential care, deepening existing social and health disparities. Targeted investments in local education, on-the-job training, and supportive policy frameworks can begin to close this gap. Goal 17 further advocates for international agreements, including ethical recruitment standards and data-sharing platforms, that guide migration while ensuring receiving countries maintain a sustainable workforce and sending countries retain enough staff to safeguard public health.

References

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ICN calls for urgent G20 action on the global nurse migration crisis. (2024). ICN - International Council of Nurses. https://www.icn.ch/news/icn-calls-urgent-g20-action-global-nurse-migration-crisis

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Leadership in Doubt: A Review of Imposter Syndrome from Bedside to Boardroom in Nursing Practice

Marie Cecille Liberty S. Varilla, MAN, RN, RM

PhDN(c)

Our Lady of Fatima University

Graduate School

Doctor of Philosophy in Nursing

INTRODUCTION

The article titled “From the Bedside to the Boardroom: Imposter Syndrome in Nursing Leadership”, authored by Karen R. Fowler, PhD, RN, CENP, and Lizette Villanueva, PhD, RN, CNE, CHW, was published online on November 8, 2022. It explores the growing concern of imposter syndrome among nursing leaders, examining its prevalence, its effects on leadership performance, and potential strategies for addressing it. This review aims to present a comprehensive summary of the article, analyze its relevance and impact within the nursing profession, and critically evaluate the authors' arguments and supporting evidence. Drawing on both personal insights and related literature, this critique also highlights the article's strengths and limitations. Ultimately, the review seeks to deepen understanding of how imposter syndrome affects leadership identity and effectiveness in nursing, and what this implies for the profession’s growth and sustainability.

ARTICLE SUMMARY

The article highlights the fact that many nurses who hold leadership positions often feel like they do not belong in those roles or that they are not competent enough to lead. The authors explore the reasons behind this phenomenon and suggest strategies to address it. The article explores the potential implications of imposter syndrome in nursing leadership. Imposter syndrome can lead to self-doubt, anxiety, and a lack of confidence in decision-making. This, in turn, can result in decreased productivity, reduced job satisfaction, and ultimately, burnout. Imposter syndrome can also have a negative impact on team dynamics, as leaders may be hesitant to delegate tasks or make decisions.

The authors start by defining imposter syndrome as a psychological pattern where individuals doubt their accomplishments and have a persistent fear of being exposed as frauds or imposters. They then discuss how this syndrome can affect nurses in leadership positions, leading to feelings of self-doubt and anxiety that can negatively affect their performance.

The authors highlight some of the factors that contribute to imposter syndrome in nursing leadership, including gender bias, lack of mentorship, and perfectionism. The authors discussed how gender affect the prominence of imposter syndrome. They mentioned “imposterism” as being experienced by high-achieving women, although other studies showed that it may affect both men and women, recent studies have found greater imposter syndrome among women. This imposter syndrome reports among women were reported to be related to their mental health outcomes and perfectionism. From this study, the author cited the result of Bernard et al., where they found that women who reported a high frequency of racial discrimination had a higher level of imposter syndrome and thus they have greater fear for both success and failure, as well as they have a lower self-esteem. The author also mentioned that women are more prone for imposterism if they are marginalized in their workplace. The authors also defined ethnicity as a factor for prominence of imposter syndrome. According to the review of related literature of the authors, they have found a growing body of research which indicates that black emerging adults are particularly vulnerable to perceptions of intellectual incompetence related to simultaneous stressors resulting from expectations, societal roles, relationships, and negative-race related experiences. They also cited the result of the study of Afran et al,. noting that feelings of insecurity and self-doubt are characteristics of imposter syndrome among Black, indigenous, and other people of color. Furthermore, the author said that imposter syndrome has been linked to a lack of belonging experienced in various fields, particularly those in science, technology, engineering, and math. In nursing administration, the author also cleared that imposter syndrome which could lead to burnout, depression, and anxiety especially those nurses who were promoted from bedside to administrative role. Despite their experiences, they feel the other component of managerial or leadership role may be unfamiliar for them, thus increasing the possibility of having the phenomena.

The article goes on to suggest several strategies for addressing imposter syndrome in nursing leadership. One strategy is to provide mentorship and coaching to nurses in leadership positions, which can help them build confidence and develop their leadership skills. Another strategy is to create a supportive work environment that encourages open communication and collaboration, which can help nurses feel more comfortable sharing their ideas and concerns.

The authors also suggest that organizations should work to address the underlying factors that contribute to imposter syndrome, such as gender bias and perfectionism. They recommend providing training on diversity, equity, and inclusion, and promoting a culture of learning and growth rather than perfectionism.

ANALYSIS AND CRITIQUE

The article by Fowler and Villanueva (2022) sheds light on an increasingly recognized yet under-discussed issue in nursing leadership, imposter syndrome, which they define as persistent feelings of self-doubt and perceived inadequacy despite evident success. Their exploration of its prevalence, psychological burden, and impact on nurse leaders is timely, especially as healthcare systems demand more adaptive, emotionally resilient, and competent leadership.

Fowler and Villanueva’s (2022) treatment of imposter syndrome primarily frames it as a psychological experience, marked by persistent self-doubt and a perceived lack of competence despite evident success. While this perspective is insightful and aligns with the lived experiences of many nurse leaders, it contrasts with more structurally grounded analyses found in the broader literature. For instance, Gunawan et al. (2023) argue that imposter syndrome frequently arises from a mismatch between clinical expertise and managerial competencies, a skills gap that fosters insecurity and contributes to burnout during the transition into leadership roles. Similarly, Toothaker et al. (2022) emphasize that the absence of formal leadership training prior to role assumption often leaves novice leaders feeling ill-prepared, further reinforcing feelings of inadequacy and self-questioning.

In addition, Breed et al. (2020) and Jiang (2024) highlight the critical role of motivation, mentorship, and the formation of a clear professional identity in developing leadership confidence and resilience. These studies collectively suggest that imposter syndrome in nursing leadership is not merely an internal psychological struggle, but rather a complex, multifactorial phenomenon shaped by both individual characteristics and systemic conditions. Therefore, addressing imposter syndrome requires more than personal coping strategies; it demands a holistic and organizationally supported approach that integrates psychological, educational, and institutional interventions. This includes the implementation of structured mentorship programs, targeted leadership development, and the cultivation of supportive work environments with clearly defined role expectations.

Fowler and Villanueva’s (2022) article provides a strong foundational perspective for understanding imposter syndrome within the context of nursing leadership. The authors effectively articulate the psychological toll this phenomenon takes on nurse leaders and suggest practical solutions to address it. However, their analysis could be strengthened by adopting a broader, more integrative lens that encompasses not only the psychological but also the structural and transitional dimensions of the issue. When viewed through frameworks such as Nicholson and West’s Work Role Transition Theory and Schlossberg’s 4S model, and further supported by literature addressing skills gaps, role ambiguity, and motivational readiness, imposter syndrome is revealed to be as much a product of professional transition and organizational support, or lack thereof, as it is a reflection of internal self-doubt.

From the outset, the article is commendable for tackling a phenomenon that, while extensively studied in business and academia, is only recently gaining attention in healthcare. It presents relevant strategies, such as mentorship, self-reflection, and institutional culture reform, to mitigate imposter syndrome and foster leadership confidence. However, like any other academic papers, it came with some limitations.

Strengths of the Article

Fowler and Villanueva’s (2022) emphasis on self-doubt among emerging nurse leaders parallels what Schlossberg’s Transition Theory (1984) describes as a disruption in professional identity during periods of role transition (Lares-Martinez & Almanzar, 2023). Similarly, Nicholson and West’s Work Role Transition Theory (1989) outlines how nurses entering leadership roles may experience psychological misalignment, particularly during the “encounter” stage, where real-world responsibilities diverge from expectations, often a key trigger for imposter syndrome (Nicholson, 1990).

Wildermuth et al. (2020) and Hyrebook (2023) further emphasize that role transition in nursing extends beyond the acquisition of new technical competencies; it also involves a significant reshaping of professional identity. This perspective aligns with Fowler and Villanueva’s (2022) assertion that imposter syndrome, if left unaddressed, can substantially hinder leadership effectiveness. Collectively, these studies suggest that the internal struggle for identity alignment during transitional phases is a critical factor influencing a nurse leader’s confidence, performance, and overall adaptation to leadership roles.

Furthermore, Alharbi et al. (2023) and Cengiz et al. (2021) highlight that new nurse leaders frequently encounter role ambiguity and skills gaps, both recognized as key precursors to imposter syndrome. These challenges often result in uncertainty, reduced self-confidence, and diminished leadership performance. The strategies proposed by Fowler and Villanueva (2022), such as fostering peer support and promoting organizational recognition, align with broader literature advocating for structured mentorship and comprehensive leadership development programs (Mohammed, 2022; Ortega-Lapiedra et al., 2023). Such interventions are essential for clarifying role expectations, enhancing competency, and reinforcing the evolving professional identity of emerging nurse leaders.

Taken together, these perspectives illuminate the multifaceted nature of imposter syndrome in nursing leadership, not merely as a psychological condition, but as a reflection of deeper systemic and structural shortcomings in transition support. The convergence of internal identity disruption and external institutional deficiencies, such as unclear role expectations, lack of preparation, and insufficient guidance, creates fertile ground for imposter syndrome to develop. This interpretation underscores the urgent need for organizations to adopt a dual-focused approach: addressing the psychological resilience of nurse leaders while simultaneously reforming institutional practices to support smoother transitions. By doing so, healthcare systems can cultivate confident, competent leaders who are equipped not only to perform effectively but also to thrive in their roles.

Limitations of the article.

While the article makes a valuable contribution to the discourse on imposter syndrome in nursing leadership, it narrows its focus primarily to race and gender as influencing factors in the development of the phenomenon. Although these variables are undoubtedly significant, particularly in light of persistent global gender-based disparities in leadership roles within the nursing profession (WHO, 2022; Gauci et al., 2023), a broader set of determinants also warrants consideration. Literature reviewed by Julnes et al. (2022) and Matlhaba and Khunou (2022) underscores that age, length of clinical experience, and the extent of leadership preparation are equally critical in shaping how nurses transition into leadership roles. These factors not only influence leadership readiness but also contribute significantly to self-perception and identity construction, core elements in the manifestation of imposter syndrome.

Furthermore, Mlambo et al. (2021) and Alenezi (2022) emphasize that many nurses are often placed into leadership roles out of necessity rather than choice. This phenomenon, described by Ting et al. (2024) as the “hot potato effect,” reflects a pattern in which leadership is handed off abruptly, often without adequate mentorship or transition planning. This involuntary assumption of responsibility, combined with insufficient preparation, can exacerbate feelings of inadequacy and heighten the risk of experiencing imposter syndrome, yet these dynamics are not explicitly addressed in the article.  

By limiting the scope of analysis to socio-demographic variables, the article overlooks key structural and experiential factors that are deeply embedded in the leadership transition process. A more comprehensive understanding of imposter syndrome in nursing leadership would require examining the interplay between individual characteristics, role expectations, and organizational practices. Recognizing that imposter syndrome may stem not only from internalized self-doubt but also from externally imposed role misalignment offers a more holistic view of the issue. This interpretation points to the need for proactive leadership succession planning, targeted preparation programs, and institutional reforms that foster intentional, well-supported transitions, rather than reactive appointments that leave emerging leaders vulnerable to psychological and professional distress.

IMPLICATIONS

Graduate students

As a PhD students who plan to pursue leadership roles in the nursing field, we should be aware of imposter syndrome and its potential impact on our career. This article's findings suggest that imposter syndrome is a common phenomenon among nursing leaders, which may affect leadership ability and the overall success of the organization. By understanding and addressing imposter syndrome, we can develop effective strategies to cope with it and enhance leadership potential.

Additionally, this article's findings also underscore the importance of promoting mentorship and supportive relationships among nursing leaders. As PhD students, we should seek out mentors and support systems that can help us navigate the complexities of leadership roles and offer guidance on how to address imposter syndrome effectively. This may include seeking out professional networks, attending leadership development programs, and engaging in ongoing education and training.

Nursing profession and workplace

One of the main implications for nursing profession and workplace is the need for greater awareness and understanding of imposter syndrome among nursing leaders. Imposter syndrome can have negative effects on the well-being and performance of nursing leaders, which can in turn, impact the quality of patient care. Therefore, it is important for nursing organizations and employers to provide resources and support for nursing leaders who may be experiencing imposter syndrome. This can include mentoring programs, coaching, and training to build self-confidence and self-efficacy.

Nursing research

The authors present a comprehensive review of the literature on imposter syndrome and provide practical strategies for coping with this phenomenon. The article's relevance to nursing research lies in its focus on imposter syndrome's potential impact on nursing leadership. Imposter syndrome can negatively affect nursing leaders' self-confidence, decision-making abilities, and overall job performance. The article's findings are essential for researchers to understand the impact of imposter syndrome on nursing leadership and develop interventions to address it.

One of the significant implications of the article is the need for nursing research to explore the prevalence of imposter syndrome among nursing leaders. Future research can investigate the prevalence of imposter syndrome in different nursing leadership roles and settings. This can provide a better understanding of imposter syndrome's impact on nursing leadership and help develop targeted interventions.

CONCLUSION

Fowler and Villanueva’s (2022) article brings valuable attention to imposter syndrome in nursing leadership, highlighting how self-doubt and perceived inadequacy can undermine leadership effectiveness. The authors offer practical strategies, such as mentorship and inclusive workplace culture, to help address these challenges.

However, the article could be strengthened by incorporating broader structural factors, such as lack of preparation, role ambiguity, and sudden leadership transitions, which also contribute to imposter syndrome. Literature suggests that this phenomenon is not purely psychological but deeply rooted in both personal and organizational contexts.

For nursing students, the article emphasizes the importance of mentorship and early leadership development. For the profession, it points to the need for supportive systems and proactive succession planning. In research, it opens opportunities to explore imposter syndrome’s prevalence and develop targeted interventions.

Overall, the article is a timely and relevant contribution that encourages a more comprehensive understanding of the challenges faced by nurse leaders and the support needed to help them thrive.

REFERENCE:

Alenezi, I. (2022). Staff Nurses’ Perceptions of Barriers and Facilitators of Effective Nursing Leadership in a Major Saudi Hospital. The Open Nursing Journal, 16(1), e187443462207140. https://doi.org/10.2174/18744346-v16-e2207140

Alharbi, E. S. (2022). Leadership Training Program and Their Effect On Nursing Job  Performance and Head Nurses Competency. https://www.eimj.org/uplode/images/photo/Leadership_Training_Program_and_Their_Effect_On_Nursing_Job_Performance_and_Head_Nurses_Competency_..pdf

Breed, M., Downing, C., & Ally, H. (2020). Factors influencing motivation of nurse leaders in a private hospital group in Gauteng, South Africa: A quantitative study. Curationis, 43(1). https://doi.org/10.4102/curationis.v43i1.2011

Cengiz, A., Yoder, L. H., & Danesh, V. (2021). A concept analysis of role ambiguity experienced by hospital nurses providing bedside nursing care. Nursing & Health Sciences, 23(4), 807–817. https://doi.org/10.1111/nhs.12888

Fowler, K. R., & Villanueva, L. (2022). From the Bedside to the Boardroom: Imposter Syndrome in Nursing Leadership. Nurse Leader, S1541461222002531. https://doi.org/10.1016/j.mnl.2022.10.003

Gauci, P., Luck, L., O’Reilly, K., & Peters, K. (2023). Workplace gender discrimination in the nursing workforce—An integrative review. Journal of Clinical Nursing, 32(17–18), 5693–5711. https://doi.org/10.1111/jocn.16684

Gunawan, J., Aungsuroch, Y., Fisher, M. L., Marzilli, C., Nazliansyah, & Hastuti, E. (2023). Refining core competencies of first-line nurse managers in the hospital context: A qualitative study. International Journal of Nursing Sciences, 10(4), 492–502. https://doi.org/10.1016/j.ijnss.2023.08.001

Hyrebook. (2023, October 10). Onwards and Upwards: Facilitating Smooth Role Transitions. LinkedIn. https://www.linkedin.com/pulse/onwards-upwards-facilitating-smooth-role-transitions-hyrebook/

Jiang, X. (2024). Nursing leadership: Key element of professional development. International Journal of Nursing Sciences, 11(1), 1–2. https://doi.org/10.1016/j.ijnss.2023.12.015

Julnes, S. G., Myrvang, T., Reitan, L. S., Rønning, G., & Vatne, S. (2022). Nurse leaders’ experiences of professional responsibility towards developing nursing competence in general wards: A qualitative study. Journal of Nursing Management, 30(7), 2743–2750. https://doi.org/10.1111/jonm.13745

Matlhaba, K. L., & Khunou, S. H. (2022). Transition of graduate nurses from student to practice during the COVID-19 pandemic: Integrative review. International Journal of Africa Nursing Sciences, 17, 100501. https://doi.org/10.1016/j.ijans.2022.100501

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BMC Nursing, 20(1), 62. https://doi.org/10.1186/s12912-021-00579-2

Mohammed, C. (2022). Lived Experiences of Nurse Leaders [Disertation].

Nicholson, N. (1990). The transition cycle: Causes, outcomes, processes and forms. On the move: The psychology of change and transition, 5, 245-260.

Ortega-Lapiedra, R., Barrado-Narvión, M. J., & Bernués-Oliván, J. (2023). Acquisition of Competencies of Nurses: Improving the Performance of the Healthcare System. International Journal of Environmental Research and Public Health, 20(5), 4510. https://doi.org/10.3390/ijerph20054510

Ting, J. J., Babenko-Mould, Y., & Garnett, A. (2024). Early Career Nurses’ Experiences of Engaging in a Leadership Role in Hospital Settings. Canadian Journal of Nursing Research, 08445621241236666. https://doi.org/10.1177/08445621241236666

Toothaker, R., Rommelfaenger, M., Flexner, R. S., & Hromadik, L. (2022). The Challenges of Transition to Practice Expressed Through the Lived Experience of New-to-Practice Nurses. Patient Safety, 11–17. https://doi.org/10.33940/culture/2022.12.1

Wildermuth, M. M., Weltin, A., & Simmons, A. (2020). Transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program. Journal of Professional Nursing, 36(1), 69–75. https://doi.org/10.1016/j.profnurs.2019.06.006

Person, Well-being and Resilience (PWR) Model: Conceptualizing the Ability of Nurses to Sustain in the Professional

Benedict A. Landicho, MAN, RN

Abstract

Nursing is a noble profession with a holistically demanding nature (Brennan, 2017; Hittle, 2020; Landicho, 2021). It is worth understanding how nurses are able to withstand and thrive through such environment. This is a concept formulated to provide insight on how Well-being and Resilience impacts nurses' ability to sustain in their profession. Well-being is approached in two way, eudaimonic and hedonic. Psychological Well-being (eudaemonic) is defined by Carol Ryff with six dimensions; self-acceptance, personal growth, positive relationships, purpose in life, environmental mastery, and autonomy. Subjective Well-being (hedonic) is defined by Ed Diener as a tripartite structure of life satisfaction, positive affect, and negative affect. Resilience defined as ability to bounce back from adversities. Linked to positive emotions through The Broaden and build Theory by Barbara Fredrickson. The concept proposes that nurses are able to sustain in the profession because of their resilience that is enhanced by participating and enabling their valued bearers of well-being. One bearer of well-being can be enabled simultaneously with another. When bearers of well-being are enabled, this results to positive emotions which enhances their perception, thinking, and decision making. Having active protection of resilience and contributions of well-being, nurses sustain and develop in the profession. In conclusion, the proposed knowledge advocates to strengthen understanding of the concepts of wellbeing and resilience in the context of the nursing profession, aimed to sustain a happy and healthy workforce.

1. Introduction

Nursing is a noble profession with a holistically demanding nature (Brennan, 2017; Hittle, 2020; Landicho, 2021). It is an act that is constantly giving whether to patients, community, or co-leagues. It is worth understanding how nurses are able to withstand and thrive through such environment. Nurses face physical and psychological problems rendering care to the critically ill, addressing end-of-life issues, performing cardiopulmonary resuscitation, post-mortem care, exposure to health hazards, emergency situations and inadequacy of equipment and supplies. This results to physical fatigue, disrupted circadian rhythm and aggravated stress (Caruso et al., 2017; Hittle, 2020; Loukzadeh & Mazloom Bafrooi, 2013; Mealer et al., 2012). Even more, professional and moral distress rises when conflicts on values are encountered. In a study among Filipino nurses, burnout results to emotional exhaustion, depersonalization and reduced personal accomplishment (George & Reyes, 2017). This are the reasons why nurse managers must seek deeper understanding on how the well-being of nurses interplay with their ability to sustain in their profession. This is a concept formulated to provide insight on how Psychological Well-being, Subjective Well-being, and Resilience impacts the ability of nurses to sustain in their profession.

Psychological Well-being. In the writings of Aristotle, he stated that the function of man is to live a certain kind of life and the function of a good man is the good and noble performance of life in accord with appropriateness and excellence (Aristotle & Happiness, 2012). This is the eudaimonic approach to understanding well-being. In the studies of Carol Ryff, defined and constructed Psychological Well-being with six dimensions of positive psychological functioning such as Self-acceptance which encompass a breadth of wellness that includes positive evaluations of oneself and one's past life; Personal growth is the sense of continuous growth and development as a person; Purpose in life is the belief that one's life is purposeful and meaningful; Positive relationship with others is the possession of quality relation; Environmental mastery is the capacity to manage effectively one's life and surrounding world; Lastly, autonomy is the sense of self-determination (Ryff, 2014; Ryff & Keyes, 1995). 

Man, shall be in a constant agreement of self-acceptance. This is true as well for nurses as the capacities, abilities, personalities and attributes as individualized. In the studies of Landicho,( 2021), self-acceptance among nurses moderately positive. This reflected their favorable outlook to their personality and how they live. Personal growth was creates high impact to psychological well-being. The nursing profession is filled with trainings and specializations. It is evident that nurses who have more training tend to have higher satisfaction in the profession and career outcomes (Manongsong, 2025). Positive relationships and Purpose in Life are significant among nurses. This improves organizational commitment and joy in the workplace (Jena & Pradhan, 2017). Given the nature of the profession, Environmental mastery and Autonomy capacitates nurses to decide specially in critical situations. Having higher level of psychological well-being facilitates internal and external effectiveness of nurses. 

Subjective Well-being. A hedonic approach to well-being. Ed Diener (1984), defined subjective well-being as a tripartite structure of life satisfaction, positive affect, and negative affect. It creates vast benefits from mental health, physical wellness, and even the economy (Kansky & Diener, 2017). This approach promotes awareness and constant assessment of happiness applied into science. Nurses will benefit from this by having more parameters in balancing work and life. Welcoming leisure activities promoting balance also enhance life satisfaction (Tokay Argan & Mersin, 2021). This can also identify what nurses value most in life how it they are able to contribute to it on a daily basis. Positive and negative affect are equally important in terms of awareness. Positive affect fuels life satisfaction and several attributes as well such as compassion and resilience. While negative affect is evaluated to facilitate mitigation of its effects.

Resilience. Defined by Bruce Smith as the ability to “bounce back” from adversities (Smith, 2022). Resilience is also viewed as a protective factor, a trait, and ability. Linked to this concept is the theory of Barbara Fredrickson, The Broaden and build Theory. The theory propose that positive emotions broadens thinking and opens creativity, critical thinking, and even survival capacities (Fredrickson, 2004). It brings new thoughts, builds enduring personal resources, enhancing health, survival, and fulfillment. Reaching fulfillment, it returns new level of positive emotions. Nurses face adversities on daily manner. This highlights the importance of awareness of emotions as it contributes highly to the formation of a stronger personality and broader perspective in handling difficult situations in the profession.

2. Assumptions

Based on the influencing theories, the following assumptions for the concept are made:

1. That well-being is personal and cannot be generalized

2. Well-being improves resilience

3. Resilience is a constant protection of man’s holistic health

3. Conceptual Model

This conceptual model presents the relationship of the individuality of man as a person (P) protected by the constantly moving inner layer of Resilience (R). Bearers of well-being (W) represents the unique areas of life that a person puts value into. Bearers of well-being adds layer of protection and potentiates development. The concept proposes that nurses are able to sustain in the profession because of their resilience that is enhanced by participating and enabling their valued bearers of well-being (e.g. family, professional growth, altruism). This means that if person recognizes his//her family as a bearer of well-being, activities involving family will highly impact his resilience. Activities such as spending quality time with children and achieving family goals. One bearer of well-being can be enabled simultaneously with another. When bearers of well-being are enabled, this results to positive emotions which enhances their perception, thinking, and decision making. Having active protection of resilience and contributions of well-being, nurses sustain and develop in the profession.

Figure 1. Person, Well-being and Resilience (PWR) –Benedict A. Landicho

4. Nursing Metaparadigm

The PWR concept, in accordance to the nursing metapardigm defines;

Person, as man having unique bearers of well-being and level of resilience

Environment, as a constant source of both positive and negative emotions serving as stimuli in building the character of man.

Health, as a complex system protected by resilience and immproved by well-being

Nursing, as a noble profession of constant service.

5. Conclusion

The PWR Concept offers a perspective in understanding how nurses sustain in the profession, highlighting variables that can be acted upon through psychosocial programs, policies, and support from nursing leaders. The proposed knowledge advocates to strengthen understanding of the concepts of wellbeing and resilience in the context of the nursing profession, aimed to sustain a happy and healty workforce.

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