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Date Available

4-20-2026

Year of Publication

2026

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Debra Hampton

Committee Member

Dr. Patricia Hughes

Faculty

Dr. Andrew Makowski

Abstract

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. The intervention included five monthly, one-hour, in-person peer support meetings designed to strengthen relationships and provide shared strategies for managing stress. Discussion topics were guided by the 2025 AONL Nursing Leadership Insight Study. Each session included a craft activity that contributed to a desktop stress-reduction toolkit. Measures included the Perceived Stress Scale (PSS) and the Copenhagen Burnout Inventory (CBI), which assesses total burnout, personal burnout, work-related burnout, and client-related burnout.

Results

The sample consisted of ambulatory NMs (15 pre-/11 post-) who were predominantly white (93.3%), female (93.3%), and BSN (53.3%) or MSN-prepared (40%), highly experienced nurses (16-20 years) with limited (1-5 years – 53.3%) management experience. Pretest results for the PSS were M 14.87 compared to post-intervention results M 14.73 (p .94). Pretest results for the CBI Total Scale were M 52.51compared to post-test results M 43.89 (p .78). CBI Subscale scores were: Personal – (pre) M 59.17, (post) M 45.84 (p .02); Work-related - (pre) M 54.76, (post) M 48.7 (p .36); Client-related - (pre) M 43.61, (post) M 37.12 (p .44).

Conclusions/Implications for Practice

Although overall stress and burnout scores did not show statistically significant changes, personal burnout improved significantly, and qualitative feedback indicated NMs perceived reduced stress and isolation. These findings suggest potential benefits of structured peer support for ambulatory NMs. A peer-to-peer resilience intervention may help reduce stress and burnout in ambulatory nurse managers. Replication with a larger sample is recommended to determine its effectiveness in this understudied leadership group.

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