Date of Award

Fall 12-2023

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Nina Mclain

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Debra Copeland

Committee Member 2 School

Leadership and Advanced Nursing Practice

Committee Member 3

Dr. Bonnie Harbaugh

Committee Member 3 School

Leadership and Advanced Nursing Practice

Committee Member 4

Dr. Lachel Story

Committee Member 4 School

Leadership and Advanced Nursing Practice


The COVID-19 pandemic is one of the largest healthcare crises that has affected the entire healthcare industry. Community health nurses in the front-line roles are greatly threatened by the COVID-19 pandemic that has decimated healthcare systems. The well-being of nurses is vital to perform their full potential of adequate patient care. Increased demands and pandemic related stressors can increase the risk of mental health problems. Nurses work in a variety of healthcare settings, however, the expectations, the fear of the unknown, and changes in demands have largely contributed to the unprecedented stressors that accompany nurses in clinical settings. Stress among community clinic nurses can lead to poor performance at work. High demands in healthcare work settings can cause symptoms of anxiety, stress, and depression. However, little research has been conducted on the mental health needs of community health nurses. The COVID-19 pandemic has been associated with the stressors facing community clinic nurses while treating patients.

Neuman’s Systems Model Theory was employed to examine different factors that resulted in stressful instances amongst nurses and how they responded to various stressors. The study utilized qualitative research with directive content analysis. Qualitative data was collected by examining perceptions of stress in 15 clinic nurses who worked in the community during the COVID-19 pandemic. As research gaps were identified, the following research questions were developed and used to guide this study:

RQ 1: What are the perceptions of stress in community clinic nurses as they deliver care during the global pandemic?

RQ 2: How did community clinic nurses handle the stressors during the COVID-19 pandemic?

Codes were examined and categorized based on Neuman's model of intrapersonal, interpersonal, and extrapersonal stressors. The intrapersonal codes included concepts related to nurses' internal thoughts, feelings, and experiences. Interpersonal codes involved nurse interactions within the organizational setting. Extrapersonal codes encompassed external systemic and environmental factors. Overall, the findings contributed to existing research on the factors that impacted stress in clinic community nurses during the COVID-19 pandemic and directly define the intricacy of their mental health needs.