1
1. Proposed title: Exploring mental health challenges for
nurse managers in operating theatre setting
1.1 Introduction
Operating theatres are high-intensity environments that demand precision, quick decision-
making, and a high level of resilience from healthcare professionals, particularly nurse
managers who are responsible for both team coordination and patient care (Shanafelt et al.,
2015). These managers face unique pressures, including the need to manage rapid patient
turnover, respond to emergency situations, and maintain effective communication among
multidisciplinary teams (Aiken et al., 2012).
Such conditions can lead to heightened levels of stress, which, if unaddressed, may result in
burnout—a psychological syndrome characterized by emotional exhaustion,
depersonalization, and a reduced sense of personal accomplishment (Maslach & Leiter,
2016). The high-stakes nature of the theatre environment can further intensify these effects,
potentially impacting not only the nurse manager's mental health but also patient outcomes
and team morale (Gilmartin et al., 2021). Understanding these mental health challenges and
developing effective interventions is essential to supporting nurse managers, ensuring
patient safety, and fostering a sustainable work environment (Embriaco et al., 2007).
2. Name Choene Rose Seema
3. Student number 18352782
4. Proposed qualification Master of Arts in Nursing science (99502)
5. College College of Human sciences
6. Department Health sciences
7. Research focus area Quality Health care
9. Problem Statement
Nurse managers in operating theatres experience unique and intense stressors that can
significantly impact their mental health, yet these challenges remain under-addressed in
healthcare institutions. Due to their responsibility for managing complex surgical schedules,
coordinating multidisciplinary teams, and handling high-stakes, life-and-death situations,
nurse managers in theatre settings are especially vulnerable to mental health issues such as
anxiety, depression, and burnout (Gilmartin et al., 2021; Aiken et al., 2012).
2
This environment often leads to chronic stress, which, if left unmanaged, can escalate into
severe mental health conditions that not only affect the well-being of the nurse manager but
also compromise their leadership efficacy, patient safety, and team morale (Shanafelt et al.,
2015).
Moreover, nurse managers may feel additional pressure to suppress their own emotional
struggles to meet the demands of their roles, further exacerbating their mental health issues
(Maslach & Leiter, 2016). Despite these risks, mental health support systems for nurse
managers remain insufficient, and organizational culture often stigmatizes seeking help,
leaving many to navigate these challenges in isolation (Embriaco et al., 2007). Addressing
these mental health challenges through tailored interventions is crucial to sustaining the well-
being of nurse managers and, ultimately, enhancing the quality of care provided in high-
stress operating theatre environments.
10. Significance of the study
This study on the mental health challenges faced by nurse managers in operating theatre
settings holds significant value for several reasons. Nurse managers play a crucial role in
ensuring the safety, efficiency, and overall quality of care in the high-stakes environment of
the operating theatre (Aiken et al., 2012). The unique demands of their position—such as
managing complex schedules, coordinating multidisciplinary teams, and handling critical
decisions under intense pressure—place them at heightened risk for mental health issues
like burnout, anxiety, and depression (Gilmartin et al., 2021). Understanding these
challenges is essential because unresolved mental health issues not only impact the well-
being of nurse managers but can also affect patient care quality, lead to higher staff turnover,
and lower overall team morale (Shanafelt et al., 2015).
By identifying specific mental health challenges and examining both current coping
strategies and gaps in institutional support, this study aims to provide insights that can
inform the development of targeted interventions. Findings from this research could help
healthcare institutions implement mental health support systems tailored to the needs of
nurse managers, thereby improving their resilience and work satisfaction. Furthermore, this
study addresses the broader issue of mental health in healthcare leadership, advocating for
a shift in organizational culture towards prioritizing mental well-being, which is vital for a
sustainable and compassionate healthcare system (Embriaco et al., 2007).
Ultimately, the study’s insights have the potential to influence policies, guide leadership
training, and inspire further research, contributing to an environment that better supports
nurse managers in maintaining their mental health and optimizing patient care outcomes.
that healthcare institutions can implement to promote mental well-being among nurse
managers.
11. Research aims and objectives
The study aims to explore and understand the mental health challenges for nurse managers
in the operating theatre setting, focusing on their personal and professional experiences, as
well as the coping mechanisms they employ. By achieving these objectives, the study seeks
to inform future policies and support systems to alleviate the pressures experienced by
nurse managers in high-stress surgical environments.
The specific objectives of this study are:
3
Explore the mental health challenges experienced by nurse managers in operating
theatre settings.
Describe mental health challenges experienced by nurse managers in operating
theatre settings
12. Research question
What are the mental health challenges faced by nurse managers in operating theatre
settings, and how can healthcare institutions effectively address these challenges to support
nurse managers' well-being?
13. Literature review
Mental Health Challenges in Operating Theatre Environments
Operating theatres are recognized as one of the most stressful environments in healthcare
due to the high-stakes nature of the work and the need for rapid, precise decision-making.
Nurse managers, who are tasked with managing theatre teams and resources under often
unpredictable conditions, experience unique pressures that can significantly impact their
mental health (Gilmartin et al., 2021). Studies have highlighted the high prevalence of
burnout, anxiety, and depression among healthcare workers in these settings, with nurse
managers particularly vulnerable due to their dual roles in patient care and team leadership
(Shanafelt et al., 2015). The theatre setting compounds these mental health challenges by
creating continuous exposure to trauma, long hours, and limited opportunities for rest, all of
which contribute to the deteriorating mental health of those in leadership roles (Embriaco et
al., 2007).
Burnout and Its Implications
Burnout is a prominent concern for nurse managers, particularly in high-intensity
environments like the operating theatre. Defined as a psychological syndrome characterized
by emotional exhaustion, depersonalization, and a reduced sense of personal
accomplishment, burnout has been linked to increased rates of absenteeism, decreased job
satisfaction, and reduced quality of patient care (Maslach & Leiter, 2016). Research by Aiken
et al. (2012) revealed that healthcare professionals experiencing burnout were more likely to
report diminished empathy, impaired decision-making abilities, and reduced productivity.
Nurse managers in the theatre setting are particularly susceptible to burnout due to the
emotional strain of managing life-and-death situations daily, leading to a higher likelihood of
emotional fatigue and job dissatisfaction. The ripple effect of burnout among nurse
managers not only affects individual performance but also influences team morale and
patient outcomes, making it a critical area for institutional intervention.
Coping Mechanisms and Institutional Support
Research indicates that nurse managers in theatre settings employ a variety of coping
mechanisms to manage their mental health, including seeking peer support, practicing
mindfulness, and engaging in resilience training (Gilmartin et al., 2021). However, these
personal coping strategies are often insufficient in addressing the cumulative stress inherent
in their roles. Studies show that organizational support, such as providing mental health
resources, flexible scheduling, and counselling services, can significantly alleviate stress for
nurse managers (Embriaco et al., 2007). Unfortunately, many healthcare institutions have
4
limited resources dedicated to mental health, and the stigma surrounding mental health
issues often prevents managers from seeking help (Shanafelt et al., 2015). The lack of
structured support from institutions leaves nurse managers to navigate these challenges
largely on their own, highlighting an urgent need for mental health policies tailored to this
high-stress environment.
Recommendations for Future Interventions
To address the mental health challenges of nurse managers in theatre settings, researchers
have called for comprehensive interventions at both the organizational and individual levels.
Organizational-level interventions, such as regular mental health assessments, training in
stress management, and implementing supportive workplace policies, have shown promise
in alleviating stress for healthcare leaders (Maslach & Leiter, 2016). Additionally, leadership
development programs that include training on mental resilience and self-care practices may
help nurse managers develop stronger coping skills. Future research should focus on
developing tailored interventions for operating theatre settings, which account for the specific
stressors of this environment, and on assessing the long-term effectiveness of these
interventions in improving the well-being of nurse managers (Gilmartin et al., 2021). These
findings underscore the need for healthcare institutions to adopt a proactive approach in
supporting the mental health of nurse managers, thereby improving both staff retention and
patient care outcomes.
14. Research design or Research or methodology or Theoretical framework
or Materials and methods or Procedures including the study area
Research Design
This study will employ a qualitative, descriptive research design to explore the mental health
challenges faced by nurse managers in operating theatre settings. This approach allows for
an in-depth understanding of the complex and personal experiences of nurse managers
regarding mental health, as it captures their perceptions, emotions, and coping strategies
within a high-stress environment (Polit & Beck, 2017).
Research Method
An exploratory phenomenological approach will be used to gain insight into the lived
experiences of nurse managers. Phenomenology is well-suited for this study as it focuses on
understanding how individuals perceive and make sense of their experiences (Smith et al.,
2009). This method will facilitate a deep exploration of the personal and professional impacts
of mental health challenges in the operating theatre.
Population and Sample
The population for this study consists of nurse managers working in operating theatres within
hospitals, specifically those with substantial experience in managing operating room
environments. The focus on nurse managers is due to their unique role in leading and
supporting theatre teams, often while facing intense stress and responsibility.
For sampling, a purposive sampling method will be employed, selecting participants who
have direct experience with the challenges of managing theatre settings. Criteria for
inclusion will include nurse managers with a minimum of two years of experience in theatre
management to ensure they have sufficient exposure to the demands of this role.
Approximately 10–15 participants will be recruited, with sample size adjustments based on
data saturation—the point at which no new themes or insights emerge from additional
interviews (Guest et al., 2006).
5
Data Collection
Data will be collected through semi-structured, in-depth interviews. These interviews will
enable participants to share their experiences openly, while guiding questions will ensure
coverage of key areas such as stressors in the theatre setting, personal coping strategies,
and experiences with institutional support. Each interview is expected to last between 45 and
60 minutes and will be conducted either in person or via secure video conferencing,
depending on participants' preferences and availability. With participants' consent, interviews
will be audio-recorded for accurate transcription and analysis.
Data Analysis
Data will be analysed using thematic analysis, following Braun and Clarke's (2006) six-step
framework: familiarizing with data, generating initial codes, searching for themes, reviewing
themes, defining and naming themes, and producing the final report. Transcripts will be
reviewed and coded to identify patterns and recurrent themes related to mental health
challenges and coping mechanisms. Thematic analysis allows for flexibility in capturing both
the explicit and underlying meanings in participants' accounts, which is essential for
understanding complex mental health experiences.
The use of Nvivo or similar qualitative analysis software will facilitate the organization and
categorization of data, making it easier to identify core themes. Throughout the analysis
process, steps will be taken to ensure trustworthiness, including member checking with
participants and peer debriefing with other researchers, to validate findings and ensure
accuracy (Lincoln & Guba, 1985).
15. Conclusion
In conclusion, nurse managers in the operating theatre setting face a unique set
of mental health challenges that stem from the high-stakes, high-stress nature of
their work environment. The constant pressure of patient outcomes, complex
team dynamics, resource limitations, and an often-unpredictable schedule
contribute to stress, burnout, and emotional exhaustion. These challenges are
compounded by professional isolation and a lack of support, which can hinder
their ability to seek help or find relief from these demands.
Addressing these issues requires a multifaceted approach. Healthcare
organizations must prioritize mental health resources for nurse managers,
promote a culture of open communication, and offer programs that support
mental well-being, resilience, and stress management. Peer support networks,
mentorship programs, and opportunities for professional development can
further empower nurse managers to handle the unique pressures of their roles.
By fostering an environment that values the mental health of nurse managers,
healthcare institutions can enhance not only the well-being of their staff but also
the quality of care provided to patients.
16. References
6
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2012).
Hospital nurse staffing and patient mortality, nurse burnout, and job
dissatisfaction. JAMA, 288(16), 1987–1993.
Embriaco, N., Papazian, L., Kentish-Barnes, N., Pochard, F., & Azoulay, E. (2007).
Burnout syndrome among critical care healthcare workers. Current Opinion in
Critical Care, 13(5), 482–488.
Gilmartin, H., Goyal, A., Hamati, M. C., Mann, J., Saint, S., & Chopra, V. (2021).
Burnout in healthcare: The case for organizational-level interventions. American
Journal of Health-System Pharmacy, 78(19), 1702–1709.
Maslach, C., & Leiter, M. P. (2016). Burnout: A leading cause of workplace stress.
John Wiley & Sons.
Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., & West, C.
P. (2015). Burnout and satisfaction with work-life balance among US physicians
relative to the general US population. Archives of Internal Medicine, 172(18),
1377–1385.
Budget:
Year Item Cost
2025 Research proposal Registrations. R 6000.00
Registration R17 000.00
Photocopying R 4000.00
Stationary R 2000.00
Audiotape and laptop R 13 000.00
Transport R 4000.00
Data transcription R500/transcript x10= R 5
000.00
Co-coding R 15 000.00
2026 Language editing R 18 000.00
2027 Re registrations R 17 000.00
Printing and binding R 2000.00
Sub total R103 000.00
