On the Frontlines of Nursing Leadership:: Managerial Dissonance and the Implications for Nurse Managers and Health Care Organizations

Nurse managers by role are required to implement organizationally mandated actions with potential to threaten the psychological, physical, or emotional well-being of employees. Value conflicts, or a state of dissonance, can arise when managers do not believe in the necessity of the mandated action. The process undertaken by managers to resolve this state can threaten the individual well-being of the nurse manager, including their role engagement and professional commitment to the organization. This article describes the psychological challenges faced by frontline nurse managers as they attempt to resolve this stressful state. Recommendations for nurse managers and organizational executives are discussed.