Association between work-related stress and turnover intention among nurses: A systematic review

 Corresponding author: Salman Salem Alzahrani Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Association between work-related stress and turnover intention among nurses: A systematic review Salman Salem Alzahrani 1, *, Dhakir Abbas Ali 2 and Faridah Mohd Said 1 1 Department of Nursing, Faculty of nursing and applied science, Lincoln University College, Malaysia. 2 Department of postgraduate studies, faculty of management, Lincoln University College, Malaysia. World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 Publication history: Received on 05 July 2025; revised on 10 August; accepted on 13 August 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.27.2.2933 Abstract Stress at work and nurses' intentions to leave are important factors. Stress at work can lead to illness and even accidents. Stress at work can negatively affect a person's health and quality of life, and nursing is perceived as challenging. The study aimed to determine whether work-related stress and nurses' intentions to leave their jobs were associated. The study's design was based on synthesizing high-quality publications and systematic reviews. Papers were identified from three databases and searched in English from 2015 to 2025. Studies selected for the study met the eligibility criteria comprising articles that described work-related stress, burnout, emotional distress, and occupational stress and articles that evaluated turnover intention, Lack of job fulfillment or factors impacting nurse attrition. Several topics emerged following a thematic analysis. Among the topics covered were the main reasons nurses experience stress at work, how this influences their desire to leave, methods for lowering stress at work, and nurses' plans to leave. The primary causes of work-related stress among nurses were workload, prolonged shifts, strained relationships with coworkers, a lack of professional skills, and inadequate preparation and support to handle the mental health requirements of patients and their families. It was also noted that work-related stress decreased work resilience, burnout and emotional distress, resulting in turnover intentions among nurses. Strategies to mitigate work-related stress include mitigating workload, providing psychological counseling for nurses, and availing stress management training for less experienced nurses. According to the study, work-related stress was linked to nurses' intentions to quit, and essential steps must be taken to reduce nurses' intentions to quit. To help them deal with obstacles in the workplace more effectively, it is necessary to train their employees—primarily nurses—in coping mechanisms and stress management techniques. Keywords: Work-related stress; Turnover Intention; Coping mechanisms; Stress Management techniques 1. Introduction Nursing is seen as a challenging career, and stress at work can harm a person's health and quality of life. Stress at work can negatively impact a person's physical and emotional well-being and productivity, which in turn can lead to higher stress levels. Babapour et al. (2022) illustrate that nursing is a stressful job linked with multiple job demands and needs, excessive responsibility, increased expectations, and minimal authority, which have been recognized as the key stressors. Stress at work may affect nurses' quality of life and, in turn, the quality of care they provide. Because they can deliver more adequate services when they have a higher quality of life, nurses who work with patients need to lead high-quality lives. Various reasons may result in turnover intention, including dissatisfaction, career growth opportunities, work overload, salary issues, and personal factors (Huang et al., 2025). Moreover, it is linked to various cognitive, behavioral, and psychological factors. Among professionals, the turnover rate of nurses is noted to be the highest. Voluntary turnover negatively impacts patients and healthcare organizations (Zhou et al., 2021). Voluntary turnover among nurses has negative impacts, which may be direct or indirect to healthcare facilities. According to World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 973 Chegini et al. (2019), work-related stress and quality of life are linked with turnover intention among nurses working in healthcare facilities. According to Ma et al. (2022), there is a greater need for nurses in healthcare facilities worldwide. However, nurses are scarce and have a higher propensity to leave. According to Zefanya Sibuea et al. (2024), job fulfillment, decreased quality of work life, lack of commitment within an organization, job stress, lengthened shifts, conflicts within the work-family, burnout, and organizational culture have been recognized as factors that could lead nurses to resign from their place of Work. Furthermore, socio-demographic elements comprising marital status, education, age, and tenure may affect nurses' turnover (Snyder, 2019). Workrelated stress is an essential factor affecting employee job fulfillment and organizational commitment, which are crucial predictors of turnover. Occupational stress occurs when there is an imbalance between workers' ability to cope and the workplace demands. Dealing with challenging patients, long work hours, demanding working environments, and various occupational health and safety risks make the healthcare industry intrinsically stressful. In healthcare facilities, nurses are key to delivering care and managing patients within healthcare services (Alshammari & Ali, 2024). According to Galanis et al. (2024), the main factors influencing nurses' intention to leave their jobs include their working environment, particularly the availability of sufficient resources, nursing staffing, work-related stress, ongoing interaction with patients and their families, and depression. Additionally, organizational support is an essential factor impacting turnover intention within a demanding and challenging work surrounding healthcare delivery. According to the concept of perceived organizational support, employees feel that their workplace values promote the care and well-being of their coworkers (Ran et al., 2024). Positive work environments, managerial incentives, help employee’s complete tasks effectively and handle difficult situations, and senior or supervisor support are all considered forms of organizational support (Wubetie et al., 2020). Regularly, nurses are confronted with acute stressors or critical incidents. Nurses are responsible for outcomes of patients, multiplexity of disease management, uncertainty regarding management of patients, progression of diseases from patients, and dealing with dying and death have been recognized as sources of occupational stress among nurses. Nurses have mentioned that increased job demands, Lack of staff, erratic shift work, and employee disagreements were highlighted as stressors. Because nurses have additional responsibilities and are overworked, work-related stress can affect their compassionate conduct. Although work-related stress is associated with lower quality of care, it also leads to a lack of or loss of compassion for patients and a rise in practice errors (Babapour et al., 2022). Numerous studies have documented workrelated stress's direct or indirect effects on patient outcomes and care delivery. The relationship between work-related stress and the intention to leave healthcare professionals—primarily nurses— is assessed in this article. The study will identify primary stressors in nursing practice and their impact on nurses' intentions to quit or leave their positions. Developing a successful action plan to reduce stress, encourage job satisfaction, and improve nurse retention rates requires acknowledging the connection. There is a shortage of nurses worldwide; therefore, acknowledging the factors that result in nurse turnover is critical for healthcare regulators and administrators. High turnover intention rates affect the continuity and quality of patient care while raising the costs of hiring and training new employees. The study also aims to recognize primary stressors and their effect on turnover intention. The study aims to provide recommendations to inform action plans within a working environment, policy alterations, and support systems to enhance nurses' job fulfillment and retention. Objectives of the Study • General Objective o To identify the association between work-related stress and turnover intention among nurses. • Specific Objectives o To recognize the main causes of nurses' work-related stress. o To assess how work-related stress affects nurses' inclinations to leave. o To analyze methods for lowering stress at work and nurses' intentions to leave. World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 974 2. Methodology 2.1. Data Sources and Search Strategy A comprehensive information search was conducted using several databases, including PubMed, Science Direct, and Google Scholar, with a particular emphasis on English particles published between 2015 and 2025. A manual search was also done to recognize additional articles that met the eligibility criteria. The search terms comprised “work-related stress OR “Burnout” OR “Occupational stress” AND “Turnover Intention” OR “Nurse turnover.” Additional search terms comprised of “Workplace stress” OR “Job stress” AND “Nurse Retention.” Zotero 6.0.4 was utilized to screen and maintain the records, eradicating duplicates. The Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) were carefully followed in organizing the systemic review and theme synthesis. Table 1 Search Terms/Keywords Search terms/ Keywords “Work-related stress OR “Burnout” OR “Occupational stress” AND “Turnover Intention” OR “Nurse turnover.” OR “Workplace stress” OR “Job stress” AND “Nurse Retention” In collaboration with colleagues, the researcher cooperated with colleagues to ensure the development of a search strategy. The colleagues were nurses who were fully aware of the topic and had more than two years of experience in the field. They were well-versed with the review objectives, responsibilities, and anticipated contributions. The librarian was contacted to ensure thorough coverage of the keywords linked to nurses' intentions to leave their jobs and work-related stress, and particular search filters were applied. It was worth noting that the collaborative effort proved valuable in navigating the multiplexity of searching the data. Studies that satisfied the eligibility requirements examined the relationship between nurses' intentions to leave their jobs and stress at work. They also concentrated on qualitative and quantitative data collection and analysis techniques. Studies that were eligible comprised a variety of factors contributing to work-related stressors, such as job fulfillment, organizational culture, and support mechanisms. Furthermore, the evaluation was expanded to include studies that assessed how these characteristics affected work-related stress and turnover intention outcomes in nursing settings. 2.2. Selection Process Basic review questions are key before the beginning of any research because they assist in narrowing down the focus and concentrating and identification of relevant literature by utilizing keywords and concepts. The PICO (Population, Intervention, Context, Outcome) approach was utilized to clarify the reviewed topic. Population: Nurses comprising related registered nurses nurse practitioners working within healthcare settings. Intervention or exposure: Work related stress comprising job burnout, occupational stress, and emotional exhaustion. Comparison: Nurses experiencing little to no work-related stress or those with workplace support to manage stress. Outcome: Turnover intention, nurse retention, or increased probability of resigning or leaving the profession. According to Eriksen & Frandsen (2019), the PICOT model is regularly used to organize clinical research topics during data synthesis. To guarantee that significant elements of the review questions are expressed, the Cochrane Handbook for Systemic Reviews of Intervention suggests the utilization of PICOT as a model. It may be modified to establish a research question on diagnosis or prognosis, and the PICOT guidelines are more understood for management issues and less appropriate for other clinical data demands (Eriksen & Frandsen, 2019). Methley et al. (2014) illustrated that PICOT was more sensitive and valid for comprehensive searches than other methods such as SPIDER (Sample, Phenom of Interest, Design, Evaluation, Research). World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 975 Table 2 PICOT PICOT Keywords Population Nurses comprise registered nurses, and nurse practitioners working within healthcare settings. Interventions Work-related stress comprises job burnout, occupational stress, and emotional exhaustion. Comparison Nurses experiencing little to no workstress or those with workplace support to manage stress. Outcome Turnover intention, nurse retention, or increased probability of resigning or leaving the profession. The studies that failed to meet the eligibility criteria comprised of a) studies that highlight personal stress without clear association with Work, b) Articles discussing nurse turnover without evaluating the role of work-related stress, c) nonempirical studies such as abstracts, unpublished dissertation/ theses, and d) articles written in other languages other than English. Colleagues examined the abstract and title of the article. Screening of full-texts on eligible publications was reviewed by a single researcher who then addressed any doubts with the colleagues. Table 3 Eligibility Criteria Inclusion Criteria Exclusion Criteria Articles focusing on all nursing cadres within healthcare settings. Studies that highlight personal stress without clear association with Work. Articles that evaluated work-related stress, burnout, emotional distress, and occupational stress. Articles discussing nurse turnover without evaluating the role of work-related stress. Articles evaluating turnover intention, Lack of job fulfillment, or factors impacting nurse attrition. Non-empirical studies such as abstracts, and unpublished dissertations/ theses. Peer-reviewed qualitative, quantitative, or mixed methods articles. Studies published in other languages other than English. Articles published in English within the last 20 years. Data collected worldwide within healthcare settings, hospital settings or healthcare surroundings. Back 2.3. Data Extraction The following information was included in each study: the author or authors, the year of publication, the relationship between nurses' intentions to leave their jobs and work-related stress, and methods for reducing the relationship between these two variables. 2.4. Synthesis of Findings Three steps were incorporated into the thematic synthesis. The first step comprised of the researcher coding relevant content line by line. Accordingly, descriptive themes across studies were developed by organizing the free codes. A coding manual was established to guarantee a systemic technique to coding the information. After an extensive examination of the topics recognized, any disagreements were resolved until an agreement was attained. The third phase was “going beyond” the data to recognize analytical themes that provide fresh opinions when paired with the first research. The researcher created a model to illustrate how the themes relate to the recognition of factors and coping strategies related to job fulfillment among nurses after utilizing group brainstorming to overarching themes to elaborate the relationship between work-related stress and nurse turnover intention among nurses. 2.5. Risk of Bias and Quality Assessment The researcher conducted an exhaustive literature search across multiple key databases, employing a well-defined search strategy that integrated various keywords and Boolean operators. This search was restricted to articles published in conference proceedings and peer-reviewed journals to decrease the likelihood of selection bias. A technique from the Critical Appraisal Skills Program was used to evaluate the articles' benefits and drawbacks. Regardless of the quality, all documents were included in the review. Each document was examined by colleagues, while engaging in discussions to sort out any issues regarding the quality evaluation. The review provides an extensive and World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 976 straightforward account of data sources, search strategy, study selection process, and synthesis of results. The results are enhanced by using tables to summarize primary data effectively. 3. Results 3.1. Systematic Literature Search The figure below highlights the PRISM 2020 flow diagram. As of 2025, 360 items that may be of interest were retrieved from multiple electronic databases. Of these, 180 were found in Science Direct, 80 in PubMed, and 100 in Google Scholar. The writers’ absolute dependence on well-established databases is enumerated by the fact that they did not acquire papers from other sources. They enhanced the integrity of their review process by reducing the quantity to 200 unique articles after eliminating 160 duplicates. During the screening stage 210 articles were eliminated due to various reasons such as irrelevance, Lack of data, and review articles. Extensive screening of data illustrated dedication to upholding strict eligibility criteria. Afterward, abstracts were quickly filtered, bringing it down to 190 articles. Subsequently, reading the complete texts followed, which further eliminated papers that lacked adequate data or were found to be modeling studies. In the final analysis, the researcher’s review highlighted eight publications, enumerating a targeted and selective method that gave highquality data over quantity. Thanks to the extensive screening of the literature, the systemic review aligned with the objectives of the systemic review, which enhanced the reliability and validity of the study. Figure 1 Selection Criteria World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 977 3.2. Study Characteristics According to the synthesis of studies illustrated in the table below, the studies included in this review evaluated various subjects linked to nurse problems due to Work-related stressors. The main area of study was the recognition of occupational stressors and its association to nurse turnover. The primary goal of the study was to identify the primary ways that work-related stressors may lead to nurse turnover and to examine the relationship between work-related stressors and nurses' intentions to leave their jobs. In several healthcare institutions, the study assessed various aspects of work-related stressors, including depression, anxiety, and burnout. One of the most important points mentioned in the literature was how organizational support might help healthcare settings deal with work-related pressures. The investigations, which were carried out in a variety of contexts, gave a thorough picture of the current landscape regarding the relationship between nurses' intention to leave and stressors associated to their jobs. The results illustrated a multiplex nature of work-related stress and nurse turnover intention. They overemphasized the need for targeted interventions to foster wellness and resilience among nurse practitioners. Table 4 Selected Articles References Objective Research Methods Results Themes AL-Yaqoubi and Arulappan (2024) The study aimed to establish the sources of work-related stress among Omani nurses. Descriptive crosssectional design A nursing stressing scale was utilized and established that workload resulted in the highest level of work-related stress. It was followed by emotional concerns associated with death and dying. Lack of support and adequate preparation to meet the emotional needs of patients and their families. Key sources of work-related stress among nurses. Elshaday Bekele Werke and Zewdu Shewangizaw Weret (2023) The study aimed to determine occupational stress and associated factors among nurses working at public hospitals in Addis Ababa, Ethiopia, in 2022. Crosssectional study design Key sources of work-related stress include working long shifts. Key sources of work-related stress among nurses. Liu et al. (2023) The study aimed to evaluate nurses' turnover intention in China and assess the associated factors. Crosssectional study design The study illustrated that most nurses had a high prevalence of turnover intention at 69.4%. The study illustrates that being a junior nurse and below, a clinical nurse, level of pay, elevated job satisfaction having a high sense of belonging, and conflicts with colleagues impacted turnover intention among nurses. Effect of workrelated Stress on Nurses' turnover intentions Shah et al. (2022) The study's objective was to recognize the association between job stress state anger, emotional distress, and job turnover intention. Crosssectional study design The study illustrated that workrelated stress resulted in decreased work resilience resulting in turnover intention. Impact of work-related stress on turnover intention. Tsegaw et al. (2022) The study was aimed at enumerating the determinants of workrelated stress among Crosssectional study design According to the study, the type of institution was a determinant of work-related stress. As a result, compared to nurses who worked in Key sources of work-related stress among nurses. World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 978 nurses working in private and public. private hospitals, those who worked in public hospitals had higher stress levels. The study concluded that mitigating workload, providing psychological counseling for nurses, and availing stress management training for less experienced nurses was found to reduce Work-related stress. Strategies to reduce workrelated stress and mitigate turnover intention among nurses. Wang et al. (2022) The study’s objective was to evaluate the association between coping strategies, stressors, and intention to leave the nursing profession among nurses. Crosssectional study design According to the study, occupational injuries, high job demands, nursepatient tension, strict leaders, and poor colleague relationships had a higher significant intention to leave. Key sources of work-related stress among nurses. Zhou et al. (2021) The study aimed to evaluate the possible job stress factors that could impact newly recruited nurses’ behavior to either continue with jobs or discontinue their jobs within an organization. Crosssectional study design The study illustrated that various work-related stressor comprising of stress from fellow nurses, Lack of professional skills, stress from looking after patients, and stress from workloads and roles played a key role in impacting nurse turnover intention. Key sources of work-related stress among nurses. 3.3. Synthesis of Results Following a study of the analysis's articles, the researcher went into further detail about the three main themes. Key sources of work-related stress among nurses, the impact of work-related stress on nurses' intentions to leave their jobs, and methods to reduce work-related stress and turnover intentions among nurses were among the subjects. 3.3.1. Key Sources of Work-related Stress among Nurses According to Liu et al. (2023), nurses' intentions to leave their jobs were influenced by their status as junior nurses or less, clinical nurses, income, degree of job satisfaction, sense of belonging, and disputes with their coworkers. According to Shah et al. (2022), stress at work reduces resilience, leading to a desire to leave. According to Tsegaw et al. (2022), the kind of institution was one factor influencing work-related stress. Wang et al. (2022) found that a significant intention to leave was associated with occupational injuries, high job expectations, nurse-patient conflict, strict leaders, and poor colleague relationships. Last but not least, Zhou et al. (2021) showed that several work-related stressors, such as stress from coworkers, a lack of professional skills, stress from patient care, and stress from workloads and duties, significantly influenced nurses' intentions to leave their jobs. 3.3.2. The Effect of Work-related Stress on Nurses' Turnover Intentions. According to Liu et al. (2023), nurses' intentions to leave their jobs were influenced by their status as junior nurses or less, clinical nurses, income, degree of job satisfaction, sense of belonging, and disputes with their coworkers. According to Shah et al. (2022), stress at work reduces resilience, leading to a desire to leave. 3.3.3. The Strategies to Reduce Work-related Stress and Mitigate Turnover Intention Among Nurses. Tsegaw et al. (2022) found that reducing workload, offering psychological counselling to nurses, and offering stress management training to less experienced nurses all help to lessen work-related stress. 4. Discussion The analysis highlighted three key subjects in the research about the relationship between stress at work and nurses' plans to leave. The subjects included the primary causes of stress at work, how stress impacts intentions to leave, and World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 979 methods for reducing work-related stress and intentions to leave as a nurse. This section integrates the information and offers an in-depth review of the issues. 4.1. Key Sources of Work-related Stress among Nurses According to AL-Yaqoubi and Arulappan (2023), the most crucial source of work-related stress among burses is workload. Mental and physical exhaustion occurs due to the increased demand, which is illustrated by constrained timetables and an increased number of patients. The stress levels are increased further by the emotional distress that occurs while caring for patients who are critically ill in addition to dealing with death. Moreover, due to decreased support networks and Lack of preparedness to attend to patients’ emotional needs, by insufficient support networks. As recognized by Werke and Weret (2023), long shifts were viewed as a significant work-related stressor. Long shifts result in fatigue, minimized job fulfillment, and minimal performance, all contributing to elevated turnover intentions. It was established that job burnout is a key factor between turnover intention and moral resilience, enumerating that emotional exhaustion and chronic stress critically affect nurses’ decision to resign. Organizational factors play a critical role in contributing to work-related stress. Tsegaw et al. (2022) highlighted that healthcare facilities impact stress levels with nurses in certain settings experiencing increased stress levels due to limited resources and workload demands. Likewise, Wang et al. (2022) elaborated that increased turnover intentions were due to high working expectations, occupational injuries, strained nurse-patient relationships, and poor associations with coworkers. The findings of Zhou et al. (2021), patient care obligations, professional competence shortcomings, role-related pressures, and stress from other nurses all impact turnover intentions. The findings illustrate the multiplex association between organizational and personal characteristics and work-related stress in nurses. 4.2. The Effect of Work-related Stress on Nurses' Turnover Intentions Various studies prove the harmful effect of work-related stress on nurses’ intentions. According to Liu et al. (2023), it was established that junior nurses, clinical nurses, and those with low pay levels were more vulnerable to turnover intentions. Job fulfillment and a sense of belonging were conversely linked to turnover intentions, illustrating the significance of promoting a supportive and fulfilling work surrounding. Furthermore, conflicts with colleagues further contributed to turnover intentions, illustrating the responsibility of interpersonal associations in directing nurses’ job experiences. Shah et al. (2022) also enumerate the association between work-related stress and minimized work resilience, contributing to turnover intentions. Work resilience, the ability to adapt to and recover from stress, is crucial for maintaining job fulfillment and performance. Nurses’ endurance diminishes and turnover is more probable when they endure elevated stress without appropriate coping strategies. When taken as an entirety, the articles illustrated how stress at Work hinders resilience, job fulfillment, and a sense of belonging, which influences a nurse’s turnover intentions. 4.3. The Strategies to Reduce Work-related Stress and Mitigate Turnover Intention Among Nurses Work-related stress must be resolved to mitigate turnover intentions and retain a skilled workforce. According to Tsegaw et al. (2022), it was established that there are various effective strategies comprising of availing psychological counseling, reducing workload, and providing stress management education, specifically for nurses who have little to no experience. The workload can be minimized by maximizing staff levels, redistribution of Work, and oversimplifying workflows to mitigate the emotional and physical burden on nurses. Executing a flexible schedule and guaranteeing periods to rest can help reduce the impacts of long shifts. Psychological counseling provides a safe space for nurses to process emotional challenges linked with patient death, care, and dying. Professional support assists nurses in developing coping mechanisms, guarantees emotional resilience, and protects against burnout. Furthermore, stress management education nurses with practical methods to manage stress to maintain their wellness. Customizing these interventions to the particular needs of nurses with less experience is critical as they are more susceptible to stress due to limited coping strategies and clinical experience. Establishing a supportive surrounding is crucial for mitigating work-related stress and turnover intentions. Promoting open communication, fostering teamwork, and promoting a positive association among colleagues can promote fulfillment within the workspace and establish a sense of belonging. Proper leadership skills are crucial in reducing work-related stress by meeting well-defined expectations, identifying nurses’ contributions, and providing constructive World Journal of Advanced Research and Reviews, 2025, 27(02), 972-981 980 feedback. Enhancing leadership skills among nurse managers can assist in creating empathy, a culture of respect, and collaboration, mitigating the stress linked to strict or unsupportive leadership. Additionally, solving organizational issues such as career development, pay, and professional growth can help minimize nurses’ turnover intention and assist in the retention of highly skilled employees. Competitive pay, skills growth opportunities, and professional growth development elevate job fulfillment and motivation. Continuous education and training can assist nurses in developing the professional skills required to manage their roles sufficiently, mitigating stress, competence, and performance. 5. Conclusion The study established from the identified articles the significant effect of work-related stress on nurses’ turnover intentions. Key sources of work-related stressors include lengthened shifts, increased workload, emotional strain, and organizational problems contributing to emotional distress and decreased job fulfillment. In addition to having a detrimental impact on nurses’ performances and wellness, these stressors raise the likelihood that they will leave their jobs. Solving the leading causes of stress is crucial for mitigating turnover intentions and retaining skilled healthcare practitioners. Executing interventions comprising workload management, psychological counseling, and management of stress can assist nurses in establishing resilience and developing coping mechanisms with challenges within the workspace. Likewise, enhancing job fulfillment and decreasing turnover intentions requires establishing a supportive work surrounding, promoting healthy interpersonal interactions, and providing career growth opportunities. Recommendations From the study, it was recommended that: • Healthcare facilities should provide flexible schedules, guarantee appropriate nurse-to-patient ratios, and redistribute Work to mitigate emotional and physical distress. • Healthcare facilities need to support their staff, particularly nurses, by training them on stress management techniques and coping strategies to assist them in navigating challenges more efficiently within the working environment. • Healthcare settings can provide an environment that fosters teamwork and collaboration by promoting open communication, mutual support, and teamwork among staff, which enhances job fulfillment, mitigates stress, and promotes a sense of belonging. • Within the healthcare settings healthcare practitioners especially nurses should be trained on empathetic leadership, well-defined communication channels, and feedback to promote a positive and supportive working space. Compliance with ethical standards Disclosure of conflict of interest No conflict of interest to be disclosed. References [1] Alshammari, W. M., & Ali, D. A. (2024). The role of inclusive leadership style in fostering employee performance: a mediating role of workplace dignity. International Journal of Religion, 5(3), 386-398. [2] AL-Yaqoubi, S., & Arulappan, J. (2023). Sources of Work-Related Stress Among Omani Nurses: A Cross-Sectional Study. Journal of Patient Experience, 10(237437352311), 237437352311665. https://doi.org/10.1177/23743735231166504 [3] Babapour, A. R., Gahassab-Mozaffari, N., & Fathnezhad-Kazemi, A. (2022). Nurses’ job stress and its impact on quality of life and caring behaviors: a cross-sectional study. BMC nursing, 21(1), 75. [4] Chegini, Z., Asghari Jafarabadi, M., & Kakemam, E. (2019). Occupational stress, quality of working life and turnover intention amongst nurses. Nursing in Critical Care, 24(5). https://doi.org/10.1111/nicc.12419