Exploring the Phenomenon of Hope for Rural Midwest Frontline RNs in Critical Access Hospitals During COVID-19
Keywords:
hope, rural, nursing, COVID-19, burnout, hopelessnessAbstract
Purpose: The purpose of this qualitative research study was to understand the phenomenon of hope among registered nurses (RNs) working at critical access hospitals (CAH) in South Dakota (SD), North Dakota (ND), and Minnesota (MN), and what facilitated hope during the COVID-19 pandemic. Past research has shown that hope can be a valuable mechanism for sustaining psychological well-being, developing personal goals, achieving goals, and promoting coping However, little research has explored what might facilitate hope for RNs during times of healthcare crises.
Sample: Ten participants met the inclusion criteria, which included RN licensure in MN, SD, or ND, English-speaking, 20+ hours per week direct patient care during COVID-19, and ability to use Zoom. It was a homogenous sample of 10 Caucasian, female RNs, between the ages of 22 and 67, whose years of nursing experience ranged from 1 to 47 years. Four participants were from SD, two were from ND, and four were from MN.
Method: The study used an interpretive, hermeneutic phenomenological method. Semi-structured interviews were completed virtually, lasted between 20 and 60 minutes, and were recorded. van Manen’s hermeneutic analysis method was used to construct components and themes.
Findings: The phenomenon of hope for these RNs can only be understood within the context of hopelessness, which emerged prominently in the study. An unexpected finding of the study was that some components/themes sparked agency, which helped foster hope, while others stifled agency, contributing to hopelessness.
Conclusions: CAH RNs experienced hopelessness and hope on the frontlines. The role of agency in relation to hope necessitates further inquiry. It is anticipated that the knowledge gained from this study will explain how hope may be fostered (and hopelessness navigated) to support and retain rural frontline nurses in future healthcare crises.
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Copyright (c) 2026 Stephanie Orth, PhD, RN, Tracy Evanson, Ph.D., R.N., P.H.N.A.-B.C., Rhoda Owens, Ph.D., R.N., Shawnda Schroeder, PhD, MA, Darlene Hanson, PhD
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