Date of Award

January 2023

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Tracy Evanson


Background & Purpose: This study’s purpose was to understand what the phenomenon of hope meant to rural critical access hospital RNs in three Midwest states, and what gave them hope during the COVID-19 pandemic. The full scope of the pandemic on the rural nursing workforce is unknown. Prior research has shown that hope can be a positive tool for sustaining psychological well-being, setting and achieving goals, and can facilitate coping (Collins, Bhathal, Field, Larlee, Paje, & Young, 2018; Hacimusalar, Kahve, & Aydin, 2020; Persell, 2016; Snyder, 1995). Methods: Ten participants were interviewed using a semi-structured, interpretive hermeneutic phenomenological approach. van Manen’s hermeneutic analysis method was used to construct components and themes. Results: The meanings of hope and hopelessness were co-created with participants. The phenomenon of hopelessness prominently emerged, and an unexpected finding of the study was that some components/themes sparked agency for the nurses, which helped to foster hope, while some components/themes stifled agency, which contributed to hopelessness. Conclusion: Nurses 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.