Nurses' Experiences of Rebel Nurse Leadership in Psychiatric Care: A Qualitative Interview Study of Positive Deviance.

Authors

Sebastian Gabrielsson, Git-Marie Ejneborn Looi, Annika Ahlblom, Ylva Kortekaas Genstrand, Anneli Björkdahl, Jessica Östling, Susanne Berg, Nina Lakso, Mattias Larsson, Johanna Salberg

Published in

Journal of nursing management. Volume 2026. Issue 1. Pages e2777470.

Abstract

Nurses play a key role in person-centered psychiatric care by supporting patient recovery, fostering independence, and building trusting relationships. However, organizational rules may conflict with nurses' ethical values, leading to moral distress, burnout, and resignation. Drawing on the theory of positive deviance, previous research has identified how nurses may engage in positive rebel leadership, leading and practicing nursing in ways that diverge from prevailing norms, rules, codes of conduct, and workplace strategies. This study explores how such leadership in psychiatric care can support professional standards and improve patient outcomes. The aim was to describe nurses' experiences of rebel nurse leadership in psychiatric care. A qualitative descriptive design was employed, using semistructured individual interviews with 33 nurses experienced in psychiatric care. A qualitative content analysis and meta-synthesis were conducted, with the support of generative artificial intelligence in the synthesis process. The results describe nurses' experiences of rebel nurse leadership in psychiatric care as taking responsibility, guided by professional competence and an internal ethical compass; leading change and challenging hierarchies to enable holistic care that respects patients' rights and dignity; relying on the support of colleagues and management, while facing the risk of exclusion. The study shows how rebel nurse leadership, grounded in professional competence and ethical conviction, might support person-centered and high-quality psychiatric care. The findings illustrate how such leadership emerges in response to organizational norms that constrain nursing practice and frame acts of resistance as expressions of professional responsibility. The study emphasizes the importance of supporting nurses' autonomy to enable improvements in care quality and patient outcomes.

PMID:
42365461
Bibliographic data and abstract were imported from PubMed on 28 Jun 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.