Nurses' and nurse leaders' perspectives on a health-promoting work environment: a meta-ethnographic study.

Purpose: The purpose of this meta-ethnography is to integrate and synthesize nurses' and nurse leaders' perspectives on a health-promoting work environment to enhance understanding of its essential aspects.

Methods: A meta-ethnographic approach developed by Noblit and Hare was conducted.

Findings: Line of argument synthesis led to the development of an overarching tree metaphor: "cultivating a flourishing environmental tree rooted in values, held stable by leadership, and nurtured by safe working conditions." This metaphor illustrates that a health-promoting work environment is imbued with three interdependent aspects: 1) core values as the roots of the tree, including respect, recognition, community, and engagement 2) value-conscious leadership as the trunk of the tree, meaning a leader who is conscious of their power position and responsibilities and 3) safe working conditions as fertile soil for the tree, comprising the physical and administrative dimensions of the work environment.

Conclusions: Collaboration between nurses and leaders is crucial for cultivating a health-promoting work environment. However, nurse leaders, due to their influential positions, have the responsibility to facilitate this environment. Consequently, leaders need to receive adequate resources and support from their superiors to foster an environment that enhances nurses' health and job satisfaction.