The Fortitude Framework: A psychological model for sustained leadership presence in nursing

Background

Despite growing recognition of the emotional strain and ethical complexity in nursing leadership, most leadership models continue to emphasize postcrisis recovery, role-based performance, or external outputs. This narrow framing leaves a gap in understanding how leaders can sustain their presence and judgment before, during, and after prolonged challenges.

Purpose

This conceptual article introduces the Fortitude Framework, a leadership model grounded in psychological appraisal theory and adapted from Pretorius’ theory of fortitude.

Methods

A concept analysis anchored in Pretorius’ theory of fortitude, combined with a theoretical synthesis of related constructs (resilience, grit, hardiness, and self-efficacy), was conducted to clarify fortitude’s conceptual boundaries. This process generated three interdependent internal capacities—Unapologetically Grounded (intrapersonal appraisal), Strategically Aligned (transpersonal appraisal), and Ethically Present (interpersonal appraisal)—that support sustained leadership presence under pressure.

Discussion

The Fortitude Framework translates these capacities into observable leadership patterns that can be actively developed through reflective practice, coaching, and context-sensitive leadership development. Public health nurses are offered as exemplars of this model in practice.

Conclusion

The Fortitude Framework is situated within existing literature on resilience, self-efficacy, and moral presence, distinguishing fortitude as a foundational capacity rather than a reactive trait. It offers a new lens for leadership development and mentoring while guiding system-level strategies to support psychological sustainability in nursing leadership.