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  1. Foglia, Dorothy C. PhD, RN, NEA-BC
  2. Grassley, Jane S. PhD, RN, IBCLC
  3. Zeigler, Vicki L. PhD, RN


The purpose of this qualitative study was to discover why 10 nurses voluntarily left the pediatric intensive care unit (PICU) at 1 large pediatric hospital in the southwest. Critical theory provided the philosophical framework, whereas action research and Heideggerian hermeneutic phenomenology provided the methodological framework. Data analysis was conducted using the circular hermeneutic process described by Heidegger and explicated by Diekelmann. From the findings of this study, it was concluded that there is an inescapable and inevitable tension between the human factors and the PICU work environment. Nurses identified the constitutive pattern of unrelieved job stress as the major reason they left the PICU. The multidimensional and interactive environmental characteristics of nature of the job, insufficient resources, and negative perceptions of managers/team leaders contributed to the development of job stress. The results of this study revealed the evidence needed to begin to focus on interventions in the areas of nursing practice, education, and research required, reducing the likelihood of losing more PICU nurses.