Toward a Better Understanding of Emotional Exhaustion Among First-Line Nurse Managers: The Role of Psychological Stress, Presenteeism, and Leader Loyalty.

Aims: Based on the Conservation of Resources and Leader-Member Exchange theories, this study investigates the relationship between psychological stress and emotional exhaustion among first-line nurse managers (FLNMs), while also examining the mediating role of presenteeism (i.e., working while ill) and the moderating effect of leader loyalty on this relationship. Method: A survey-based study was carried out on 161 French FLNMs. A mediated moderation model was tested through bootstrap regression analyses using PROCESS Macro. Results: The analyses yielded three primary findings. First, psychological stress among FLNMs is positively related to their level of emotional exhaustion. Second, presenteeism is found to be an explanatory mechanism of the psychological stress-emotional exhaustion relationship. Third, leader loyalty was found to moderate the indirect link between psychological stress (i.e., through presenteeism) and emotional exhaustion. Conclusion: The results provide a better understanding of the relationship between psychological stress and emotional exhaustion in the case of French FLNMs. They also clarify the role of other mechanisms, such as presenteeism and leader loyalty, that may be involved. Practical Implications: Considering the pivotal role of FLNMs within hospitals, findings from this study raise awareness of the detrimental consequences of psychological stress and presenteeism on FLNMs' health, while also showing the constructive aspects of the relationships between FLNMs and their superiors.