Background: Nurses, irrespective of position, encounter stressors in the work environment from the existing challenges in the healthcare system. The impact of the work environment, specifically the psychological work demands and the practice environment, on the distress symptoms in nurses and health outcomes has not been adequately explored. Distress can be detrimental, resulting in nurses leaving the profession and exacerbating staffing shortages. There is insufficient evidence to support the organization’s efforts to mitigate distress and if health promotion behaviors can be valuable in coping with distress and promoting nurses’ wellness. Thus, it is critical to examine factors in the work environment in relation to distress symptoms in nurses and explore behaviors that promote nurses’ health. Purpose: The purpose of this study was to examine the relationship between the work environment (workload and practice environment), health promotion behaviors, and nurses’ psychological distress symptoms, sleep disturbance, and health. The conceptual framework of distress, guided by the ‘Theory of Moral Reckoning’ and the ‘Health Promotion Model,’ was used to explore the mediating effect of health promotion, a behavior-specific component to mitigate distress and promote wellness. Methods: This was a secondary data analysis of a cross-sectional survey collected between November 2020 and March 2021 as part of the Nurse Worklife and Wellness Study (NWWS) from 1170 registered nurses across the US. A regression analysis was performed to determine the relationship between psychological distress and intention to leave. A confirmatory factor analysis tested the factorial structure of the nine latent constructs using the weighted least squares estimation with missing data (WLSMV). A structural equation modeling (SEM) approach was used to test the direct and indirect associations between the variables – workload, practice environment, health promotion behaviors, psychological distress symptoms, sleep disturbance, and health. Results: Overall, psychological distress was negatively associated with nurses’ years of experience. Psychological distress was significantly associated with increased intention to leave (B=0.04, 95% CI: 0.02, 0.06). Nurses with less than two years’ and >25 years’ experience had increased intention to leave. However, nurses with <2 years of experience had significantly higher psychological distress (p<.01), and those with >25 years of experience had significantly lower psychological distress (p<.01) compared to nurses with 16-25 years’ experience. Based on the confirmatory factor analysis in the SEM, the measurement model reported adequate model fit (CFI=0.96; TLI=0.95; SRMR=0.048 and RMSEA =0.039). According to the structural model, the workload was related to significantly increased psychological distress (β = 1.47, p<0.001), increased sleep disturbance (β = 1.22, p<0.01), and decreased overall health (β = -1.36, p<0.01). Similarly, a positive practice environment was associated with significantly higher psychological distress (β = 1.61, p<0.001), sleep disturbance (β = 1.31, p<0.01), and lower overall health (β = -1.51, p<0.01). A statistically significant indirect relationship was found between workload and psychological distress, mediated by health promotion behaviors. Psychological health promotion activities were related to decreased psychological distress (β = -1.01, p <0.001) and sleep disturbance (β = -0.94, p <0.001) while increasing overall health (β = 0.67, p <0.001). Conclusion: Psychological and physical health promotion had potential restorative effects by mitigating the impact of distress. This study emphasizes the need for organizations to prioritize the work environment by addressing workload and practice conditions to mitigate nurses’ psychological distress symptoms and stabilize the nursing workforce. It also supports the need for healthcare organizations to develop policies and strategies to promote nurse wellbeing and incentivize nurses' participation in health promotion behaviors.