"I feel broken": Chronicling burnout, mental health, and the limits of individual resilience in nursing.

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future.

Mapping the peer-reviewed literature on accommodating nurses' return to work after leaves of absence for mental health issues: a scoping review.

BACKGROUND: The complexity of nursing practice increases the risk of nurses suffering from mental health issues, such as substance use disorders, anxiety, burnout, depression, and posttraumatic stress disorder (PTSD). These mental health issues can potentially lead to nurses taking leaves of absence and may require accommodations for their return to work. The purpose of this review was to map key themes in the peer-reviewed literature about accommodations for nurses' return to work following leaves of absence for mental health issues. METHODS: A six-step methodological framework for scoping reviews was used to summarize the amount, types, sources, and distribution of the literature. The academic literature was searched through nine electronic databases. Electronic charts were used to extract code and collate the data. Findings were derived inductively and summarized thematically and numerically. RESULTS: Academic literature is scarce regarding interventions for nurses' return to work following leaves of absence for mental health issues, and most focused on substance use concerns. Search of the peer-reviewed literature yielded only six records. The records were primarily quantitative studies (n = 4, 68%), published between 1997 and 2018, and originated in the United States (n = 6, 100%). The qualitative thematic findings addressed three major themes: alternative to discipline programs (ADPs), peer support, and return to work policies, procedures, and practices. CONCLUSIONS: While the literature supports alternative to discipline programs as a primary accommodation supporting return to work of nurses, more on the effectiveness of such programs is required. Empirical evidence is necessary to develop, maintain, and refine much needed return to work accommodations for nurses after leaves of absence for mental health issues.

Caribbean nurse migration-a scoping review.

BACKGROUND: The migration of Caribbean nurses, particularly to developed countries such as Canada, the United States, and the United Kingdom, remains a matter of concern for most countries of the region. With nursing vacancy rates averaging 40%, individual countries and the region collectively are challenged to address this issue through the development and implementation of sustainable, feasible strategies. The aim of this scoping review is to examine the amount, type, sources, distribution, and focus of the conceptual and empirical literature on the migration of Caribbean nurses, and to identify gaps in the literature. METHODS: Identified records were selected and reviewed using Arksey and O'Malley's scoping framework. A comprehensive search was conducted of eight electronic databases and the Google search engine. Findings were summarized numerically and thematically, with themes emerging through an iterative, inductive process. RESULTS: Much of the literature included in our study (N = 6, 33%) originated in the United States. Publications steadily increased between 2003 and 2016, and half of them (N = 9) were journal articles. Many (N = 6, 33%) of the records used quantitative methods. The themes identified were as follows: (1) migration patterns and trends; (2) post-migration experiences; (3) past and present, policies, programs, and practices; and (4) consequences of migration to donor countries. More than half (N = 11, 56%) of the literature addressed nurse migration policies, programs, or practices, either solely or in part. Several gaps were identified including the need for evaluation of the effectiveness of current nurse migration management strategies and to study policies, trends, and impacts in understudied Caribbean countries. CONCLUSION: This review demonstrates the need for future research in key areas such as the impact of nurse migration on health systems and population health. The literature tends to focus on Caribbean countries with higher levels of nurse migration. However, data regarding this phenomenon in other Caribbean countries is needed for a more comprehensive understanding of the plight of the Caribbean region and would answer the call from the International Organization for Migration to study policies, trends, and impacts in understudied Caribbean countries.

Student-faculty relationships and its impact on academic outcomes.

OBJECTIVE: The aim of this review of the literature is to synthesis the knowledge attained about determinants of student-faculty relationships and its impact on student outcomes. While adding to the body knowledge, the researchers discuss the importance, barriers, and facilitators to student-faculty academic relationships in nursing education. DESIGN: We conducted a narrative literature review using a modified version of the framework of the Population, Intervention, Comparison, and Outcome method to develop the research question for this review. That question was: What determinants of undergraduate nursing students' relationships with faculty affect those students' academic outcomes? DATA SOURCES: To search and review the literature systematically, we entered the specific criteria into the EBSCOhost interface. The following databases were used for data sourcing: Cumulative Index to Nursing and Allied Health Literature Plus with Full Text; Teacher Reference Center; Education Resources Information Center; Medline; and Theses and Dissertations. We selected only full-text, peer-reviewed sources that were written in English for final inclusion. REVIEW METHODS: After the retrieval of 56 reports via an EBSCO host search, abstracts were reviewed and 29 were rejected based on the exclusion/inclusion criteria. The rejected reports met some or no criteria and not others; or showed little to no association with determinants of nursing student-faculty academic relationships or students' academic outcomes. An inductive method of analysis was used to review and extract emerging themes. RESULTS: Findings revealed four core determinants of student-faculty relationships: support, caring, diversity, and incivility. These determinants were interrelated and appeared to have an impact on student academic outcomes. CONCLUSIONS: Nursing institutions should be proactive to ensure that barriers such as incivility are reduced and that diversity is included and appreciated in the teaching and learning environment. Additionally, a caring and supportive climate of learning should be emphasized and enacted by nurse educators.