"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.

Sustainability: an evolutionary concept analysis. Exploring nursing's role within the sustainability movement.

AIM: This paper aimed to explore the evolution of the concept of sustainability to facilitate further knowledge development in the discipline of nursing. BACKGROUND: The concept of 'sustainability' emerged in the 1950s as a result of the environmental movement. The concept has been adapted by the discipline of management and is increasingly discussed in the context of health care. The concept remains ambiguous in the discipline of nursing, resulting in a struggle to articulate the role of nursing in the sustainability movement. DESIGN: Rodgers evolutionary method of concept analysis was used. DATA SOURCES: Literature was searched from 1987-2011, including English, peer reviewed texts in the databases CINAHL and ABI/INFORM global. Two book chapters and grey literature were also included. REVIEW METHODS: References were read and analysed according to antecedents, attributes, consequences, surrogate terms and related terms. RESULTS: Defining antecedents, attributes and consequences highlight the complexity and diversity of the concept. Attributes include: sustainability as a condition of change, as process, as outcome, as dependent of multiple stakeholders, and as social consciousness. 'Sustainability' is a fragile concept highly dependent on the processes and stakeholders involved in its fruition. There is a distinct difference in the level of concept clarity between the disciplines of management and nursing. CONCLUSIONS: The complexities associated with the concept of 'Sustainability' have led to its ambiguity. Nursing must, however, work to further clarify the concept to fully understand nursing's potential role in the sustainability movement.

Predictors of Nursing Faculty Job and Career Satisfaction, Turnover Intentions, and Professional Outlook: A National Survey.

BACKGROUND: Retaining talented and experienced nurses in clinical practice and academia is crucial for maintaining continuity, ensuring high-quality care and education, and fostering a positive work environment. Although factors influencing nursing staff retention are well documented, little is known about how workplace factors impact nursing faculty retention outcomes. METHODS: A national survey involving 645 nursing faculty across Canada was undertaken. Multivariate regression analysis with interaction effects was conducted to determine the association between work-related factors (i.e., workplace culture and work-life imbalance) and faculty job and career satisfaction, turnover intentions, and professional outlook. RESULTS: Supportive workplace culture positively influenced faculty job and career satisfaction and professional outlook, while it negatively impacted turnover intentions. Conversely, work-life imbalance decreased faculty job and career satisfaction and professional outlook (i.e., confidence in nursing program, profession), and it increased intentions to leave the job. CONCLUSION: Our results offer insights into the work-life experiences of Canadian faculty members and shed light on key factors that impact their job-related outcomes. In the context of competing resources, every effort must be made to improve modifiable workplace factors such as the academic work environment and create targeted interventions and policies to promote faculty retention.

Working through a pandemic: The mediating effect of nurses' health on the relationship between working conditions and turnover intent.

AIM: While research has demonstrated that nurses' health and working conditions are important predictors of turnover in COVID-19, the relationship between these factors is not well understood. Our study investigated the mechanism through which working conditions and nurses' physical and mental health could impact intent to leave the nursing profession. DESIGN: Secondary data from a cross-sectional survey of 3478 nurses in British Columbia administered in May 2021 were analysed using structural equation modelling. METHODS: Two models were assessed utilizing workplace conditions as the predictor, nurses' health as the mediator, and reported turnover intent (Model 1), and anticipated time to turnover (Model 2) as the outcomes. RESULTS: Nurses' health partially mediated the relationship between working conditions and turnover intent, where poorer workplace conditions were directly and indirectly associated with greater likelihood of leaving the profession. Nurses' health fully mediated the relationship between working conditions and nurses' anticipated time to turnover, after controlling for age. The findings from this study underscore the importance of enhancing working conditions and improving nurses' mental health and safety on the job. PATIENT OR PUBLIC CONTRIBUTION: The British Columbia Nurses' Union provided the data for this study; survey data from 3478 nurses were utilized in our study.

Critical care nursing north of the 6oth Parallel: A qualitative pilot study.

BACKGROUND: There is growing knowledge specif c to remote, rural and northern nursing practice in Canada's north. However, there is limited research that specifically addresses the experiences of critical care nurses working in Canada's northern communities. PURPOSE: The purpose of this pilot study was to begin to explore and better understand the experiences of Canadian nurses providing critical care to patients and families in intensive care units north of the 60th parallel. STUDY DESIGN: An interpretive phenomenological analysis was used. METHOD: Telephone interviews were conducted with three registered nurses currently employed in the designated intensive care unit on a full-time, part-time or casual basis. Interviews were thematically coded and analyzed. Member checks were used to ensure thick description for this pilot study was obtained. FINDINGS: The following themes evolved through the interpretive phenomenological analysis process, Going North, The Role of the Northern ICU Nurse, Challenges, Support, Positive Aspects of the Experience, and The Northern Experience. CONCLUSIONS: Threaded throughout the main themes, participants made reference to "making it work". Making it work was reflected in how the participants described managing limited resources (particularly human resources), working within an expanded scope and managing the expectation that "the ICU nurse can do it."

UVA-photoactivated riboflavin effect on isolated vaginal tissues derived from pelvic organ prolapse cases.

PURPOSE: To determine the optimal riboflavin exposure time before UVA irradiation and to study the effects of exogenous collagen on the mechano-tensile stiffness of isolated vaginal tissue strips after riboflavin UVA photoactivation. METHODS: Vaginal tissue strips from pelvic organ prolapse (POP) cases were soaked in 0.1% riboflavin (0, 10, 20, 30 min), exposed to UVA photoactivation, and tensile stiffness was measured with a tensiometer. Collagen solution was injected (0.2 mL) into each strip, exposed to riboflavin with or without UVA photoactivation, and tensile stiffness was measured (n=6). RESULTS: Vaginal tissues treated with riboflavin for 10, 20 or 30 min followed by UVA irradiation displayed 21.2, 32.4 and 33.9% stronger tensile stiffness, respectively. Exogenous collagen administered before riboflavin UVA photoactivation resulted in 20% improvement in tensile stiffness. The tensile stiffness of vaginal tissues injected with collagen without the riboflavin UVA treatment was similar to control tissues. CONCLUSION: The results demonstrated increased tensile stiffness in isolated POP-derived vaginal tissues after riboflavin UVA photoactivation suggesting improved mechanical properties from collagen cross-linking. Administering exogenous collagen before riboflavin UVA treatment also improved tensile stiffness. More studies are needed to corroborate the present minimally invasive approach for strengthening vaginal tissues.