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Background: Persistently high turnover rates reflect nurses' discontent. Although personal reasons, career advancement, and relocation are cited as the top reasons for departures, macro-level data overlook the organizational and unit-level factors that erode nurses' desire to stay., Methods: Survey methods were used for data collection. The analysis included statistical and qualitative methods., Results: Salary, benefits, and work schedules were important in influencing nurses' decisions to stay, but their importance varied by career stage. Ergonomic aspects of nurses' daily work were key themes., Conclusions: Organizational and unit elements play enduring roles in job satisfaction. Critically examining nurses' work environment from meso- and micro-level ergonomic perspectives can enhance understanding of nurse retention and provide evidence to fine-tune retention strategies., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aimed to explore the prospective associations of organizational changes with health outcomes among employees who remained in employment., Methods: The study relied on the prospective data of the national French working conditions survey collected from employees and their employers in 2013, 2016, and 2019. The study sample included 4480 private sector employees. Organizational changes were assessed by the employers. The two health outcomes, collected from the employees, were psychological well-being and self-reported health. The prospective associations between organizational changes and health outcomes were studied using multilevel mixed-effects linear and robust Poisson regression models., Results: No association was found between organizational changes and well-being and self-reported health., Conclusions: Our study did not find significant prospective associations between organizational changes and two health outcomes among employees who remained in employment. More high-quality research is needed., Competing Interests: Niedhammer and Bertrais have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objective: To investigate perceived task privacy in 2022 associated with short (1-3 days) self-certified sickness absence (SA) in 2023., Methods: A prospective cohort of 1400 Finnish office workers with survey data in 2022 about, for example, task privacy, telework, and office type were linked with employer-owned register data of SA in 2022-2023. Poisson regression models were used to obtain risk ratios with 95% confidence intervals., Results: Each one-unit increase in task privacy was associated with a less likely short SA (risk ratio, 0.83-0.89; 95% confidence interval, 0.74-0.97), also across the amount of telework in 2022. The association was only statistically significant in activity-based offices., Conclusions: Each one-unit increase in perceived task privacy at the office was associated with less likely short, self-certified, 1-3 days SA. Task privacy is an important factor to be considered in offices., Competing Interests: Conflicts of interest: None declared., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Background: Currently in the United States, the demand for RNs is stronger than is being supplied. This site-specific pediatric RN turnover rate was estimated at 15% per year, which is above the national average., Methods: A descriptive correlational study was conducted using the Revised Casey-Fink Nurse Retention Survey tool., Results: The top 2 areas that impacted nursing retention at this study site were workplace morale, and pay and benefits. These data are inconsistent with multiple other studies where decreased job satisfaction and burnout were top factors in nursing retention., Conclusions: Although national data reveal reasons for leaving an institution or the profession, it is important to survey the local workforce to identify areas for focus in retention efforts., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: As part of the "Japan Environment and Children's Study (JECS)," a national prospective birth cohort study, we examined the association between the maternal work environment and psychological distress during pregnancy in Japan., Methods: Employing a cross-sectional design, we analyzed data from 42,797 participants, originally collected between 2011 and 2014. Associations between the maternal work environment and psychological distress (Kessler 6) were examined using generalized estimation equation models adjusted for confounding factors., Results: Pregnant women who worked ≥51 hours/week had a 1.19-fold higher odds ratio (OR) of psychological distress than those who worked 36 to 40 hours/week (95% confidence intervals [CIs], 1.07-1.32). Pregnant women who worked ≥5 days/month of shift work had a 1.11-fold higher OR of psychological distress than those who worked 0 days/month (1.00-1.24)., Conclusions: We observed an association between the maternal work environment and psychological distress during pregnancy., Competing Interests: Kishi, Kobayashi, Saijo, Itoh, Tamura, Tojo, Iwata, Yamaguchi, and Ito, The Japan Environment and Children's Study (JECS) Group have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objectives: Chronic skin diseases (CSD) may lead to productivity losses. This mixed-methods study investigated symptom severity, social challenges, need for workplace accommodation, sick leave, and their association with perceived impaired work performance (IWP) among workers with CSD., Methods: Data were collected from April to June 2023. Participants (n = 102) completed an online questionnaire sent from the Institute for Occupational Safety and Hygiene and almost 20% were interviewed. The analyses included logistic regression and structural equation models and a thematic analysis., Results: Of participants, 72.3% reported perceived IWP. The need for workplace accommodation and sick leave duration were directly associated with IWP. These findings were integrated with common themes based on a socioecological approach., Conclusions: By working together to address personal, interpersonal, organizational, and societal aspects associated with CSD, occupational physicians and stakeholders can alleviate perceived IWP., Competing Interests: Conflict of interest for all authors: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

The objective of this study is to examine the phenomenon of workplace bullying and its potential associations with burnout and depression among clinical nurses in China. A convenience sampling method was utilized to conduct a survey among 415 clinical nurses across 9 hospitals. All questionnaires were completed within a 2-week period in October 2023. The survey questionnaire comprised 3 sections, namely basic information, negative acts questionnaire (NAQ), and self-rating depression scale (SDS). Based on their depression status, the participants were categorized into 2 groups, namely depression group and control group. A comparative analysis of the basic data and NAQ was performed between 2 groups, and factors exhibiting statistically significant differences in the single factor analysis were subjected to binary logistic regression analysis. Additionally, Pearson correlation analysis was utilized to examine the correlations among the variables. Ninety-four individuals were included in depression group, accounting for 22.65% of the total sample, with a mean SDS of 44.7 ± 5.5. The control group consisted of 321 participants, representing 77.35% of the total, with a mean SDS of 24.8 ± 9.0. No statistically significant differences were observed between 2 groups regarding gender, monthly income, education level, night duty, body mass index, working hospital, department, employment status, only child status, local residency, and number of children. The age, length of services, professional title, marital status, and NAQ of depression group and control group were compared, and the difference was found to be statistically significant (P < .05). The findings from the binary logistic regression analysis indicated that both length of service and NAQ emerged as significant independent predictors of nurses' depression. Furthermore, the results of the Pearson correlation analysis demonstrated a positive association between the depression levels of clinical nurses and NAQ. The duration of employment and NAQ of clinical nurses were independent factors influencing depression. A positive correlation was found between depression and NAQ. It is evident that workplace bullying has a detrimental impact on the mental well-being of clinical nurses. To address this issue, hospital administrators are advised to implement regular psychological clinics for clinical nurses and offer targeted educational programs aimed at increasing awareness of workplace bullying and enhancing coping strategies., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.)

Measuring and understanding experiences of workplace prejudice faced by underrepresented nurses comprise a first step toward workplace equality and enhanced morale and retention. With no existing instruments to measure prejudice directed toward nurses, the primary goal of the current study was to report the results and validation of the newly developed Workplace Prejudice toward Nurses (WPtN) scale. Participants (1692 nurses, 65% whom identified as an underrepresented racial or ethnic group) completed an online survey assessing WPtN. Participants reported on the types and frequency of WPtN they experienced, who directed the prejudice toward them, and the impact it caused on their job satisfaction and retention. Results supported the fit of a 1-factor model assessing general workplace prejudice, and 4-factor model comprising WPtN directed from different groups (ie, patients, their family members, coworkers, and administrators). More than one-third (34%) of participants reported experiencing WPtN. Those reporting WPtN indicated this prejudice was directed toward them from patients (45%), family members (41%), coworkers (42%), and administrators (14%). Experiencing WPtN negatively impacted job satisfaction and retention. Together, findings indicate that the WPtN scale is a reliable measure of WPtN of underrepresented backgrounds. The development of this tool is an important step to combating prejudiced behavior and attitudes, which can often be covert and difficult to validate., Competing Interests: We have no known conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Workplace violence (WPV) against nurses is a growing concern within the health care industry, contributing to increased stress, burnout, and higher staff turnover., Purpose: The purpose of this study is to understand the experiences of nurses with WPV and examine the scope and impact of this violence based on nurse's recollections., Methodology/approach: Using qualitative interpretive meta-synthesis and the job demands-resources framework, we examined patterns in nurses' experiences of WPV. Our analysis (N = 401) of nurses' accounts from diverse sources-patients, colleagues, and supervisors across various locations and health care settings-provides deep insights into WPV dynamics., Results: Four main themes were identified: (a) it comes with the job-patient and family violence are normal, (b) a vulnerability in nurse safety, (c) sexual harassment, and (d) poor treatment within the organization., Conclusion: WPV against nurses is a deeply ingrained issue that impacts their psychological health and job performance. A stark need for health care systems to address and mitigate WPV is evident., Practice Implications: There are clear signals that health care organizations need to implement comprehensive strategies to prevent WPV, foster a safe and supportive work environment, and equip nurses with job resources to manage the high stress of their roles., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Proactive behaviors at work refer to behaviors that are self-starting, future focused, and change oriented. Proactive behaviors are generally thought of as positive and desired and can benefit both the employee (e.g., job promotion) and organization (e.g., innovation). These behaviors can, however, backfire (e.g., due to unintended consequences), reflecting the "initiative paradox.", Purpose: The aim of this study was to investigate, through the perspectives of health care executives, how employees can be more effective when engaging in proactive behaviors., Methodology: We used the episodic narrative interview method. Health care executives narrated instances of perceived effective and ineffective proactive behaviors among employees. We then performed an inductive qualitative analysis of these episodes to identify emerging themes and dimensions., Results: The effectiveness of proactive behaviors among health care employees is shaped by three dimensions: managerial expectation (in)congruence (e.g., knowledge of expectations, engagement with chain of command), organizational priority (in)congruence (e.g., degree of alignment between individual and organizational benefits), and boundaries of action and change (e.g., nonadherence to regulatory or financial conditions). Among the dimensions, managerial expectations may be the most challenging for employees to navigate., Conclusion: Engaging in proactive behaviors is not a straightforward process. Navigating multiple dimensions is necessary for health care employees to be effective., Practice Implications: Employees should be equipped with knowledge on relevant expectations, priorities, and boundaries when engaging in proactive behaviors at work. Health care leaders and managers should aim to clarify and periodically reassess these dimensions to facilitate effective proactive behaviors and to generate benefits for employees and the organization., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Practice environments have a significant impact on nurses' practice and their retention within the oncology and hematology specialty. Understanding how specific elements of the practice environment impact nurse outcomes is important for creating supportive and safe practice environments., Objective: To evaluate the impact of the practice environment on oncology and hematology nurses., Methods: A scoping review was conducted according to the PRISMA-ScR Statement Guidelines. Electronic databases (MEDLINE, CINAHL, PsychINFO, Google Scholar, and Scopus) were searched using key terms. Articles were assessed according to the eligibility criteria. Data extraction was conducted with results explained through descriptive analysis., Results: One thousand seventy-eight publications were screened with 32 publications meeting the inclusion criteria. The 6 elements of the practice environment (workload, leadership, collegial relations, participation, foundations, and resources) were found to significantly impact nurses' job satisfaction, psychological well-being, levels of burnout, and intention to leave. Negative practice environment elements were linked to increased levels of job dissatisfaction, higher levels of burnout, greater prevalence of psychological distress, and greater intention to leave both oncology and hematology nursing and the nursing profession., Conclusions: The practice environment has a significant impact on nurses, their job satisfaction, well-being, and intention to stay. This review will inform future research and forthcoming practice change to provide oncology and hematology nurses with practice environments that are safe and lead to positive nurse outcomes., Implications for Practice: This review provides a foundation upon which to develop and implement tailored interventions that best support oncology and hematology nurses to remain in practice and provide high-quality care., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Survey newly licensed nurses (NLNs) with respect to burnout, resilience, perception of the work environment, and intended short- and long-term job plans., Background: NLN retention is a significant contributing factor to the nursing shortage., Methods: A 126-item survey measuring demographics, burnout, resilience, work environment, and job plans distributed via email, using Listservs to recruit nurses licensed for 5 years or less., Results: Participants (N = 547) reported moderate burnout, specifically emotional exhaustion, and resilience. Overall scores on perception of the work environment were positive. Multiple logistic regression suggests odds of 1-year intended job flight are positively associated with emotional exhaustion (odds ratio [OR], 1.77; P < 0.001), resilience (OR, 1.07; P = 0.003) and non-White racial identity (OR, 2.99; P < 0.001) and negatively associated with staffing and resource adequacy (OR, 0.63; P = 0.038)., Conclusions: Retaining NLNs requires mitigating burnout, addressing the experience of non-White NLNs in clinical practice, and improving support and resources for NLNs., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of this study's phase 1 was to determine the current wellness levels of RNs in rural America settings, including barriers to maintain and recommendations for wellness., Background: Nurses are experiencing more anxiety and burnout currently than prepandemic. A review of literature revealed a gap in describing nurses' wellness and strategies to maintain wellness in rural American healthcare settings., Methods: The Integrative Health and Wellness Assessment (IHWA) V2 2022 holistically measured participants' wellness. The survey was deployed in 2023 to 6989 clinical nurses, nurse leaders, and advanced practice nurses., Results: The IHWA V2 2022 mean was 134.72. Significant findings included age, years of experience, and role. Barriers of insufficient time, work environment, and family responsibilities were identified. Recommendations involved the work environment, stress management, and healthy boundaries with suggestions to implement in rural settings., Conclusion: Study findings can assist leaders to implement interventions that positively impact nurse wellness in rural settings. Interventions promoting wellness are essential for nurses to meet these same needs of their patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: In this study, we aimed to structure motivation for workplace health promotion (WHP) and explore the relationship between motivation and WHP performance., Methods: We qualitatively categorized the WHP motivations written on the Health Productivity and Management (HPM) survey sheet in Japan. We then quantitatively analyzed the relationship between the categories and their HPM rankings using multiple logistic regression., Results: Responses from 2003 companies were analyzed. The WHP motivations were summarized into 12 categories. Higher-ranked companies more frequently mentioned corporate impressions, workplace environments, employee productivity, employee autonomy, and system management and less often mentioned recruitment and retention., Conclusions: For more effective WHPs, companies need to support their current workforce, set specific goals, and allocate resources in the appropriate direction, such as increasing work engagement., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Verbal deescalation training is lacking in nurse residency programs. This results in inability to mediate violent events, increased staff injury, and decreased job satisfaction. Training in verbal deescalation promotes confidence, satisfaction, and safety. Nurses participated in didactic and simulated verbal deescalation training resulting in an increase in verbal deescalation confidence of 1.6 on a 1-10 Likert scale. Meaningful verbal deescalation training increases confidence and could reduce workplace violence as well as improve workplace safety and job satisfaction., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To assess a novel worksite wellness program to enhance mindfulness and well-being of corrections professionals., Methods: This is a quasi-experimental prospective study of a total worker health and mindfulness program. Sessions were observed. Prestudy and poststudy surveys assessed program outcomes and poststudy-only surveys evaluated acceptability., Results: The intervention was feasible and delivered with high fidelity. Participants uniformly rated the program highly and would recommend it to others. Almost half were doing brief daily meditations after the program, and most gained abilities to use breathing to reduce stress ( P < 0.001). Significant positive changes also were observed in vigorous physical activity ( P = 0.01), sleep ( P < 0.001), and knowledge of the recommended health maintenance components ( P < 0.005)., Conclusions: This 12-week worksite wellness program is innovative combining a health and safety e-learning curriculum with a group format to promote mindfulness. This positive proof-of-concept trial is a new model for adding mindfulness training to other components of Total Worker Health., Competing Interests: Conflicts of interest: None declared., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Background and Objectives: A work environment where employees feel comfortable taking chances without fear and with sufficient protection from retaliation is psychologically safe. The objective of this study was to investigate the effects of leader training for nurse managers on psychological safety of clinical registered nurses., Methods: The study was designed a longitudinal outcomes approach to assess nurse leader intervention (classes on leadership methods and psychological safety) with pre- and post-intervention measurement of nurse psychological safety at each time point., Results: The intervention and nurse leader rounding were shown to increase individual psychological safety climate scores of clinical nurses., Conclusion: Psychological safety is an important component to consider in a nursing leadership role. Leadership interventions that focus on the tenets of psychological safety and include methods of being present, such as nurse leader rounding, can foster a sense of a psychologically safe environment for clinical registered nurses., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Burnout in health care workers (HCWs) has serious ramifications for individual well-being, patients, organizations, and health systems. Global evidence demonstrates the COVID-19 pandemic has amplified the risk of burnout. Scalable interventions to address burnout are critical to protect HCW well-being., Purpose: Underpinned by the Conservation of Resources theory, this study examines the impacts of a statewide improvement initiative (the Initiative), using the Institute for Healthcare Improvement Joy in Work (JiW) Framework, to reduce burnout and increase joy at work across participating health care organizations in Victoria, Australia., Methodology/approach: An impact evaluation was undertaken utilizing a mixed-methods design. Quantitative outcomes included burnout and joy at work measured using an adapted Mini Z tool. In-depth interviews with implementation teams sought insights into the effectiveness of interventions., Results: Overall, 20 teams from 17 organizations across diverse health care settings and geographical locations participated. At a statewide level, outcomes in burnout and joy at work were inconclusive due to limited data. However, five out of eight teams reporting sufficient data achieved measurable improvements in one or more outcomes. Qualitative data revealed the Initiative increased workplace resources and supports such as providing "permission" for HCWs to prioritize well-being at work, improved communications between management and HCWs, and increased HCWs' teamwork and camaraderie, resulting in safer and more positive workplaces., Conclusion and Practice Implications: The JiW Framework, implemented across diverse settings, provided organizations with a structured process to develop multifaceted improvements that resulted in enhanced resources that appeared to improve HCW well-being. Compared to individual well-being support, this approach offers organization-level change and scalability potential., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Occupational stress in the work setting can lead to burnout. Health care workers are at a higher risk of experiencing stress and burnout. Mindfulness has gained momentum as a coping mechanism for stress and feelings of burnout, although it is unknown which mindfulness practices are the most effective for reducing feelings of occupational stress. The purpose of the qualitative portion of this mixed-methods study was to explore health care staff's perceptions of the characteristics of mindfulness interventions that were effective in reducing their stress and feelings of burnout. Health care staff consisting of nurses, State Tested Nursing Aides, housekeeping staff, culinary staff, activities staff, social workers, and chaplain staff ( N = 48) in a senior care and rehabilitation setting in a Midwestern city were invited to attend a semi-structured focus group, post-intervention. Thematic analysis was used to identify 3 main themes: ease of use promotes effective implementation, positive impact of mindfulness on self and others, and home- and work-related factors affect implementation. Overall, participants perceived benefit from various mindfulness practices for reducing their feelings of stress and burnout in the workplace. Guidance, ease of use of the mindfulness practice, and addressing barriers such as time and location can help with implementation., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of the study is to spotlight the challenges, gaps, and opportunities to improve workforce mental health and well-being in higher education institutions., Methods: We convened a full-day summit of subject matter experts from academia, business, government, and practice to share research and best practices on workplace mental health., Results: Highlights from the summit are presented in this paper covering the importance of leadership and culture; the mental health costs associated with being a Black STEM scholar; the role of the environment; case studies of three university mental health and well-being programs; and the future of work., Conclusions: Establishing a culture of caring requires leadership commitment, strategic planning, accountability and shared responsibility, and measurement and evaluation. Higher education institution leaders are called to lead by example; foster community partnerships; adopt a Total Worker Health framework; and regularly evaluate progress., Competing Interests: Conflict of interest: None declared, (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Objective: The aim of this study was to explore the lived experiences of presenteeism among Taiwanese nursing staffs., Background: Presenteeism is a subjective and multifaceted experience, but nurses have rarely been invited to provide their own views of presenteeism., Methods: A qualitative study based on content analysis was conducted. Fifteen participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method., Results: Four key categories and their subcategories were identified: 1) burden of being forced to attend work; 2) physical or mental discomfort; 3) predisposing factors; and 4) binding duty., Conclusion: This preliminary study provides guidance for administrators to establish a healthy workplace and maintain quality patient care. Managers should understand the predisposing factors that lead to absenteeism, such as insufficient staffing, and propose effective measures. This study contributes to the development of research and measurement tools, adds preliminary data, and explores nursing staff presenteeism., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Although the proportion of male nurses in the nursing profession has risen in recent years, their turnover rate remains higher than their female counterparts. Male nurses tend to report lower levels of job satisfaction. However, there has been a dearth of research examining the relation among perceptions of work environment, social support, and job satisfaction in male nurses., Purpose: The aim of this study was to investigate the associations among work environment, social support, and job satisfaction in male nurses in Korea. In addition, the potential mediating effect of social support on the relationship between work environment and job satisfaction was explored., Methods: A cross-sectional design was employed to investigate the research questions. The study was conducted in a metropolitan area in South Korea, and self-administered questionnaires were distributed to participants. Hierarchical multiple regression analysis was utilized to explore the potential associations among work environment, social support, and job satisfaction., Results: Work environment was found to correlate positively with job satisfaction (r = .53, p < .001) and social support (r = .57, p < .001) in the participants, whereas a positive correlation was also found between social support and job satisfaction (r = .57, p < .001). Social support was shown to partly mediate the relationship between work environment and job satisfaction., Conclusions: The findings of this study suggest that social support partially mediates the relationship between work environment and job satisfaction in male nurses as well as confirm the importance of both work environment and social support as factors that can positively influence job satisfaction in this group., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Objective: Relationships among coworker and patient visibility, reactions to physical work environment, and work stress in ICU nurses are explored., Background: Millions of dollars are invested annually in the building or remodeling of ICUs, yet there is a gap in understanding relationships between the physical layout of nursing units and work stress., Methods: Using a cross-sectional, correlational, exploratory, predictive design, relationships among variables were studied in a diverse sample of ICU nurses., Results: Visibility had a direct effect on work stress (P < 0.01). The ViPES (Visibility, Physical Environment and Stress) model can help explain relationships among study variables. The findings from this study support the notion that high visibility is a job resource and low visibility is a job demand., Conclusions: Design features supporting a sense of connection may be especially important to less experienced ICU nurses. Elements of the built environment that allow nurses to see not only patients, but also their coworkers, may help mitigate work stress., Competing Interests: Y.K. is a reviewer for JONA. E.F.-O. declares no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aimed to investigate the mediating role of psychological distress in the relationship between work-family conflict and nurse managers' (NMs') professional and organizational turnover intentions., Background: Work-family conflict is prevalent among NMs. It can have a significant impact on their intent to leave their organization and the profession. However, the role of psychological distress as a potential mediator in the relationship between work-family conflict and turnover intentions has not been studied in the context of NMs., Methods: A cross-sectional design was used, and data were collected from a sample of 260 NMs using self-report questionnaires., Results: NMs experienced a moderate level of work-family conflict and psychological distress. Organizational turnover intention was moderate, whereas professional turnover intention was low. Higher levels of work-family conflict among NMs contributed to increased psychological distress, which, in effect, influenced their desire to leave the organization., Conclusion: To support NMs and mitigate turnover intentions, healthcare organizations need to prioritize the creation of a work environment that promotes work-life balance and reduces psychological distress., Competing Interests: The author declares no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Workplace tokenism, the use of superficial efforts to appear equitable, which often leads to burnout of marginalized groups, is pervasive, even in health and human service organizations dedicated to improving their community's health and well-being. An original research project to identify interventions addressing tokenism within Lesbian, Gay, Bisexual, Transgender, Queer plus serving health and human service agencies in New York was unable to engage staff in focus groups. A follow-up survey with 41 potential participants reported burnout as the main reason for nonparticipation. Qualitative data revealed desired aftercare for the retraumatizing nature of sharing individual experiences. Utilizing a community-based participatory research approach with an antiracism lens may mitigate challenges addressing tokenism, thereby increasing workplace inclusion of our Lesbian, Gay, Bisexual, Transgender, Queer plus community., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc.)

Purpose: This study aimed to assess the perceptions of nurses who self-identify as Black or African American regarding their workplace health and safety and to explore how these perceptions are associated with their perceived personal health., Background: Nurses practicing in unhealthy work environments can experience poorer physical and mental health. Recent civil unrest and ongoing dialogue about structural and systemic racism have prompted calls for greater efforts to understand the workplace perceptions and experiences of ethnic minority nurses, and how these influence nurses' personal well-being. But there is a dearth of relevant evidence concerning these nurses, including Black nurses., Methods: This cross-sectional, descriptive study involved analysis of secondary data collected from May 1, 2017, through December 31, 2019, by the American Nurses Association's HealthyNurse Survey (N = 19,131). We employed descriptive, bivariate, and multivariate analyses to examine the data for the 1,143 respondents who both self-identified as Black or African American and responded to all items concerning the major variable of personal health., Results: Overall, respondents reported a slight tendency to agree or strongly agree that their practice environments were safe. When looking at various factors explaining personal health, the perception of workplace health and safety was found to be a significant contributing factor., Conclusions: The study findings suggest that, among Black nurses, perceptions about workplace health and safety are associated with perceived personal health. These findings underscore the importance of fostering healthy work environments., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Employees are often placed within an organization based on their respective roles or duties, which can lead to vertical and horizontal organizational silos. Organizational silos may restrict information, resources, and stymie progress and innovation. This analysis presents a framework to mitigate silos and overcome communication barriers within an organization by increasing collaboration., Methods: The project team examined results from the Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) 2020 Employee Viewpoint Survey Results and conducted 19 key informant discussions with NCCDPHP employees. Participants were asked to provide feedback on (1) understanding silos in the workplace and (2) best practices for reducing silos and fostering collaboration. A thematic analysis was conducted to understand organizational silos, the motivation to reduce silos, and identify best practices and strategies., Results: Respondents felt that siloing exists at the division and branch levels; however, 95% of respondents were motivated to reduce silos. Fifty-eight percent of respondents identified that institutional factors such as the organizational structure (n = 8) and red tape/bureaucracy (n = 3) contribute to siloing. Additional behaviors and actions that perpetuate silos were identified, and efforts to reduce silos were categorized to propose a model: Framework to Foster Collaboration for improving organizational collaborative efforts., Discussion and Conclusion: Key themes included inclusion, shared goals and vision, bi-directional communication, and relationship building and developing trust as critical elements for improving collaboration and creating synergy across teams in efforts to reduce silos in the workplace., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The primary objective of this study was to explore the viewpoints held by employees at a pharmaceutical manufacturing workplace in a middle-income country regarding management's role in promoting health behaviors in the workplace., Methods: This study used transcripts of focus group discussion from an original study that investigated employee perceptions of factors associated with healthy behaviors among South African pharmaceutical manufacturing factory workers., Results: Participants felt that workplace managers could improve capability through health promotion strategies, supportive leadership, and promoting a culture of health. They could provide opportunity through employee engagement programs and resources, and physical activity opportunities were specifically identified., Conclusions: This study demonstrates that managers in a middle-income country have the potential to contribute to workplace health in a range of ways that include addressing capability, opportunity, and motivation of their workers., Competing Interests: Conflict of interest: The authors declare that they have no competing interests., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objectives: To assess occupational burnout (OB) changes among Brazilian healthcare workers (HCWs) from COVID-19 onset to 6 months later (T1) and identify risk and protective factors., Methods: Using the Copenhagen Burnout Inventory and hierarchical multivariate linear regression in a two-stage online survey (initial n = 1054; T1 n = 316), this study examined the impact of various factors on OB., Results: Significant increases in personal and work-related OB were observed by T1. Psychiatric diagnosis and workload emerged as risk factors ( P < 0.01), while having a partner, good family relations, workplace well-being, and adequate sleep were protective ( P < 0.001)., Conclusions: OB levels among Brazilian HCWs increased during the COVID-19 pandemic. Interventions should target personal and organizational wellness to alleviate burnout, emphasizing the importance of strong relationships, workplace health, and good sleep practices., Competing Interests: Conflict of interest for all authors: none declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objectives: The current study aims to identify individual and joint drivers that significantly influence the safety climate in healthcare industries by using Bayesian network (BN) simulations for an in-depth analysis., Methods: Survey data were collected from 452 employees from two branches of one hospital in China for a study about workplace safety. The original English surveys were translated into Chinese using the back-translation procedure recommended by Brislin. Employees were asked to complete two online surveys with 1 month in between each administration. The sample was 42% doctors and 58% nurses. A BN model, based on theory, was updated and complemented with expert knowledge. A graphical model based on expert knowledge and data-driven machine learning approaches was used to refine the BN structure, representing interrelationships among all studied variables. The BN model was employed to identify the best key drivers and joint strategies for safety climate improvement., Results: The BN model demonstrated a good overall fit. The Euclidean distance metric was used to assess the influence between connected variables, with interpersonal trust and locus of control having the strongest independent effects on safety climate among the five contributing factors. Joint strategies, particularly joint optimization of error disclosure culture and interpersonal trust, as well as error disclosure culture and self-efficacy, were most effective in promoting a safe climate., Conclusions: The findings suggest that hospital safety climate can be improved by providing a psychologically safe error disclosure culture and enhancing interpersonal trust among employees and their self-efficacy., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Workplace violence (WPV) has become a crisis for health care workers, with a significant increase in violent events taking place in health care settings across the nation. Health care organizations should develop a comprehensive WPV program that includes recognition, management, and reporting of all types of WPV. A large health care system developed strategies and a program to address WPV. The health care system believes that a safe and respectful work environment is foundational to the goal of zero preventable harm. The "Safety in the Workplace" initiative was designed to raise awareness of concerning behaviors and to offer tools and resources for identifying, responding to, and reporting incidents of violence, aggression, or disruptive behaviors of WPV. During a 6-month pilot of a WPV bundle, there was a 44% reduction in physical violence reports and a 44% reduction in reported incidents of WPV. From June 2020 to June 2021, there was a 10% decrease in WPV overall., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Workforce shortages, increasing costs, decreased reimbursement, and focus on quality outcomes are crucial issues for health care leaders. To remain competitive, profitable, and productive, health care organizations need to provide structure, a safe working environment, and an acceptable leader workload to guarantee effective leader performance. Poorly designed work environments and interfaces can increase workload resulting in decreased performance and satisfaction. Excessive workload has led to reduced job satisfaction, productivity, and resilience. Due to leadership turnover and vacancy rates, leader workload was perceived to be unreasonable in the respiratory therapy (RT) department of an academic medical institution in central North Carolina. The aim of this quality initiative was to explore the workload of health care leaders in the RT department to identify the factors that influenced workload as well as implement strategies to decrease perceived workload. A workload assessment was performed, which identified inefficiencies and opportunities to partner with ancillary departments to align the workload with appropriate clinical teams. The redistribution of workload provided alignment, top of scope practice, and improved satisfaction among the RT department leaders. This article identifies the strategies utilized which can be translated to other institutions., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Turnover intention research with the addition of independent variables of work-life balance and work stress in nurses with health backgrounds is rarely found in type c public hospitals in Karawang city, where literature about this research needs to explain it. This research aims to ascertain how work-life balance, workplace stress, and work-family conflict affect nurses' intentions to quit their jobs by using job satisfaction as a mediator. The sampling for this study was carried out using the probability sampling method known as proportionate stratified random sampling. A total of 550 nurses from 4 schools submitted responses. Work-life balance, work-related stress, and job happiness all significantly influence the likelihood of turnover. The desire to increase or reduce hospital turnover is significantly influenced by work-life balance, stress at work, and work-family conflict. This study has limitations that can lead to imperfect conclusions because the sample used is only the nurse division, so this study can only be generalized to some other districts. The variables studied still need to be reviewed to affect turnover intention by mediating job satisfaction., Competing Interests: The authors have no conflicts of interest in the manuscript, including financial, consultant, institutional, and other relationships that might lead to bias or a conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To examine the correlation between nurse manager (NM) competencies, work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI]), and frontline nurses' intent to stay; the direct effect of NM competency on frontline nurses' intent to stay; and the indirect effect of NM competency on frontline nurses' intent to stay, mediated by PES-NWI., Background: PES-NWI and NMs' competency can impact frontline nurses' intent to stay., Methods: Cross-sectional study with secondary analysis of NM Competency and NDNQI ® (National Database of Nursing Quality Indicators ® ) RN Survey data with path analysis for effects of the model's variables., Results: Positive, weak correlations between NM competencies and frontline nurses' practice environments were found; NM competencies and frontline nurses' intent to stay were not correlated. Paths were NM competency/PES-NWI ( β = 0.20, P = 0.001) and PES-NWI/intent to stay ( β = 0.55, P < 0.001); NM competency/intent to stay was not significant. Indirect effect of NM competency on frontline nurses' intent to stay was mediated through PES-NWI ( β = 0.11, P = 0.002; 95% confidence interval, 0.05-0.17)., Conclusions: Investing in NMs' competency can help create supportive work environments and frontline nurses' intent to stay., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Nurse retention remains a pivotal issue, necessitating urgent strategies aimed at the recruitment and retention of highly qualified nurses. However, there is limited knowledge regarding the influence of nurses' personal and professional values, along with work environment, on predicting intent to leave an organization. Utilizing a secondary analysis approach, this study employed logistic regression to predict intent to leave among registered nurses (n = 671) using results from the Short Schwartz's Value Survey, the Nurses Professional Values Scale-3, and the Practice Environment Scale of the Nursing Work Index. Regression analysis indicates that the work environment including "Participation in Hospital Affairs" (B = -.665, odds ratio = .514), "Nurse Manager Ability, Leadership, and Support" (B = -.448, odds ratio = .639), and "Staffing and Resource Adequacy" (B = -.589, odds ratio = .555) are significant predictors of nurses' intentions to leave. Establishing and maintaining supportive work environments is essential for retention, highlighting the importance of effective leadership., Competing Interests: The authors declare no conflicts of interest or funding sources., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: With rapidly declining birth rates and aging populations worldwide, the demand for nursing care has increased in recent years. High turnover, an important cause of nurse staffing shortages, directly affects the quality of nursing care. However, no comparison studies on turnover intention in East Asia have been published., Purpose: The purpose of this study was to clarify the relationships among turnover intention, the work environment, and related factors among new nurses in Japan and China., Methods: A self-administered questionnaire survey was used to collect data from nurses employed for < 2 years. This questionnaire included participant characteristics, assessment of desire to become a nurse at the start of employment, current turnover intention, the Practice Environment Scale of the Nursing Work Index, and the Maslach Burnout Inventory-Human Services Survey. The relationship between current turnover intention and, respectively, number of hospital beds, strength of desire to become a nurse at the start of employment, level of participation in hospital affairs, emotional exhaustion (EE), personal achievement, and demographic variables was assessed., Results: The number of nurses who intended to leave the hospital was higher in Japan (74.1%) than in China (42.4%). However, of those expressing intention to leave, 46.6% of the nurses in China and only 5.0% of those in Japan indicated intention to quit the nursing profession altogether. In Japan, collegial nurse-physician relations and EE were related to turnover intention, whereas in China, number of hospital beds, strength of desire to become a nurse at the start of employment, participation in hospital affairs, EE, and personal achievement were all related to turnover intention., Conclusions: To enhance retention and reduce turnover intention among nurses, the strength of desire to become a nurse in China and the nurse-physician relationship and EE in Japan should be taken into particular consideration when designing retention strategies and nurse education programs., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim was to describe the factors leading to, and explore the coping strategies and the consequences of, nurse manager presenteeism., Background: Presenteeism, or presence at work while not fully performing, is prevalent among direct-care nurses, yet no studies have explored nurse manager presenteeism., Methods: This study used a convergent mixed-methods design with 1:1 interviews, a demographic questionnaire, mental/physical health and work situation questions, and the Job Stress-Related Presenteeism Scale (JSPS). Participants included 14 nurse managers from 3 hospitals in Central Pennsylvania., Findings: Quantitative results reveal participants' physical and mental health, results of the JSPS, and inferences between presenteeism and health/demographic items. The overarching qualitative theme was the cyclic nature of presenteeism. Work demands and other contributing factors, like illness and personal factors, contribute to presenteeism, which leads to adverse consequences. The consequences lead to more work demands and can lead the nurse manager to consider leaving a job or the profession. The cycle can be broken by protective factors, coping mechanisms, and support. Mixed-methods results revealed convergence among the quantitative and qualitative results., Conclusions: Executive leaders must help nurse managers break the cycle of nurse manager presenteeism. Nurse managers need fewer work demands and more support to improve their performance at work., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aimed to explore the relationship between workplace discrimination and psychological distress across 9 years using data from the Midlife in the Unites States study., Methods: Workplace discrimination was measured with a validated six-item scale at baseline with three categories (low, intermediate, and high), and psychological distress was measured with the Kessler 6 scale at baseline and follow-up. In total, 1,546 workers were analyzed by linear regression., Results: High levels of workplace discrimination were significantly associated with increased psychological distress at follow-up (crude β = 0.633; 95% CI, 0.307-0.959). After adjusting for demographic factors, socioeconomic status, and health-related behaviors, associations were slightly attenuated (fully adjusted β = 0.447; 95% CI, 0.115-0.780)., Conclusions: High workplace discrimination was longitudinally associated with higher levels of psychological distress. Organizations should actively prevent discrimination, which may improve workers' mental health consequently., Competing Interests: Li, Keller, and Guardiano have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Background: The extensive research already conducted in numerous non-healthcare disciplines has consistently demonstrated the effectiveness of flow in alleviating work-related stress and boosting employee engagement in the workplace. Despite the potential benefits to nursing of improving flow, no valid instrument is currently available to measure the work-related flow experience of clinical nurses., Purpose: This study was designed to develop the Flow State Scale for Caregiving Tasks (FSS-CT) and to evaluate its psychometric properties in the context of clinical nurses., Methods: This study, guided by the flow theory of Mihaly Csikszentmihalyi (1975), employed a three-phase approach to developing and evaluating the psychometric properties of the FSS-CT. Five hundred thirty-six full-time clinical nurses working in hospitals of various levels in Taiwan were recruited via cluster random sampling to participate in an anonymous online survey. The content validity of the developed scale was established through expert panel verification, criterion-related validity was assessed by correlating the scale with the Work-related Flow Inventory, and construct validity was evaluated via explanatory and confirmatory factor analyses. Scale reliability was determined using Cronbach's α coefficient., Results: The FSS-CT, a 12-item Likert scale comprising four domains, was developed. These domains capture the elements of nurses' work-related flow, including professional confidence, merging of action and awareness, balance between skill and challenge, and autotelic experience. The FSS-CT demonstrated high content validity (content validity index > .90) and satisfactory criterion-related validity (coefficient = .55, p < .001). Furthermore, the scale was found to have excellent internal consistency (Cronbach's α = .91). Factor analyses yielded a four-factor structure accounting for 69.34% of the total variance, indicating a good fit for the final model based on recommended goodness-of-fit indices., Conclusions: The FSS-CT is a viable and dependable instrument for assessing the work-related flow experiences of nurses, with the measured outcomes offering to nursing administrators valuable insights into or directions for personnel development and work allocation initiatives., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Aims: This study aimed to examine the relationship between work environment and missed nursing care (MNC) in nurses and determine whether profession self-efficacy has a moderator role in this relationship., Design: A quantitative, cross-sectional, correlational study design was used to test the study model., Methods: The study was conducted with 433 nurses in 2 city hospitals in Istanbul, Turkey. Data were collected between November 2022 and February 2023 using the "MISSCARE Survey-Turkish," the "Work Environment Scale," and the "Nursing Profession Self-Efficacy Scale.", Results: The participants had a mean Nursing Profession Self-Efficacy Scale score of 66.67 ± 14.37, a mean Work Environment Scale score of 84.96 ± 13.62, a mean elements of MNC score of 1.30 ± 0.73, and a mean reason for MNC score of 3.18 ± 0.78. Nursing profession self-efficacy was determined to be positively related to the work environment of the participants and their reasons for MNC (respectively, r = 0.276 and r = 0.114) and negatively related to elements of MNC ( r = -0.216) ( P < 0.05). There was also a negative relationship between the work environment and elements of MNC ( r = -0.249; P < 0.05). Profession self-efficacy had a significant moderator role in the relationship between the work environment and elements of MNC. Having low or moderate levels of profession self-efficacy moderated the negative effects of the work environment on elements of MNC., Conclusions: There is a need for interventions to reduce elements of missed nursing care in nurses. Especially nurses and/or nurse managers may have difficulties in improving their work environment, considering its multifaceted structure. In such cases, administrators can reduce missed nursing care by increasing the profession self-efficacy of nurses. Therefore, profession self-efficacy should be considered in addition to interventions for the work environment to improve care., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors., Background: Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff., Methods: A cross-sectional, descriptive correlational design was used. The Florida Organization for Nursing Leadership enabled distribution of a wellness survey to nurse managers., Results: There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout., Conclusions: Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Faculty-to-faculty incivility is a national and global problem. Recent studies examining faculty incivility in nursing academe found that respondents expressed emotional and physical distress stemming from workplace incivility, and most avoid dealing with the problem. A top strategy for improving workplace civility includes providing ongoing education to improve communication skills., Problem: Faculty and academic nurse leaders require evidence-based strategies to prevent and address the range of uncivil behaviors occurring in academic work environments., Approach: Cognitive Rehearsal (CR) is a primary prevention and intervention communication strategy used to address incivility in health care and educational settings. Working with a skilled facilitator, participants practice addressing stressful situations in a non-threatening environment. This is the first known publication using CR to address faculty-to-faculty incivility., Conclusions: The author uses real-life situations derived from faculty-to-faculty incivility research studies and in-person conversations to describe each step of the CR process., Competing Interests: The author declares no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of this study was to understand newer nurses' perception and expectations of their work environment, professional and institutional satisfaction, and motivating/decision-making factors around nursing and intent to leave their positions., Background: Studies have shown newly graduated nurses face many challenges transitioning from a student to an independently practicing nurse. The COVID pandemic complicated this transition and created new stressors resulting in discouragement and turnover for newer nurses., Methods: This study used a qualitative approach through purposive sampling, semistructured qualitative interviews, and content analytic techniques. Transitional Shock Theory was used as the theoretical framework., Results: Four themes emerged from the study: 1) confronting the reality; 2) betrayal/mistrust; 3) relational integrity; and 4) enablers of clinical competence., Conclusions: The findings will help nurse leaders understand the importance of organizational-level supports to improve the transition of newer nurses in typical periods and in times of additional stress., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The nursing work environment is often stressful and can lead to burnout. The use of humor may help nurses adapt and cope. Although most would agree that, in general, humor can help build camaraderie and ease tense situations, little is known about how nurses use humor in their professional lives., Purpose: The study's main purpose was to explore how humor is used and perceived by nurses in the workplace., Methods: A sample of LPNs, RNs, and advanced practice RNs was recruited in the United States. Participants were interviewed via the videoconferencing platform Zoom. Data from the video recordings, audio transcripts, and investigators' field notes were analyzed using reflexive thematic analysis., Results: Sixteen nurses were interviewed about their use of humor, whether intentional or spontaneous, in the workplace. Three main themes were identified: entertainment , influencing others , and well-being . Participants reported using humor with self and others, including patients, families, and colleagues. Reported benefits include emotional regulation, relationship building, and work enjoyment. Some participants noted feeling insecure over when and whether the use of humor was "appropriate.", Conclusions: The results indicate that nurses' use of humor in the workplace had many benefits. Participants reported that humor could relieve tension, create bonds and strengthen relationships, and enhance both learning and work environments. Many recognized that humor can also be maladaptive and harmful, and that sensitivity and caution are part of using humor skillfully. Still, the benefits of humor appear to outweigh the risks. We conclude that humor is a useful tool nurses can and should use to optimize their nursing experience., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of this study was to explore the mediating role of psychological capital in the relationship between perceived social support and presenteeism among nurses., Background: The concept of presenteeism explored in this study refers to the behavior of nurses who hold on to their jobs despite poor physical or mental health, manifested in poor work productivity and loss of productivity. Perceived social support and psychological capital may help reduce presenteeism. However, there is limited knowledge about the association between perceived social support, psychological capital, and presenteeism among nurses., Methods: Data were collected through questionnaires from 468 RNs. Data analysis used Pearson's correlation analysis, multiple linear regression, and structural equation model., Results: The results indicated that perceived social support and psychological capital were significantly negatively correlated with nurses' presenteeism. Structural equation modeling revealed that psychological capital mediated the relationship between perceived social support and presenteeism, with a partial mediating effect of -0.191, accounting for 28% of the total effect., Conclusions: These results identified structural relationships between the 3 variables of perceived social support, psychological capital, and presenteeism and provided a theoretical reference for developing strategies to decrease nurses' presenteeism., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment., Background: Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention., Methods: Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored., Results: MD was significantly higher among RNs intending to leave employment. System-level and team-level integrity attributes were significant factors predicting intent to leave, controlling for potential confounders. The odds of intending to leave were 147% higher for new graduate RNs, 124% higher for direct care RNs, and 63% higher for 2nd-career RNs. Gender and race were not significant predictors., Conclusion: Exploring root causes contributing to MD frequency and severity is critical to maintain a healthy work environment. Mitigating MD in the work environment may enhance nursing practice and improve patient care. Support for new graduate and 2nd-career RNs can be realized, further reducing turnover for these vulnerable populations of the nursing workforce., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The relationship between workplace justice and nonfatal occupational accidents in a single-payer healthcare system has rarely been explored. As countries strive to achieve and sustain universal health coverage, healthcare workers' occupational safety and health require greater concerns. We used the data from a national survey conducted on randomly sampled Taiwanese workers. One hundred forty eight males and 567 females, with a total of 715 healthcare workers aged 20 to 65, were analyzed. The workplace scale consisted of 4 subcomponents, including distributive justice, interpersonal justice, information justice, and procedural justice, and was dichotomized into low and high groups in each dimension. Logistic regression models examined the relationship between workplace justice and self-evaluated occupational accidents among healthcare employees. The prevalence of self-evaluated occupational accidents in healthcare employees was 15.54% and 11.64% for men and women, respectively. After adjusting variables such as sociodemographic variables, physical job demands, shift work status, work contract, and psychological job demands, regression analyses indicated that health employees with lower distributive justice, interpersonal justice, information justice, and procedural justice were significantly associated with self-evaluated occupational accidents both in males and females. Expanding the study to include healthcare systems in different countries could enhance the generalizability of the findings. Offering specific recommendations for policymakers and healthcare administrators to improve workplace justice and reduce occupational accidents., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The Gratitude at Work Scale, originally developed by American scholars, has been widely administered to mental health professionals and human service workers to explore gratitude in the workplace. No Chinese-language instrument is currently available for assessing workplace gratitude., Purposes: The aims of this study were to (a) translate the original English version of the Gratitude at Work Scale into a traditional Chinese version (TC-GAWS), confirm its factor structure, and analyze its psychometric properties among newly employed nurses and (b) develop and evaluate the psychometric properties of the TC-GAWS short form., Methods: A psychometric study using a cross-sectional web-based design was conducted in Taiwan. Three hundred twenty-two employed nurses completed a battery of self-administered online questionnaires that included a demographic datasheet, the Gratitude Questionnaire-Six-Item Form, the Connor-Davidson Resilience Scale-10, and the Thoughts of Quitting Scale. IBM SPSS 24.0 and AMOS 28.0 were used for data analysis, and Cronbach's alpha and Pearson's correlation were used to assess reliability and concurrent validity. Exploratory factor analysis and confirmatory factor analysis (CFA) were conducted., Results: The internal consistency and stability of the TC-GAWS total scale were .88 and .91, respectively. The exploratory factor analysis showed a satisfactory Kaiser-Meyer-Olkin value of .88 and a Bartlett's test value of 654.01 ( p < .001), suggesting that 64.55% of the total variance was explained by the two-factor TC-GAWS. After item reduction, the CFA of the six remaining items of the TC-GAWS short form revealed adequate fit statistics for a two-factor structure and a second-order factor. Strong correlations were found between the 10-item and six-item TC-GAWS ( r > .94) in the two samples, suggesting good concurrent validity. The overall scores for the 10-item and six-item TC-GAWS had similar convergent validity, with moderate-to-strong correlations for the Gratitude Questionnaire-Six-Item Form ( r = .45 and .540), Connor-Davidson Resilience Scale-10 ( r = .49 and .51), and Thoughts of Quitting Scale ( r = -.57 and -.53). The CFA yielded a two-factor, six-item model that exhibited good fit with the latent constructs of χ 2 / df = 11.06/8 = 1.38, p = .198, comparative fit index = .996, goodness-of-fit index = .979, root mean square error of approximation = .045, root mean square residual = .030, and standardized root mean squared residual = .023., Conclusions/implications for Practice: Both the 10- and six-item TC-GAWS instruments demonstrated good reliability and validity in nurse participants. The TC-GAWS may be used to measure gratitude in nurses in the workplace. This instrument has the potential to facilitate a better understanding of gratitude in nurses, which may be applied to the improvement of nursing management, research, and education., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Objectives: Qualitatively assess experiences of occupational pregnancy discrimination., Methods: A fully remote phenomenological qualitative study was completed leveraging semistructured interviews with a sample of pregnant employees in the United States. Inclusion criteria included being pregnant, working at least 35 hours per week, employed at least 1 year at current employer, and without diagnosed depression/anxiety., Results: Participants (N = 20) were, on average, 30 years of age, worked 42.6 hours per week, self-identified as non-Hispanic black (50%), and earned least a bachelor's degree (85%). Individuals successfully identified various forms of pregnancy discrimination, believing it occurred due to systemic issues or perceptions that women are weak. Most did not report experiences of discrimination fearing retaliation or being unaware of workplace protections., Conclusion: Pregnancy discrimination in the workplaces comes in various forms and is an issue for some working pregnant individuals., Competing Interests: Conflicts of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)