Houssem Eddine Ben-Ahmed

Purpose: Literature documenting mental health concerns among nurses is abundant, as is evidence that working conditions are a significant contributing factor. While conducting a study on the mental health experiences of seven professional cohorts in Canada, an unexpected finding was that for nurses struggling with their mental health, compassion profoundly shaped their experiences. This paper reports findings from a secondary analysis of the nursing cohort of this dataset to examine the role that compassion played in the experiences of nurses, their interprofessional relationships, and engagement with institutional policies and processes. Qualitative analysis of interviews with 52 nurses across Canada was conducted using interpretive description's inductive approach. Analysis was guided by the conceptual framework of Compassionate Communities. Results: Compassion in the workplace impacted nurses’ experiences of mental health, the process of requesting a leave of absence, and negotiating return to work. Nurses described how practicing in uncompassionate environments prompted them to engage in presenteeism at the expense of their own wellbeing, often missing the signs of their distress. Seeking help was deemed more complicated than remaining at work; leave of absence and return to work processes were marked by uncompassionate responses from managers and institutional procedures. Nurses encountered stigma when disclosing a mental health concern, negatively impacting their professional identity and interprofessional relationships. Conclusions: Implementing compassionate organizational practices and processes is instrumental in supporting nurses’ mental health experiences and supporting psychologically safe work environments. This paper adds to the literature on compassion, compassionate communities, and nurses’ mental health experiences.

Background: Emotional exhaustion is a core component of burnout, linked to poor nurse well-being and negative patient outcomes. In Canada, where nurse burnout has risen sharply, there is limited evidence tracking changes across healthcare sectors over time. This study addresses that gap to inform workforce and policy interventions. Purpose: To examine trends in emotional exhaustion and perceptions of quality and safety among nurses in British Columbia working in acute care, long-term care, and community care settings over three time points: 2015, 2019, and 2020. Methods: We conducted a secondary analysis of three cross-sectional surveys of nurses in BC. The analytic sample included 8,412 nurses. Emotional exhaustion was measured using the Maslach Burnout Inventory, and quality and safety outcomes were assessed using validated RN4CAST indicators. Survey year was the key independent variable; six demographic and professional characteristics were included as controls. Linear regression was used for emotional exhaustion and ordered logistic regression for ordinal outcomes. Results: Nurses' emotional exhaustion demonstrated a two-fold increase from 2015 to 2019 and a four-fold increase from 2015 to 2020. While nurses’ ratings of all quality and safety measures improved from 2015 to 2020, only their ratings of last shift and general quality of care improved between 2015 to 2019. Conclusion: The observed increase in nurses’ emotional exhaustion over time likely reflects the cumulative impact of persistent system pressures and escalating workloads, particularly during the COVID-19 pandemic. Incorporating measures of burnout into Canada's health workforce dashboards would inform more targeted, data-driven strategies for sustainable health workforce planning.

Utilizing an integrated knowledge translation framework (iKT), the purpose of this study was to identify best practices for long-term care (LTC) staffing in British Columbia, Canada, based on learnings from the COVID-19 pandemic. Through multiple data sources, including an electronic survey provided to LTC operators and knowledge-generation forums held with LTC community members, four staffing recommendations were created. Our major findings emphasize how the pandemic exposed and further exacerbated LTC workforce shortcomings and provide rich, contextual information to help create efficacious and practical outcomes and enhance public health. Our recommendations include conducting contingency planning for potential crises, increasing the use of volunteers, implementing recruitment and retention strategies for the LTC workforce, and standardizing evaluations of staffing adequacy and resident outcomes. These investments can serve to strengthen LTC currently and to protect against potential future health crises. This project highlights how lived experience can be utilized to address health inequities and bolster public health outcomes.

Strategies to promote workplace mental health can target system, organization, team, and individual levels exclusively or in concert with each other. Creating toolkits that include these different levels is an emerging innovative strategy to support employees working in various sectors. Our paper describes the development, implementation, and refinement of two different online toolkits: the Healthy Professional Worker Toolkit for Education Workers and the Health Worker Burnout Toolkit. The Knowledge to Action Framework guided the team during the development and early interventions phases of toolkit development. Stakeholder engagement regarding the intended use of the toolkit of promising practices for workplace interventions was integrated throughout with different forms of feedback in a research capacity between 2022 and 2024. Reflecting on the different phases of the KTA Framework, we describe first the engagement involved in building the toolkits and then on their utilization. Our toolkits were built to include different resources aimed at empowering workers, teams, and employers offering innovative ideas to address the mental health-leaves of absence and return to work cycle in one case and the different forms and consequences of burnout in the other. Criteria for inclusion were informed by ongoing research with a range of stakeholders and other intended toolkit users including managers, supervisors, executives, human resource specialists, staff, and others in healthcare and educational organizations and settings. In the implementation phase, the volume of resources available in each toolkit considered a strength by some was overwhelming for some partners and individual workers to navigate. Capacity, engagement, time, and readiness for change, are themes that heavily influenced if and when organizations interacted with each toolkit, and how much time they spent exploring the resources provided. It is critical to ground toolkits in the experiential evidence of workplace mental health as is linking these to evidence-informed interventions that correspond to workplace concerns. Organizational readiness to adopt and adapt resources and implement changes is a key consideration. Ultimately, user engagement is what brought these toolkits to life.