Advocating for the Health and Wellbeing of Our Nurses : Journal of Nursing Research

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Advocating for the Health and Wellbeing of Our Nurses


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doi: 10.1097/jnr.0000000000000533
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Nursing turnover and nursing manpower shortfalls are chronic, long-standing problems in the healthcare field. New emerging infectious diseases, exemplified by the COVID-19 pandemic, have exacerbated these problems and further increased the work burdens and stress on nurses (International Council of Nurses, 2020).

Nursing is a high-stress profession. Shift work, long work hours, lack of work flexibility, clinical care responsibilities, and the threat of violence from patients and family members are known stressors to nurses (Chang et al., 2021; Wei et al., 2016). High job stress along with long work hours and shift work cause sleep problems, chronic fatigue, and mood disorders (e.g., anxiety and depression) that increase the risks for a wide-spectrum of health threats and problems, including low back pain, sprained/strained muscles, sharp/needlestick injuries, and verbal or sexual harassment/violence (Chiou et al., 2013; Lo et al., 2016; Wei et al., 2016). Cumulative physical and mental health problems increase the risk of nurses leaving the profession (Lo et al., 2018; Panunto & Guirardello, 2013).

Nurses understand the importance of health promotion and self-care behaviors. However, this knowledge does not translate into actual health screenings and health-promoting behaviors (Ross et al., 2017). High job stress is a main negative factor affecting health screenings (e.g., pap smear) and health promoting behaviors (e.g., physical activity, healthy diet) in nurses (Chiou et al., 2014; Su et al., 2016).

Persistent health morbidities and a lack of health promoting behaviors negatively impact health, leading to chronic conditions/diseases among nurses (Chang et al., 2021; Wang et al., 2018). Leaving the nursing profession seems a natural choice, especially for first-line nurses who must perform shift work, have less control over their job, and have not been promoted to administrative positions.

Personal health and employee protection are the two most important factors on nursing human capital considered by nurses (Goh et al., 2020). When combined with the aforementioned mechanisms facilitating nurses leaving the profession, it is clear that there is an urgent need to improve health promotion programs and employee protection measures for nurses. Strategies such as promoting a supportive work environment, implementing worksite health promotion programs, offering stress adaptation and relaxation training, and improving work conditions (e.g., decreasing work hours and arranging reasonable shift schedules) have shown some level of effectiveness (Paguio et al., 2020; Stanulewicz et al., 2019). Nonetheless, longer-term, novel approaches that are more effective and reflect better methodological rigor must be developed. New technologies such as robots, artificial intelligence, wearable devices, and light therapy may be incorporated into the health promoting strategies to decrease job stress and improve health among nurses.

Articles in this issue cover research on emotional labor in nurses, the effects of work satisfaction and work flexibility on burnout, nurses’ experience of stigma in caring for COVID-19 patients, sleep problems and role overload among first-line nurses during the COVID-19 pandemic, and the potential alleviating effect of mindfulness on stress. These studies add to the growing body of literature focused on identifying the key challenges to the health and wellbeing of nurses and providing effective strategies for improvement.


Chang P.-Y., Chiou S.-T., Lo W.-Y., Huang N., Chien L.-Y. (2021). Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: A national questionnaire survey. BMC Nursing, 20(1), Article No. 250.
Chiou S.-T., Chiang J.-H., Huang N., Chien L.-Y. (2014). Health behaviors and participation in health promotion activities among hospital staff: Which occupational group performs better?BMC Health Services Research, 14, Article No. 474.
Chiou S.-T., Chiang J.-H., Huang N., Wu C.-H., Chien L.-Y. (2013). Health issues among nurses in Taiwanese hospitals: National survey. International Journal of Nursing Studies, 50(10), 1377–1384.
Goh C. F., Chen Z.-L., Chien L.-Y. (2020). The indicators of human capital for hospital-based nursing workforce in Taiwan. Journal of Nursing Management, 28(3), 577–585.
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Lo W.-Y., Chien L.-Y., Hwang F.-M., Huang N., Chiou S.-T. (2018). From job stress to intention to leave among hospital nurses: A structural equation modeling approach. Journal of Advanced Nursing, 74(3), 677–688.
Lo W.-Y., Chiou S.-T., Huang N., Chien L.-Y. (2016). Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey. International Journal of Nursing Studies, 64, 130–136.
Paguio J. T., Yu D. S. F., Su J. J. (2020). Systematic review of interventions to improve nurses’ work environments. Journal of Advanced Nursing, 76(10), 2471–2493.
Panunto M. R., Guirardello E. B. (2013). Professional nursing practice: Environment and emotional exhaustion among intensive care nurses. Revista Latino-Americana de Enfermagem, 21(3), 765–772.
Ross A., Bevans M., Brooks A. T., Gibbons S., Wallen G. R. (2017). Nurses and health-promoting behaviors: Knowledge may not translate into self-care. AORN Journal, 105(3), 267–275.
Stanulewicz N., Knox E., Narayanasamy M., Shivji N., Khunti K., Blake H. (2019). Effectiveness of lifestyle health promotion Interventions for nurses: A systematic review. International Journal of Environment Research and Public Health, 17(1), Article 17. https//
Su S.-Y., Chiou S.-T., Huang N., Huang C.-M., Chiang J.-H., Chien L.-Y. (2016). Association between Pap smear screening and job stress in Taiwanese nurses. European Journal of Oncology Nursing, 20, 119–124.
Wang J.-L., Chiou S.-T., Chien L.-Y., Huang N. (2018). Examination of the relevant factors of satisfaction with salary and intention to resign or leave the industry among clinical nurses in Taiwan. Cheng Ching Medical Journal, 14(2), 27–39.
Wei C. Y., Chiou S. T., Chien L. Y., Huang N. (2016). Workplace violence against nurses - Prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study. International Journal of Nursing Studies, 56, 63–70.
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.