Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper.

Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge-rooted in the philosophy of care-is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.

The relationship between nurse burnout, missed nursing care, and care quality following COVID-19 pandemic.

OBJECTIVES: To determine the relationship between nurse burnout, missed nursing care, and care quality following the COVID-19 pandemic. BACKGROUND: Quality of care and missed nursing care can be consequences of nurse burnout. Little is known about how these factors related to nurse burnout following the COVID-19 pandemic. DESIGN: This study used a cross-sectional correlational design and was conducted in 12 general hospitals across Thailand from August to October 2022. METHODS: 394 nurses providing direct nursing care to patients during the COVID-19 pandemic completed the survey. The Emotional Exhaustion (EE) subscale of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), MISSCARE survey, and quality of care reported by nurses were used to collect data. Descriptive statistics and logistic regression models were used to analyse the data. RESULTS: Approximately thirty-six percent of nurses had burnout following the COVID-19 pandemic. Missed nursing care was higher among nurses with burnout. Most participants reported illness/symptoms such as anxiety, fatigue, a lack of concentration, and sleeping problems. After adjusting for demographic characteristics, every additional unit of emotional exhaustion was associated with 1.61 times higher odds of missed nursing care, 3.37 times higher odds of poor quality of nurse care, and 2.62 times higher odds of poor quality of care for the overall unit. CONCLUSION: The study findings demonstrate that burnout is associated with missed nursing care and poor quality of care following the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE: Policymakers, hospital administrators, and nurse managers should invest in strategies to reduce nurse burnout, which can increase patient safety and quality of care.

An assessment of organizational well-being, organizational health, and work-related stress: A cross-sectional study of nurses involved with COVID-19 interventions.

BACKGROUND: Nurses have been affected by stress, developing many related consequences during the health emergency caused by the SARS-CoV-2 (COVID-19) pandemic. It is essential for healthcare organizations to protect their human resources because there is a strong correlation between the health status of healthcare workers and the quality of care provided. OBJECTIVE: The aim of the study was to measure the perception of the organizational health level of the workplace among COVID-19 nurses (i.e. nurses who directly dealt with COVID-19 countermeasures) as an influence on work quality and work-related stress. METHODS: A cross-sectional study was carried out by administering the Nursing Questionnaire on Organizational Health (QISO) to nurses in contact with COVID-19 patients. The search period ranged between August and September 2021 with nurses who work and/or worked in Lazio. RESULTS: 123 questionnaires were collected. The scores with a value below the recommended level (2,6) are: "Comfort of the working environment" (mean = 2.57; SD = 0.66); "Valorization of skills" (mean = 2.40; SD = 0.62); "Openness to innovation" (mean = 2.46; SD = 0.77); "Satisfaction with top management" (mean = 2.48; SD = 0.81); and the inverse scale "Fatigue" (mean = 2.94; SD = 0.55). CONCLUSION: Management of healthcare organizations should define action strategies to promote and increase organizational well-being and reduce work-related stress risk factors. Some action strategies that could be used include improving the elements of the work environment to make it more comfortable for workers; strengthening and improving communication; improving the relationship between nurses and senior management; and establishing a team of experts for psychological assistance.

Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: a single-centre, cross-sectional study in Morocco.

OBJECTIVES: To describe the sociodemographic, occupational and health factors that influence nurses' recognition at work and to examine a recognition pathway model to assess the relationship between recognition at work and health-related quality of life (HRQOL), job satisfaction, anxiety and depression. DESIGN: This is a cross-sectional observational study with prospective data collection based on a self-report questionnaire. SETTING: University hospital centre in Morocco. PARTICIPANTS: The study included 223 nurses with at least 1 year of practice at the bedside in care units. MEASURES: We included the sociodemographic, occupational and health characteristics of each participant. The Fall Amar instrument was used to measure job recognition. HRQOL was measured using the Medical Outcome Study Short Form 12. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Job satisfaction was measured using a rating scale (ranging from 0 to 10). Path analysis was used to examine the nurse recognition pathway model to assess the relationship between nurse recognition at work and key variables. RESULTS: The participation rate in this study was 79.3%. Institutional recognition was significantly correlated with gender, midwifery specialty and normal work schedule: ß=-5.10 (-8.06, -2.14), ß=-5.13 (-8.66, -1.60) and ß=-4.28 (-6.85, -1.71), respectively. Significant correlations were found between recognition from superiors and gender, mental health specialisation and normal work schedule: ß=-5.71 (-9.39, -2.03), ß=-5.96 (-11.17, -0.75) and ß=-4.04(-7.23, -0.85), respectively. Recognition from coworkers was significantly associated with mental health specialisation: ß=-5.09 (-9.16, -1.01). The trajectory analysis model found that supervisor recognition had the best impact on anxiety, job satisfaction and HRQOL. CONCLUSIONS: Recognition from superiors is important in maintaining nurses' psychological health, HRQOL and job satisfaction. Therefore, managers in hospitals should address the issue of recognition at work as a potential personal, professional and organisational lever.

Psychological capital, grit and organizational justice as positive strengths and resources among registered nurses: A path analysis.

AIM: To examine registered nurses' individual strengths (psychological capital and grit) and an organizational resource (organizational justice) as well as associated work-related outcomes. In a time of a global nursing shortage, there is an urgent need to identify strengths and resources that can have a positive impact on the health, well-being and retention of registered nurses. DESIGN: A cross-sectional survey. METHODS: A nationwide convenience sample of 514 registered nurses responded to a survey. Data were collected using a self-reported questionnaire between March and May 2018. Data were analysed using descriptive statistics and multivariate path analysis. RESULTS: Participants rated their psychological capital and grit moderately high. Grit and organizational justice were found to have significant direct effects on psychological capital. Furthermore, psychological capital had positive direct effects on engagement and the perception of well-conducted everyday nursing as well as negative direct effects on burnout, the stress of conscience and the intent to leave the profession. CONCLUSION: The results suggest that nurse leaders and managers could consider improving registered nurses' well-being with two complementary approaches. It might be useful to reinforce positive, individual strengths, such as psychological capital, and at the same time create more favourable nursing work environments, for example by strengthening organizational justice. IMPLICATIONS FOR THE PROFESSION: Psychological capital and grit are emerging concepts in nursing workforce research. Identifying registered nurses' positive strengths and resources is important for inventing interventions that enhance nurses' engagement and well-being as well as reduce turnover intentions. IMPACT: Nurse leaders and managers play crucial roles in managing and developing registered nurses' individual strengths and organizational resources. This has gained even more importance now as the COVID-19 pandemic could have a long-term negative impact on nurses' well-being. REPORTING METHOD: The study is reported following STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Determining the effect of selected mental factors on turnover intention through two modulators - stress and resilience over COVID-19 period.

INTRODUCTION: Turnover intention among nurses has risen in an alarming rate since the onset of the pandemic. There are various underlying factors to turnover intention. The present study aims to determine the effect of a number of mental factors on nurses' professional-turnover intention through two modulators of stress and resilience over COVID-19 period. METHODS: The current cross-sectional study was conducted at three hospitals in Khuzestan Province, southern Iran, during the winter of 2021. To collect the data, given the restrictions in place during COVID-19 period, the web link of electronic self-reported questionnaires (including general health, mental workload, work-family conflict, resilience, job stress, corona fear, and turnover intention) were sent to 350 nurses through e-mail and other social media (WhatsApp and Telegram). Accordingly, they were asked to complete the questionnaire during rest periods within two weeks. Totally, 300 people (85% participation) filled out the questionnaires. Finally, a model was constructed in the Amos software. RESULTS: The results showed that the four independent parameters of decreasing general health, increasing mental workload, increasing WFCs and fear of COVID-19 can indirectly increase nurses' turnover intention by increasing job stress. Among these variables, the highest indirect effect coefficient on turnover intention was related to the general health parameter (-0.141). The results also demonstrated a negative correlation between job stress and resilience, with lower resilience raising job stress and, consequently, increasing intention to quit the job. CONCLUSION: Mental factors affecting turnover intension were identified in this study through path analysis. Therefore, it is recommended that the required resilience-enhancing measures to be taken by hospitals and nursing administrations to reduce psychological pressures caused by mentioned variables with the aim of minimizing job-related stress and fostering nurse retention.

Effects of Workplace Ostracism on Burnout among Nursing Staff during the COVID-19 Pandemic, Mediated by Emotional Labor.

This study investigated the effects of workplace ostracism on emotional labor and burnout among current nursing staff during the COVID-19 pandemic, as well as the relationship between the surface acting and deep acting of emotional labor as the mediators of workplace ostracism and burnout. The sample for this study consisted of 250 nursing staff recruited from Taiwanese medical institutions, and the questionnaire was divided into two stages. The first stage included questions about ostracism and personal data, and then two months later the same respondents completed part two of the questionnaire regarding emotional labor and burnout, which solved the problem of common-method variance (CMV). The results of this study indicate that ostracism had a positive and significant effect on burnout and surface acting, but its negative effect on deep acting was not supported. While surface acting showed partial mediation between ostracism and burnout, deep acting did not have a significant mediating effect between ostracism and burnout. These results can provide a reference for practice and researchers.

Are America's Caregivers on the Brink of Extinction? The Pandemic Straw that Broke the Nurses' Back.

The coronavirus disease 2019 pandemic has drawn attention to many of the inadequacies of the US health-care system. Perhaps, no profession has felt these shortcomings more than nurses. This female-dominated profession has the potential to suffer a high attrition rate for several reasons, including declining mental health and increasing workplace violence. Nurses have already begun to leave the bedside. Unless significant changes can be made quickly to prevent more of these caregivers from leaving the profession, the health and safety of the US population are at risk.

Nurses' Perceptions of Ethical Conflicts When Caring for Patients with COVID-19.

The COVID-19 pandemic has caused ethical challenges and dilemmas in care decisions colliding with nurses' ethical values. This study sought to understand the perceptions and ethical conflicts faced by nurses working on the frontline during the first and second waves of the COVID-19 pandemic and the main coping strategies. A qualitative phenomenological study was carried out following Giorgi's descriptive phenomenological approach. Data were collected through semi-structured interviews until data saturation. The theoretical sample included 14 nurses from inpatient and intensive care units during the first and second waves of the pandemic. An interview script was used to guide the interviews. Data were analyzed following Giorgi's phenomenological method using Atlas-Ti software. Two themes were identified: (1) ethical conflicts on a personal and professional level; and (2) coping strategies (active and autonomous learning, peer support and teamwork, catharsis, focusing on care, accepting the pandemic as just another work situation, forgetting the bad situations, valuing the positive reinforcement, and humanizing the situation). The strong professional commitment, teamwork, humanization of care, and continuous education have helped nurses to deal with ethical conflicts. It is necessary to address ethical conflicts and provide psychological and emotional support for nurses who have experienced personal and professional ethical conflicts during COVID-19.

The Relationship Between Social Support, Fear, and Psychological Distress Among Frontline Nurses During the COVID-19 Pandemic in Indonesia.

The current cross-sectional study aimed to examine the relationship between social support, fear, and psychological distress among frontline nurses during the coronavirus disease 2019 (COVID-19) pandemic. Participants from 20 wards for adult patients from public and private hospitals in Indonesia were recruited. The Fear of COVID-19 Scale, Job Stress Scale, and Perceived Social Support Questionnaire were used to measure outcomes of interest. Questionnaires were completed by a total of 211 nurses. High risk working unit, higher fear score, younger age, less working experience, and less social support were significant influences on nurses' psychological distress. Social support as a modifiable factor is a potential target for intervention strategies to manage psychological issues among nurses. Findings can help policymakers and managers better understand how to support frontline nurses' psychological health and maintain well-engaged nursing staff. [Journal of Psychosocial Nursing and Mental Health Services, 61(5), 53-58.].

The Mediating Role of Sense of Coherence and Striving for Work-Life Balance on Intention to Leave From Nurses' Burnout.

High turnover and understaffing are significant issues plaguing the healthcare system. Some of the leading reasons of turnover include child-bearing and -rearing, stress related to working, and health concerns. With the onset of the coronavirus (COVID-19) pandemic, this problem of turnover worsened due to increased risk of infection and escalating workload. This study aimed to clarify and validate the effect of burnout on intention to leave among full-time nursing professionals and the structural relationship with sense of coherence (SOC) and striving for work-life balance (S-WLB). Secondary analyses of data obtained from a previous study was carried out; a hypothesized model was tested for goodness of fit and a final model was developed. Burnout directly affected intention to leave (P < .001). It also affected intention to leave through SOC and S-WLB (P < .01); SOC lessened the effect of burnout on S-WLB, therefore reducing its impact on intention to leave. Effective strategies need to be developed to improve the SOC and WLB of nurses to alleviate the effects of burnout and thus reduce the likelihood of turnover. Improving their ability to grasp and deal with emergencies and ambiguous situations, as well as providing emotional and tangible support can be other ways to retain nursing professionals.

Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study.

BACKGROUND: The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. METHODS: This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. RESULTS: A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. CONCLUSION: Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.

The impact of nurses' sense of security on turnover intention during the normalization of COVID-19 epidemic: The mediating role of work engagement.

Background: COVID-19 pandemic has entered a normal stage in China. During this phase, nurses have an increased workload and mental health issues that threaten the sense of security. Poor sense of security may have a considerable impact on turnover intention through low work engagement. It was challenging to maintain the nurse workforce. Fewer studies have been conducted on the effect of nurses' sense of security on their turnover intention in that phase. This study aimed to investigate the interrelationship between nurses' sense of security, work engagement, and turnover intention during the normalization phase of the epidemic in China and to explore the impact of sense of security on turnover intention. Methods: A cross-sectional survey was conducted from September 2020 to May 2021 in Guangdong Province, China. Data were collected online using Sense of Security Scale for Medical Staff (SSS-MS), Utrecht Work Engagement Scale (UWES), and Turnover Intention Scale. Pearson's correlation analysis was used to assess the correlation between sense of security, work engagement, and turnover intention. The hypothesis model used multiple linear regression models and the bootstrapping procedure to analyze the relationship between these variables. Results: Data were collected from 2,480 nurses who met the inclusion criteria. Over half(64.5%) of nurses had a high and very high turnover intention. After controlling the demographic and working variables, sense of security (ß = 0.291, P < 0.001) had a direct positive effect on work engagement. Sense of security (ß = -0.447, P < 0.001) and work engagement (ß = -0.484, P < 0.001) had a direct negative effect on turnover intention. Sense of security and all of its components were associated with turnover intention through the partially mediating effects of work engagement. Conclusions: Nurses' turnover intention was at a high level during the normalization phase of the epidemic. Sense of security and its components act as positive resources to reduce turnover intention by improving work engagement. Policy makers and managers may pay attention to the needs of nurses' sense of security, which may be a new perspective to help managers reduce their turnover intention and stabilize the nurse team.

Evaluation of work conditions of nurses employed in a shift system in hospital wards during the COVID-19 pandemic.

BACKGROUND: Nurses work in a shift system that determines the provision of round-the-clock care of a patient in hospital conditions; however, it entails health consequences. OBJECTIVE: The aim of the study was the evaluation of work conditions of nurses engaged in shift work in hospital wards during the COVID-19 pandemic. METHODS: The study was conducted in 2020, and included 108 nurses working in a shift system in hospital wards. The research method was a diagnostic survey, using an author-constructed questionnaire. RESULTS: 88.9% nurses reported a negative effect of shift work on their physical health: 'musculoskeletal pain', 'elevated arterial blood pressure', and 'hormonal disorders' - 54.5% of respondents used pharmacological treatment. The causes of physical disorders were: 'microclimate', 'physical effort', 'noise', and 'forced body position'. Shift work exerted a negative effect on psychological health of the majority of respondents (75.0%): 'deconcentration', 'sleep disorders', 'feeling of occupational burnout' - treatment in 38.9% of respondents. Psychological health disorders were caused by: 'circadian rhythms disturbance by shift work', 'chronic stresses', and 'conflicts at work'. 69.7% of respondents reported that their shift work was disturbed by organizational factors, including: a 'badly planned work schedule', 'enhanced pace of work due to staff shortage', 'ambiguous division of duties, rights, responsibilities', 'shortages of equipment at the workplace'. CONCLUSION: The examined nurses experienced a negative effect of shift work on their physical and psychological health which, for some of them, was the cause of pharmacological treatment. Many organizational factors hindered the work of nurses in a shift system in hospital wards.

Mediating effect of work stress in the relationship between fear of COVID-19 and nurses' organizational and professional turnover intentions.

Nursing is one of the most stressful and high-risk professions. It is important to identify the psychological problems experienced by nurses during the COVID-19 pandemic and examine the relationship between these problems to devise measures that can properly address them. This study examined mediating effect of work stress in the relationship between fear of COVID-19 and nurses' organizational and professional turnover intentions. Using a cross-sectional research design, this study was conducted on 486 nurses working in seven hospitals in Turkey. The mean age of the participants was 35.24 ± 6.81 and 59.9 % of them were women. The Fear of COVID-19 Scale, the General Work Stress Scale, and the Turnover Intention Scale were used to collect data. A mediation model showed that fear of COVID-19 was positively associated with work stress and organizational and professional turnover intentions. The model also revealed that work stress was positively associated with organizational and professional turnover intentions. Furthermore, the results demonstrated that fear of COVID-19 did not only have a direct effect on organizational and professional turnover intentions but also had an indirect effect on it via increased work stress. Findings improve our understanding of the role of work stress in the relationship between fear of COVID-19 and organizational and professional turnover intentions. The findings are fruitful for tailoring and implementing intervention programs to reduce the adverse psychological impacts of COVID-19 on nurses.

Reducing Staff Turnover and Clinician Burnout With a Structured Support Group During the COVID-19 Pandemic.

Retention and burnout have always been a challenge for nurse leaders, but the pandemic brought these concerns to a whole new level. And now the Great Resignation is affecting health care. So how can nurse leaders at hospitals and health care systems create a supportive environment for staff during a public health emergency? Structured support groups are a viable option for emphasizing self-care and wellness. We explain why we decided to form a structured support group for our intensive care unit nurses and illustrate the results from our clinical research team. In addition, we share feedback we received from participating nurses and offer advice on forming a structured support group in acute care settings. This strategy resulted in a change in the participant's behaviors after attending the structured emotional support group. This finding aligns with the literature, which supports strategies to protect nurses' mental well-being and to take preventive measures in critical situations. Using this as a foundation, a structured emotional support group can change nurse engagement and involvement in their process and practice, during times of crisis. Many other benefits could be realized from this strategy such as improved nursing practice and processes, improved nurse satisfaction, and improved recruitment and retention.

Post-traumatic growth experience of first-line emergency nurses infected with COVID-19 during the epidemic period-A qualitative study in Shanghai, China.

Background: In March 2022, Shanghai, China, was hit by a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The medical staff was greatly infected during this period, which posed a traumatic event for them. Meanwhile, they also experience post-traumatic growth under introspection and positive change. However, the psychological coping and growth after infection with COVID-19 among medical staff have rarely been investigated. Objectives: To explore the process and influencing factors of post-traumatic growth among emergency nurses infected with coronavirus disease (COVID-19) so as to provide a new perspective and theoretical basis for psychological rehabilitation or intervention for medical staff who experienced traumatic events. Methods: The study used a qualitative design based on the phenomenological approach. A purposive sampling method was used to explore the subjective feelings and post-traumatic growth among 13 first-line emergency nurses infected with COVID-19 in Shanghai, China. Semi-structured face-to-face interviews were conducted in June 2022. A Seven-step Colaizzi process was used for data analysis. Results: Themes were described and extracted from the experience and insights at different stages during the fight against the virus. Three main themes, i.e., stress period, adjustment period, and growth period, as well as several sub-themes, were identified. Conclusion: First-line emergency nurses infected with COVID-19 are a sensitive group that should be given more attention. Investigating how they achieve psychological adjustment and growth in the case of severe trauma can provide valuable references for nursing management and education in the future. Society, hospital and nursing managers should pay more attention to the PTG of nurses and establish supportive PTG strategies, which will benefit the retention rate and career development of nurses.

"Endless Vicious Circle ..." Psychosocial Difficulties and Needs of Nurses Working in the Emergency Department During the COVID-19 Pandemic.

Emergency nurses are one of the groups at risk most during the COVID-19 pandemic. The purpose of the authors of this qualitative study was to reveal the psychosocial difficulties and needs of nurses working in the emergency department of a university hospital during the COVID-19 pandemic. This descriptive phenomenological study was conducted in the emergency department of a university hospital in the West of Turkey. In-depth interviews were conducted with 14 emergency nurses. Colaizzi's descriptive analysis method was used. Findings regarding the psychological difficulties and needs of nurses during the COVID-19 pandemic were collected under the following 4 themes: being a nurse in the emergency department in the pandemic, emotional chaos, living with losses, and the support needs. Not only did the emergency nurses state that working as a nurse in the pandemic was challenging and exhausting but they also emphasized the vital importance of nursing care in the pandemic. During the pandemic, the nurses went through different emotional processes according to the stages of the pandemic. Although they needed psychological support, they were expected to meet organizational requirements.

Professional commitment, resilience and intent to leave the profession among nurses during the COVID-19 pandemic - a descriptive study.

AIM: The three-component model of commitment, resilience and selected nurse characteristics were tested as predictors of nurses' intent to leave the profession. BACKGROUND: In the wake of the COVID-19 pandemic, news reports suggest that a mass exodus of nursing professionals is occurring. METHOD: This nonexperimental, descriptive, correlational, predictive study used a cross-sectional approach to collect survey data from a convenience sample of 189 registered nurses (RNs) who were providing direct patient care in adult inpatient units with a high likelihood of admitting patients diagnosed with COVID-19 and met other eligibility requirements. RESULTS: Most (73.5%) plan to remain in the nursing profession and feel highly resilient. Only affective commitment demonstrated a significant relationship to the intention to leave the nursing profession. CONCLUSIONS: The study was conducted after the pandemic had been in effect for a prolonged time, and it is likely the nurses with the intent to leave the profession had already left. The findings provide a glimpse of a sample of nurses drawn from a population likely much different from only a few months prior. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies to retain nurses should include efforts to strengthen professional commitment and build resilience.

A year after COVID-19: Its impact on nurses' psychological well-being.

BACKGROUND: Nurses' burnout and psychological well-being are a significant concern during the pandemic. AIMS: The aim of this study is to (i) examine the level of burnout, anxiety, depression, perceived stress and self-rated health for nurses at two time-points, 2020 and 2021, and (ii) examine the socio-demographic characteristics, work-related factors and perceived workplace support factors in relation to the level of burnout. METHODS: This is a cross-sectional study with a longitudinal approach. A convenience sample of registered nurses who worked in an acute care tertiary hospital in Singapore were surveyed during two time-points. Participants' health, socio-demographic characteristics, work-related factors and perceived workplace support factors were collected. RESULTS: Among the 179 nurses, there was a significant increase in burnout level, poorer self-rated health and reduced job dedication. A decrease in the percentage of nurses who felt appreciated at work was reported in 2021 (p = 0.04). Nurses who felt their team was not working well together were 3.30 times more likely to experience burnout (95% CI 1.12 to 9.69; p = 0.03). Nurses who reported that they never felt appreciated by their department/hospital were 8.84 times more likely to experience burnout (95% CI 2.67 to 29.21; p < 0.001). Nurses with poorer self-rated health were more likely to report burnout (95% CI: 1.32-6.03; p = 0.008). CONCLUSION: Nurses had an increased experience of burnout, reduced job dedication and poorer self-rated health after the outbreak. IMPLICATIONS FOR NURSING MANAGEMENT: Interventions at the departmental and organizational levels are needed to improve the workplace support. Strategies to support nurses' psychological well-being during the aftermath of COVID-19 are vital to managing nurses' burnout and improving job dedication and self-rated health.