Background:Integration and retention of internationally educated nurses (IENs) play a vital part in ensuring the sustainability of our healthcare systems. Historically, the focus of support has been placed on the IENs to adapt to the new country, failing to recognize the role of the receiving workplace. A one-time funding was provided by the Ontario government to develop a program preparing healthcare employers and IENs for integration into the Canadian healthcare workforce. Aim:To describe the finding of a workplace integration program (WIP) - based on a continuous evaluation of each program component that prepares employers, nursing leaders, members of the interprofessional team and IENs for the integration of IENs into the Canadian healthcare workforce. Strategy:Incorporating our lived experiences in supporting IENs and feedback from IENs, the CARE Centre for Internationally Educated Nurses (CARE Centre) invited employer partners to co-design the WIP and provide evaluation results to each participating healthcare organizations. Result:From January 2024 to the end of 2025, 22 organizations and close to 1,000 persons participated in the WIP. A mixed-methods approach was employed to evaluate the results of surveys completed by participants after each session of the WIP. Participating organization evaluation results revealed that over 90% of participants find the strategies provided by the program useful in strengthening their abilities in supporting IENs' integration into their interprofessional team, recruitment strategies of IENs and client- and family-centred care. Conclusion:The WIP provided concrete strategies for employers and the healthcare team for integrating and retaining IENs. Ongoing participating organization evaluations allow for continuous improvement and rapid changes to meet institutional needs.
The purpose of this paper is to identify studies of hospital-based occupational stress prior to the COVID-19 pandemic that can offer lessons to nurse leaders in our current post-pandemic environment. A scoping review was conducted based on the Joanna Briggs Institute framework, including key phases and principles identified by Arksey and O'Malley. Evidence from different disciplines and settings has been relatively siloed. Nurses and doctors have tended to be studied separately using different constructs. Progress in developing more effective interventions to mitigate occupational stress in healthcare may require greater cross-disciplinary collaboration in which nurse leaders are well poised to lead.
Background:Leadership is vital for fostering work environments that support nurses' well-being, job satisfaction and high-quality patient care. This study examined the role of empowering leadership in shaping nurses' perceptions of a healthy work environment (HWE) and moral injury. Methods:A cross-sectional design was used with a convenience sample of nurses from an Italian public healthcare organization. Data were collected through an online survey, incorporating the Empowering Leadership Questionnaire (ELQ), the N2N-HWE and the Moral Injury Events Scale (MIES). Pearson's correlations and a multivariable linear regression model analyzed the relationship between ELQ, N2N-HWE and MIES. Results: Of the 155 nurses who participated (78.1% females, mean age = 34.06 ± 10.03 years), 92.9% perceived their work environment as unhealthy, and 31.6% reported high levels of moral injury. No direct association was found between HWE and moral injury (β = 0.03; 95% CI: -0.46, 0.53). However, a statistically significant interaction between HWE and empowering leadership on moral injury was observed (β = -0.08; 95% CI: -0.16, 0.002). Conclusions:Empowering leadership may buffer the negative impact of unhealthy work environments on nurses' moral injury, highlighting its protective role and the need for leadership-focused interventions in high-demand healthcare settings.
The Integrated Filipino Canadian Nurses Association (IFCNA) represents a vital community-driven response to the challenges faced by internationally educated nurses in Canada. Founded in 2019, this federally registered non-profit organization primarily provides comprehensive support for Philippine-educated nurses navigating the complex Canadian healthcare system. This leadership profile presents insights from IFCNA's founding chair, Austine Gaqui, and immediate past president, Mark Anthony Gravoso, highlighting the organization's programs, challenges and advocacy efforts. Through mentorship, skills development and policy engagement, IFCNA embodies the Filipino cultural value of bayanihan, a strong sense of civic unity and co-operation traditionally practised by Filipinos, demonstrating how grassroots organizations can address systemic barriers while building a supportive professional community. This profile offers nurse leaders insights into how collaborative partnerships with organizations such as IFCNA can strengthen workforce integration and advance equity in nursing.
Nurse practitioners (NPs) report concerning levels of burnout that can negatively impact patient outcomes and job turnover. Little is known about how NPs effectively navigate their practice and mitigate worklife stressors. Using a constructivist grounded theory approach, this study explored this gap by investigating burnout, job satisfaction and resilience among 10 hospital-based NPs. Data analysis revealed three key themes: (1) making a difference … keeps me going; (2) finding the sweet spot; and (3) being the safety net. Promoting a healthy work environment requires a targeted plan that involves colleagues, educators and leaders who together address NPs' workplace tensions.
The 2026 International Workforce Forum highlighted a projected global shortage of 11 million health workers by 2030, more than half of whom are nurses. This paper examines the Forum's findings through a Canadian policy lens, drawing on the Canadian Nurses Association's Policy Roadmap for 2025 and Beyond and recent national workforce data. It identifies converging challenges, including workforce shortages, underutilization of nursing scope, barriers to mobility and declining workforce well-being. The analysis positions Canadian policy priorities as both aligned with and responsive to global imperatives, arguing that nursing leadership and strategic investment are essential to system transformation. This article establishes the foundation for focusing on the experience of internationally educated nurses and nurses' mental health and well-being.
Canadians living with mental illness experience poor access to care, worse health outcomes and premature mortality. Nurse practitioners (NPs) are uniquely positioned to address these inequities, yet their role in mental health remains underoptimized. This commentary highlights three evidence-informed priorities for nurse leaders: (1) removing systemic barriers to NP role integration, (2) strengthening NP education in mental health and (3) leveraging nursing leadership to drive policy and practice change. Drawing on recent evidence of the critical role of nurse leaders in integrating physical and mental healthcare, we stress the importance of nurse leader advocacy across policy, organizational and clinical domains, to champion the NP role and its contribution to comprehensive care. Doing so will improve mental healthcare delivery and reduce disparities. The time for action is now.
How to implement trauma-informed organizational cultures that advance psychological safety and processes within the larger leadership and organizational contexts was identified as a gap. This modified rapid review was guided by principles outlined by Tricco and the methodological framework by Arksey and O'Malley for scoping reviews. Results showed four thematic areas (leadership practices, organizational culture, training and education and policy) in which trauma-informed organizational and leadership practices can be implemented to support workers. In conclusion, trauma-informed leadership practices are best enabled within a broader, intentional organizational approach to supporting workplace psychological health and safety.
The intensifying climate crisis poses significant challenges to healthcare systems, including extreme weather events, rising temperatures and evolving disease patterns. In response, healthcare leaders must both adapt care delivery and pursue system-wide decarbonization. Nursing roles are expanding to include advocacy for planetary health, with educational programs working to equip nurses for climate-responsive practice. This commentary presents examples of nursing leadership in climate resilience and calls on healthcare organizations to leverage the profession's capacity to lead efforts integrating planetary health into sustainable, climate-resilient patient care.
Nursing workforce data development, standardization and liberation enable enhanced evidence-informed planning, staffing decision making and quality improvement initiatives. This commentary discusses how the nursing profession can work collaboratively to create an agile, responsive nursing workforce to meet patient needs and respond to broader health system goals through the optimal use of data, and describes data initiatives in progress that can assist nursing leaders to understand how to prepare the nursing workforce for a changing world. The data generated at registration by nursing regulators is a particularly strategic opportunity to leverage efforts to standardize and optimize data for such needed planning.
Nursing regulators must uphold their mandate to protect the public amid increasing scrutiny and shifting expectations. As understandings of the public interest evolve, so too must regulatory policy and practice. In this commentary, we explore the role of nursing regulation in addressing system-level challenges, including workforce dynamics, racism, misinformation and planetary health. Stronger investment by governments and nursing leadership in regulatory research, as well as support for partnerships between regulators and researchers, can help build an evidence base demonstrating the unique role of regulation in not only supporting a safe, competent workforce but also advancing equity and sustainability in health systems.
Nursing's moral imperative toward anti-racism has been vital in opening spaces of critical dialogue within the discipline and profession. Yet, solely focusing on a moral mandate is limiting by risking professional precarity and moral distress. A renewed reflection is required to address the material and structural conditions that impede sustained anti-racism action. Nursing leaders are well-positioned to undertake anti-racist worldmaking through their commitments for a political imperative.
The contemporary debate on equity, diversity and inclusion (EDI) in nursing practice has been affected by numerous intersecting forces. In this commentary, we draw on insights from Bukola Salami's 15-year research program, which offers critical perspectives on how racism, migration status, labour precarity, social inequities and institutional structures influence the health and well-being of Black and immigrant populations across the life course. For researchers, practitioners and legislators dedicated to promoting EDI inside health systems and associated social institutions, her corpus of work offers useful evidence. Significant implications for clinical nursing practice, leadership and research are also outlined.
We are living in increasingly complex and uncertain times that demand both resilience and agility. A reality that is made ever more challenging in healthcare environments that face long-standing pressures to do more with less by a healthcare workforce that often is exposed to great personal and professional strain. Adopting and actioning principles of trauma-informed organizational culture and leadership can provide a pragmatic and responsive framework that can bolster health worker well-being and system agility in the face of adversity.
It's no surprise to anyone to have us say that we are living in challenging times. Though some may have thought that a postpandemic world would see the recovery and stabilization of economies, healthcare systems and workforces, at times it feels somewhat similar to a never-ending era of calamity. We continue to live in a time of polycrisis - from economic instability exacerbated by ongoing global trade wars, struggling health workforces impacting the accessibility and availability of healthcare services, to worsening planetary health exacerbating food and water insecurity, physical and mental health issues, health inequities and forced migration and displacement. We are severely off track to meet the United Nations' Sustainable Development Goals (SDGs) by 2030 (UN 2015). Nurses and nurse practitioners are leaving the profession at record numbers, with many leaving just within the first few years of being licensed (Faubert 2025). Working conditions remain a challenge across provincial and territorial health systems (CFNU 2025). Yet, while the future may look bleak, these wicked problems are not impossible to fix. Indeed, this is our new normal - a constantly changing world that, now more than ever, needs our resolve to create a healthier future for all.
The COVID-19 pandemic intensified Canada's nursing shortages, increasing reliance on internationally educated nurses (IENs) as a solution for these vacancies. IEN integration strategies vary across Canadian provinces and territories, driven by contextual needs and available resources. This discussion paper provides a high-level overview of IEN integration in Canada, offering practical recommendations for nursing leaders to develop an ethical, equitable and sustainable nursing workforce. We outline the benefits of investing in improvements to IEN integration and the value it plays in achieving the United Nations' Sustainable Development Goals. This requires equity-focused reforms at macro-, meso- and micro-levels to fully utilize IEN expertise and experiences.
Artificial intelligence (AI) offers many opportunities for nursing to improve health outcomes and contribute to meeting the Sustainable Development Goals nationally and globally. However, it also presents challenges to meeting these goals and keeping pace with innovation, which nurses must anticipate and mitigate. Canadian nurse leaders are well-positioned to guide transformative change in the nursing workforce, ensuring that nurses have the competencies and resources needed to thrive in AI-supported care environments. This not only allows nurses to better adapt to AI but also leverages new skills to take on more significant roles in improving healthcare on a wider scale.
The role and influence of nursing associations (NAs) are evolving, making their collective power more vital than ever. This reflective piece traces my professional journey from direct care to executive leadership, showing how active engagement in NAs shaped my career and deepened my understanding of their pivotal impact on the nursing profession and health policy across Canada. Readers are invited to consider a nursing leadership challenge and reflect on their own involvement with provincial/territorial NAs and the Canadian Nurses Association. Amid current system pressures, united and active participation in NAs is essential to strengthen nursing's voice and drive meaningful, lasting change.
The world is off-track to meet most of the health-related Sustainable Development Goal (SDG) targets by 2030, including SDG 3.8, universal health coverage (UHC). A sustainable nursing workforce is needed to advance UHC. This paper discusses key issues surrounding the global nursing shortage and offers solutions for the Canadian context to build a sustainable nursing workforce and strengthen health systems to improve access to care for all. Primary healthcare, investment in nursing and enhanced nursing leadership capacity are just a few of the proposed policy levers discussed.
