Nurses At-Risk for Mental Health Distress and Suicidality Describe Stressors and Strategies for Healthcare System Change: A Thematic Analysis

OBJECTIVE: Analyze qualitative baseline data from a randomized controlled trial to identify factors that drive stressors among at-risk nurses and identify their desired actions to improve health/well-being. BACKGROUND: Reducing nurse suicide is a national imperative. METHODS: Prospective nurse cohort deemed at-risk of adverse mental health outcomes, including suicidality. Inductive reflexive thematic analysis (n = 466) of survey responses regarding stressors and solutions for positive change. RESULTS: The nurses' caring identity can cross work/life boundaries and become all-consuming with health consequences. Themes driving stressors include suboptimal work environments, mental/physical health issues, financial insecurity, and unmet relationship and familial obligations. Participant suggestions include transforming workplace culture/resources and providing resources for holistic mental health support and practices, financial planning, and career transitions. CONCLUSION: When obligations and expectations exceed capacity, the price of caring results in a deterioration in mental and physical health. Leaders must holistically address these concerns within suicide prevention/well-being programs.