Background: Healthcare organizations are now challenged to retain nurses’ generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses’ dedication, commitment, satisfaction, and loyalty to their organization. Purpose: This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses’ organizational commitment, job satisfaction, and turnover intention. Methods: A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection. Findings: The result revealed positive significant correlations between nurses’ perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses’ turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention. Recommendation: Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses’ commitment and satisfaction and decreasing their turnover intention.

Background: Implementing digital transformation and artificial intelligence (AI) in education and practice necessitates understanding nursing students’ attitudes and behaviors as end-users toward current and future digital and AI applications. Purpose: This study aimed to assess the perceived knowledge, attitudes, and skills of nursing students regarding digital transformation, as well as their digital health literacy (DHL) and attitudes toward AI. Furthermore, we investigated the potential correlations among these variables. Methods: A descriptive correlational design was employed in a Saudi nursing college utilizing a convenience sample of 266 nursing students. A structured questionnaire consisting of six sections was used, covering personal information, knowledge, skills and attitudes toward digital transformation, digital skills, DHL, and attitudes toward AI. Descriptive statistics and Pearson correlation were employed for data analysis. Results: Nursing students exhibited good knowledge of and positive attitudes toward digital transformation services. They possessed strong digital skills, and their DHL and positive attitude toward AI were commendable. Overall, the findings indicated significant positive correlations between knowledge of digital transformation services and all the digital variables measured (p = < 0.05). Senior students reported greater digital knowledge and a positive attitude toward AI. Conclusion: The study recommends an innovative undergraduate curriculum that integrates opportunities for hands-on experience with digital healthcare technologies to enhance their digital literacy and skills.

Background: Today, healthcare organizations are challenged to retain nurses’ generation and to maintain justice that is a predictor of nurses’ behaviors in their work environment. Acquiring knowledge about the level of organizational justice and workplace deviance could help in identifying factors amenable for change that can make a difference in enhancing nurses’ dedication and loyalty to their organizations. Aim: The aim of this study was to investigate nurses’ perception of organisational justice and workplace deviance in their hospital, and to determine the relationship between perceived organisational justice and workplace deviance. Methods: A cross-sectional design was used with a convenient sample of all nurses (N = 400) who were working in inpatient care units at two Egyptian hospitals affiliated to the university and private health sectors in Alexandria governorate, Egypt. Organisational justice and workplace deviance questionnaires proved valid and reliable to measure studied variables. Descriptive analysis, Student’s t-test, Pearson correlation (r), and regression analysis (R²) were used for statistical analysis. Ethical considerations: This study was approved by the Ethics Committee at the Faculty of Nursing, Alexandria University. Informed consent, information confidentiality, and voluntary participation were guaranteed. Results: This study showed that overall nurses’ perceptions of organisational justice and workplace deviance are lower than the average. Organisational justice significantly related negatively to workplace deviance (r = −0.152, p = 0.002) and organisational justice as an independent variable contributed a significant predictive power of workplace deviance (R² = 0.023). Conclusions: This study highlighted important implications for hospital and nurse managers to create and maintain a healthy and supportive work environment that promotes organisational justice and decreases workplace deviance. To achieve this, a culture of respectful communication, justice in policies, and a proper procedure for allocating resources, workload, and rewards systems is a must. Educational interventions to increase nurses’ awareness of workplace deviance and its potential consequences and coping strategies are imperative for the health of the nursing profession.

Background: A brain drain is a migration of employees in their quest for an improved level of living conditions, better earnings, access to advanced technology and secure political conditions in diverse places worldwide. The brain drain of nurses is an ongoing phenomenon that impacts the quality and quantity of the nursing workforce and affects the quality of care. The nurses' brain drain is commonly known as a result of the interplay of many factors. So, identification of these factors and how to manage them is a timely topic in nursing research. Aims: This study aims to investigate determinants of the nurses' brain drain and mitigating factors from nurses' perspectives in Egypt. Methods: Mixed-methods research was conducted using a concurrent triangulation design. A sample of 325 nurses who were working at an Egyptian university hospital answered a brain drain questionnaire while the qualitative investigation was guided by a semi-structured interview with a purposive sample of 35 nurses to elicit exploratory perspectives on factors causing brain drain and mitigation strategies. Results were analysed using inferential statistics and thematic data analysis. Results: Both push and pull factors can predict about 99.6% and 97.5% of the nurses’ brain drain, respectively. Seven themes were derived from the qualitative content analysis, and six themes were categorised under ‘push-pull’ factors. In addition, the ‘mitigating factors theme’ was identified with five sub-factors as possible solutions. Economic and work environment reasons were reported as the most influential for nurses’ brain drain. Conclusions: Policymakers could use the identified factors from quantitative and qualitative data for creating a system that would improve nurses' conditions and policies, and prevent nurses' migration. Nursing leaders have a significant role with non-remuneration strategies in retaining nurses through creating an empowering work environment. In addition, shared governance, a strong nursing syndicate role and professorial marketing would be essential mitigating factors for the nurses' brain drain.

Objective: Digital empathy is an emerging concept in telehealth nursing, emphasizing emotional engagement and compassionate communication in virtual care settings. Despite its importance, digital empathy remains underexplored. This concept analysis aims to define digital empathy in nursing, explore its key attributes, antecedents, consequences, challenges, and actionable recommendations for practice. Methods: Using Walker and Avant's eight-step framework, a comprehensive literature review was conducted on digital empathy in telehealth nursing. A total of 52 sources were reviewed, comprising 46 research articles, four books, and two web pages, published between 2000 and 2024. Results: This concept analysis identifies key attributes of digital empathy in nursing, including authenticity, trust-building, communication effectiveness, emotional engagement, adaptability, technological proficiency, and cultural sensitivity critical for meaningful connections in telehealth. Antecedents encompass digital literacy, emotional intelligence, supportive infrastructures, and cultural competence, emphasizing individual, contextual, and organizational factors. Consequences include enhanced patient satisfaction, trust, adherence to treatment, improved nurse well-being, and organizational benefits such as team cohesion and reduced staff turnover. Challenges such as cultural variability, technological limitations, and the lack of validated measurement tools highlight barriers to effective implementation. Conclusion: This concept analysis underscores the vital role of digital empathy in telehealth nursing. By incorporating its attributes and antecedents, healthcare organizations can enhance patient outcomes and foster supportive, patient-centered environments. Addressing measurement and technological gaps will be pivotal in fully realizing the benefits of digital empathy in telehealth. Actionable recommendations include implementing targeted training, developing standardized tools, and leveraging artificial intelligence advancements to enhance empathetic communication in telehealth.

Introduction: Shift work and demanding work schedules contribute to occupational fatigue, negatively affecting patient safety and nurses’ well-being, consequently placing nurses and patients at risk for injury and adverse health outcomes. For preventing fatigue and minimizing its negative consequences, information about its characteristics and associated factors is required. Objectives: This study aimed to assess occupational fatigue “acute fatigue, chronic fatigue, and inter-shift recovery” among Saudi nurses working 8-h shifts. Further, we explored factors associated with fatigue from nurses’ perspectives. Methods: We conducted a mixed-method study with a convenience sample of Saudi nurses ( N = 282) working in four public hospitals in Saudi Arabia. Data were collected using the nurses’ profile form; the occupational fatigue exhaustion recovery (OFER) scale, for relevant quantitative data; and open-ended questions for qualitative data. We used descriptive and inferential statistics for analysing the quantitative data and content analysis of the qualitative data. Results: The results showed that Saudi nurses rated themselves moderately fatigued with working 8-h shifts. The inter-shift recovery subscale showed a negative correlation with chronic fatigue and acute fatigue ( r = −0.518, r = −0.356, P < 0.001). Sleeping problems, meals per day, and frequency of exercise showed significant relations with chronic fatigue among nurses ( p < 0.05). In addition, three categories were derived from the qualitative content analysis. Saudi nurses reported work-related, psychosocial, and individual factors as major contributors to fatigue and recovery. Conclusion: Occupational fatigue is a multidimensional issue, and nurses and nurse managers are challenged with reducing its prevalence and negative impact on nurses and patients. Our quantitative and qualitative findings suggest the need for a comprehensive approach to fatigue management and mitigation, including organizational support, creative workforce planning, flexible work schedules, and psychosocial support. Fatigue reduction and prevention policies and educational programs are vital strategies to improve nurses’ well-being and inter-shift recovery.