Law enforcement is a stressful occupation that places significant psychological demands on those serving in this role. However, little is known about the severity of work-related stress and psychological distress among law enforcement officers (LEOs) in North Carolina (NC). This cross-sectional study examined the severity of work-related stress and psychological distress among 283 LEOs in NC. The Maslach Burnout Inventory, the Operational Police Stress Questionnaire, the Depression, Anxiety, and Stress Scale, and the Post-Traumatic Stress Disorder (PTSD) Checklist were used to assess burnout, operational police stress, depression, anxiety, stress, and PTSD among LEOs. Descriptive statistics, independent t-tests, Mann–Whitney U tests, one-way ANOVA, and Kruskal–Wallis tests were performed. Rural and male LEOs reported higher burnout levels related to depersonalization (i.e., increased mental distance from one’s job) compared with their urban and female counterparts. LEOs exposed to toxic materials or performing patrol duties exhibited higher operational police stress levels than those who did not. Caucasian LEOs exhibited higher depression, anxiety, and stress than their African American counterparts. Rural LEOs and LEOs who were exposed to toxic materials displayed higher levels of PTSD than their counterparts. Our findings highlight the need for increased mental health support and better working environments for LEOs.

Background: Clinician well-being is crucial to the healthcare system, particularly during the COVID-19 pandemic, which intensified psychological distress among clinicians. This study examines well-being disparities between rural and urban clinicians using the NIOSH Worker Well-Being Questionnaire (WellBQ). Methods: A cross-sectional survey was conducted with 222 clinicians from one urban and three rural hospitals in North Carolina between September and December 2022. The WellBQ assessed well-being across five domains. Data analysis identified concerning thresholds based on positive and negative responses, with discrepancies resolved through independent reviews and focus group validation. Findings: In the work evaluation and experience domain, rural hospitals reported concerns with time paucity and work overload, while urban hospitals focused on work-related fatigue and job engagement. Rural hospitals noted issues with job benefits, health programs, and schedule flexibility, whereas urban hospitals emphasized the lack of supportive work culture and management trust. Both settings reported concerns in the physical environment and safety climate domain, including sexual harassment, physical violence, and bullying. Health status concerns in rural hospitals included overall stress and poor mental health, while urban hospitals highlighted chronic health conditions and risky drinking. Conclusion: This study identified significant well-being disparities between rural and urban clinicians, with urban hospitals showing higher concerning thresholds. Future research should refine these thresholds, explore workplace violence causes, and assess long-term impacts on clinician well-being. Applications to Practice: This study reveals significant well-being disparities between rural and urban clinicians, emphasizing the need for tailored occupational health interventions.

Purpose: Critical access hospitals (CAHs) play a crucial role in rural healthcare, especially during crises (e.g., the COVID-19 pandemic). This study addresses how changes in swing bed operations from spring to fall of 2020 influenced CAHs by focusing on their operations, staff experiences, and community engagement. Sample: Fourteen staff from five CAHs in the US participated in this study. Method: Descriptive, qualitative research design with semi-structured interviews. Findings: During the first year of the COVID-19 pandemic, CAHs faced challenges in maintaining swing bed operations due to resource constraints and increased patient volumes, leading to changes in swing bed operation. The findings highlight four team approaches adopted by CAHs during the changes in swing bed operations: (1) implementing innovative patient care strategies, (2) providing support, (3) strengthening community bonds, and (4) empowering community education. Staff developed innovative patient care strategies (e.g., using baby monitors) due to insufficient standardized protocols, equipment, and in-house care for severe cases. Telehealth became a critical tool to maintain patient care amidst staff shortages and patient reluctance to visit clinical settings. Community support, including local residents and retired healthcare professionals, played a crucial role in meeting the demands. Upper management highlighted cross-training, financial incentives, and role adjustments to address staffing shortages and enhance team unity. CAHs actively engaged in community education and support through various platforms to provide information on COVID-19, testing, and vaccinations. Conclusions: Collaboration among CAH staff and strong community support facilitated effective resource management and a return to pre-pandemic operational levels. This study underscores the importance of CAHs in rural healthcare during crises and highlights the need for continued support and investment in these essential healthcare providers to ensure they can sustain operations and effectively respond to future health emergencies. DOI: https://doi.org/10.14574/ojrnhc.v24i2.777

Nursing shortages in the United States (U.S.) have increased reliance on internationally educated nurses (IENs), yet their workplace outcomes remain poorly understood. This scoping review synthesized peer-reviewed empirical studies examining IEN workplace outcomes and associated individual characteristics and work conditions. Findings from 34 studies published between 2004 and 2025 showed that IENs generally reported moderate to high job satisfaction, while burnout findings suggested moderate to high occupational strain. Evidence on intention to leave was limited by inconsistent measurement and insufficient reporting. Workplace outcomes were most consistently associated with organizational conditions, particularly workload, discrimination, leadership support, orientation, and organizational commitment. Individual characteristics, including age, host-country tenure, and sociocultural adaptation, showed less consistent associations. Interpretation was limited by heterogeneity in study designs, outcome measures, and international settings. Future research using standardized measures and longitudinal or mixed-methods designs is needed to inform organizational practice and workforce policy supporting IEN well-being and retention.