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The perioperative nursing workforce continues to experience shortages. This scoping review on literature published between January 2013 and December 2023 aimed to map the evidence on prelicensure program innovations supporting immersive clinical learning in perioperative nursing. The review included 25 articles from the United States, Canada, and New Zealand focusing on program descriptions, evaluations, and curriculum components. The findings highlighted the importance of academic‐practice partnerships in developing effective learning opportunities and addressing recruitment and retention challenges. Key components identified included structured practicum lengths, diverse teaching strategies, and preceptor support. The review emphasized the need for well‐designed clinical practice courses to provide positive student experiences and support entry‐level competencies. Limitations included language restrictions and exclusion of short‐term programs. Final recommendations included enhancing academic‐practice collaborations, developing creative solutions for resource generation, and conducting additional research on the effect of clinical course design on learning and retention.

The term bullying describes negative behaviour most frequently associated with childhood school conduct. However, bullying frequently occurs among adults across diverse professional working environments. Being bullied is a common experience for nursing students and is seen as an unavoidable feature of the clinical practice environment. The literature reports multiple negative impacts on student learning, health care team functioning, quality of care, and future retention in and satisfaction with the nursing profession. Despite decades of research and interventions, bullying persists. Conceptual clarification of bullying is needed to further understand this phenomenon and develop sustainable interventions to reduce and eliminate bullying in nursing. This evolutionary concept analysis contributes to dialogue on the need for continued clarity and further research on the phenomenon of bullying in the practice environment through reflecting the changes and adaptations that continue in the nursing profession. Ongoing research of the concept of bullying will address the aim of developing and maintaining a concept that is both relevant and useful to the nursing discipline.

One goal of qualitative health research is to fully capture and understand stories of people who experience inequities shaped by complex interlocking structural and social determinants. With this social justice–oriented goal in mind, it is critical to use a methodological approach that appreciates prevailing inequities and oppression. In this article, we propose an innovative approach that joins qualitative health research methodology with critical inquiry. Specifically, we propose advancing constructive grounded theory (CGT) through applying intersectionality as an emergent critical social theory and an analytical tool. With our proposed approach being novel, minimal attempts to conceptualize and operationalize CGT with intersectionality exist. This article focuses on initiating theoretical conceptualization through focusing on demonstrating congruency. We are guided by this focus to seek connectedness and fit through analyzing historical and philosophical assumptions of CGT and intersectionality. In our article, we demonstrate congruency within four units of analysis: reflexivity, complexity, variability, and social justice. Through these units, we offer implications to applying intersectionality within CGT methodology. These include a foundation that guides researchers toward further conceptualizing and operationalizing this novel research approach. Implications also include innovatively exploring complex population groups who face structural inequities that shape their lived vulnerabilities. Our proposed research approach supports critical reflection on the research process to consider what shapes the researcher–participant relationship. This includes reflecting on analysis of power dynamics, underlying ideologies, and intermingling social locations. Thus, our conceptual paper addresses the call for evolving social justice methodologies toward inquiring into complex populations and generating knowledge that challenges and resists inequity.

Background Promoting health equity and reducing heath inequities is a foundational aim and ethical imperative in public health. There has been limited attention to and research on the ethical issues inherent in promoting health equity and reducing health inequities that public health practitioners experience in their work. The aim of the study was to explore how public health providers identified and navigated ethical issues and their management related to promoting health equity within services focused on mental health promotion and preventing harms of substance use. Methods Semi-structured individual interviews and focus groups were conducted with 32 public health practitioners who provided public-health oriented services related to mental health promotion and prevention of substance use harms (e.g. harm reduction) in one Canadian province. Results Participants engaged in the basic social process of navigating conflicting value systems . In this process, they came to recognize a range of ethically challenging situations related to health equity within a system that held values in conflict with health equity. The extent to which practitioners recognized, made sense of, and acted on these fundamental challenges was dependent on the degree to which they had developed a critical public health consciousness. Ethically challenging situations had impacts for practitioners, most importantly, the experiences of responding emotionally to ethical issues and the experience of living in dissonance when working to navigate ethical issues related to promoting health equity in their practice within a health system based in biomedical values. Conclusions There is an immediate need for practice-oriented tools for recognizing ethical dilemmas and supporting ethical decision making related to health equity in public health practice in the context of mental health promotion and prevention of harms of substance use. An increased focus on understanding public health ethical issues and working collaboratively and reflexively to address the complexity of equity work has the potential to strengthen equity strategies and improve population health.

The ways in which we understand and respond to perinatal substance use are explicitly and implicitly driven by policy. Perinatal substance use is a visible manifestation of intersecting systems of oppression, shaped by racist, colonial and sexist discourses surrounding mothering and drug use. Policies related to perinatal substance use and mental health have far-reaching impacts on families, communities and generations. This scoping review examined the conceptualization and operationalization of equity within foundational perinatal policies in one Canadian province, British Columbia (BC), between 2005 and 2025. Documents were included if they were: (1) provincial-level policy documents that either (a) guided perinatal service delivery generally or (b) focused on mental health promotion, prevention of mental disorders or harms of substance use; (2) publicly available; and (3) published within the study timeframe. Inductive content analysis and sensitizing questions were used to explore how equity concepts were conceptualized and integrated. In total, 30 documents met inclusion criteria. Equity was mentioned in 15, but only 4 provided explicit definitions. Often, implied proxy terms for equity were substituted to discuss equity considerations, such as risk, disadvantage, social determinants of health, vulnerable, marginalized and harm reduction, with limited direction on public health system roles or accountability in addressing root causes of inequities. Content analysis yielded the following missed opportunities in the results: an absence of clear definitions; focus on accessibility; inattention to structural conditions; and incoherent concepts of equity. Given BC’s reputation as a leader in equity-oriented perinatal substance use policy, these gaps are notable. In the context of an expanding drug poisoning crisis and increasing global recognition of equity as foundational to public health, it is imperative to examine how equity is understood and actioned in policy to strengthen alignment between intentions and outcomes.

Background Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use. Methods As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. Results Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control. Conclusions Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.

Background Health system policies and programs that reduce health inequities and improve health outcomes are essential to address unjust social gradients in health. Prioritization of health equity is fundamental to addressing health inequities but challenging to enact in health systems. Strategies are needed to support effective prioritization of health equity. Methods Following provincial policy recommendations to apply a health equity lens in all public health programs, we examined health equity prioritization within British Columbia health authorities during early implementation. We conducted semi-structured qualitative interviews and focus groups with 55 senior executives, public health directors, regional directors, and medical health officers from six health authorities and the Ministry of Health. We used an inductive constant comparative approach to analysis guided by complexity theory to determine critical elements for prioritization. Results We identified seven critical elements necessary for two fundamental shifts within health systems. 1) Prioritization through informal organization includes creating a systems value for health equity and engaging health equity champions. 2) Prioritization through formal organization requires explicit naming of health equity as a priority, designating resources for health equity, requiring health equity in decision making, building capacity and competency, and coordinating a comprehensive approach across levels of the health system and government. Conclusions Although creating a shared value for health equity is essential, health equity - underpinned by social justice - needs to be embedded at the structural level to support effective prioritization. Prioritization within government and ministries is necessary to facilitate prioritization at other levels. All levels within health systems should be accountable for explicitly including health equity in strategic plans and goals. Dedicated resources are needed for health equity initiatives including adequate resourcing of public health infrastructure, training, and hiring of staff with equity expertise to develop competencies and system capacity.

Nurse turnover is a significant issue and complex challenge for all healthcare sectors and is exacerbated by a global nursing shortage. Nurse-Family Partnership is a community health program for first-time pregnant and parenting girls and young women living in situations of social and economic disadvantage. In Canada, this program is delivered exclusively by public health nurses and only within a research context. The aim of this article is to explore and describe factors that contribute to recruitment, retention, and turnover of public health nurses delivering Nurse-Family Partnership in British Columbia, Canada between 2013 and 2018. Interpretive description was used to guide sampling, data collection and analytic decisions in this qualitative component drawn from the British Columbia Healthy Connections Project mixed methods process evaluation. Semi-structured, individual interviews were conducted with 28 public health nurses who practiced in and then exited Nurse-Family Partnership. Nurses were motivated to join this program because they wanted to deliver an evidence-based program for vulnerable young mothers that fit with their personal and professional philosophies and offered nurse autonomy. Access to program resources attracted nursing staff, while delivering a program that prioritizes maintaining relationships and emphasizes client successes was a positive work experience. Opportunities for ongoing professional development/ education, strong team connections, and working at full-scope of nursing practice were significant reasons for nurses to remain in Nurse-Family Partnership. Personal circumstances (retirement, family/health needs, relocation, career advancement) were the most frequently cited reasons leading to turnover. Other factors included: involuntary reasons, organizational and program factors, and geographical factors. Public health organizations that deliver Nurse-Family Partnership may find aspects of job embeddedness theory useful for developing strategies for supporting recruitment and retention and reducing nurse turnover. Hiring nurses who are the right fit for this type of program may be a useful approach to increasing nurse retention. Fostering a culture of connectivity through team development along with supportive and communicative supervision are important factors associated with retention and may decrease turnover. Many involuntary/external factors were specific to being in a study environment. Program, organizational, and geographical factors affecting nurse turnover are modifiable.

Background Effective strategies for participant retention are critical in health research to ensure validity, generalizability and efficient use of resources. Yet standardized guidelines for planning and reporting on retention efforts have been lacking. As with randomized controlled trial (RCT) and systematic review (SR) protocols, retention protocols are an opportunity to improve transparency and rigor. An RCT being conducted in British Columbia (BC), Canada provides a case example for developing a priori retention frameworks for use in protocol planning and reporting. Methods The BC Healthy Connections Project RCT is examining the effectiveness of a nurse home-visiting program in improving child and maternal outcomes compared with existing services. Participants ( N  = 739) were girls and young women preparing to parent for the first time and experiencing socioeconomic disadvantage. Quantitative data were collected upon trial entry during pregnancy and during five follow-up interviews until participants’ children reached age 2 years. A framework was developed to guide retention of this study population throughout the RCT. We reviewed relevant literature and mapped essential retention activities across the study planning, recruitment and maintenance phases. Interview completion rates were tracked. Results Results from 3302 follow-up interviews (in-person/telephone) conducted over 4 years indicate high completion rates: 90% ( n  = 667) at 34 weeks gestation; and 91% ( n  = 676), 85% ( n  = 626), 80% ( n  = 594) and 83% ( n  = 613) at 2, 10, 18 and 24 months postpartum, respectively. Almost all participants (99%, n  = 732) provided ongoing consent to access administrative health data. These results provide preliminary data on the success of the framework. Conclusions Our retention results are encouraging given that participants were experiencing considerable socioeconomic disadvantage. Standardized retention planning and reporting may therefore be feasible for health research in general, using the framework we have developed. Use of standardized retention protocols should be encouraged in research to promote consistency across diverse studies, as now happens with RCT and SR protocols. Beyond this, successful retention approaches may help inform health policy-makers and practitioners who also need to better reach, engage and retain underserved populations. Trial registration ClinicalTrials.gov , NCT01672060 . Registered on 24 August 2012.

The purpose of this analysis was to understand public health nurses’ experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.