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Organizational Approaches That Support Nurses and Healthcare Workers to Thrive:...
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Organizational Approaches That Support Nurses and Healthcare Workers to Thrive: Moving Beyond Burnout

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 September 2026 | Viewed by 6278

Special Issue Editors

Dr. Stephen Phillip Jacobs

E-Mail Website
Guest Editor
The School of Nursing, University of Auckland, Auckland 1142, New Zealand
Interests: nurse management; thriving; burnout; resilience; workforce; organizational support
Dr. Willoughby Moloney

E-Mail Website
Guest Editor
Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA 95817, USA
Interests: nursing; workforce; organizational support; burnout; engagement; thriving; turnover
Dr. Daniel Terry

E-Mail Website
Guest Editor
School of Nursing and Midwifery, University of Southern Queensland, Ipswich, QLD 4305, Australia
Interests: nursing; rural health; rural workforce; chronic-ill health; nursing education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The International Council of Nurses estimates a global shortage of 13 million nurses by 2030. Nursing is the largest occupational group in the health sector; however, attracting and retaining sufficient numbers of nurses is a near-universal challenge. In 2024, approximately 25 percent of nurses in America left the profession within their first year. Job stress and work environment are listed as challenges encountered by nurses, with burnout stated as the primary reason for leaving. Beyond the negative impacts on the individual nurse, burnout is associated with poor quality patient care, decreased patient satisfaction, and lower organizational commitment and productivity. While common approaches to dealing with nurse retention and burnout issues have been targeted at individuals, the evidence suggests that a major focus needs to be on job characteristics and organizational support.

Thriving at work focuses on identifying the personal and organizational factors that influence the ability of nurses to be energized and thriving, thereby reducing their intention to leave. Thriving is a positive psychological state in which individuals experience both a sense of vitality and a sense of learning at work. Thriving employees experience growth and momentum marked by feeling energized and alive (vitality) and a sense that they are continually improving and getting better at what they do (learning). The outcomes of thriving at work include reduced burnout and turnover. Paying attention to thriving at work is an important means by which managers and their organizations can improve both the health outcomes of nurses and organizational performance.

This Special Issue aims to move the focus from building personal resilience in nurses to cope with anticipated burnout towards creating supportive organizational environments to improve thriving and mitigate the development of burnout. We are pleased to invite you to contribute innovative research on issues of burnout and thriving in nurses, providing evidence-based recommendations and intervention evaluations on how organizations can better support nurses, thereby reducing burnout and improving thriving.

In this Special Issue, original research articles and reviews are welcome. Research may include (but is not limited to) the following:

  • Systematic reviews and meta-analyses of existing approaches to burnout and thriving in nursing or healthcare.
  • Cross-sectional studies exploring issues of burnout and thriving in nursing or healthcare.
  • Longitudinal studies reporting changes in burnout and thriving in healthcare over time.
  • Intervention studies that evaluate the effectiveness of interventions aimed at reducing burnout or promoting thriving in healthcare.
  • Qualitative research exploring personal experiences of burnout and thriving among nurses or other healthcare workers.
  • Mixed-methods studies that provide a comprehensive understanding of burnout and thriving in nursing and healthcare.
  • Technological research on the use of technology, such as apps or telehealth, to support nurses and other healthcare workers’ well-being.

I/We look forward to receiving your contributions.

Dr. Stephen Phillip Jacobs
Dr. Willoughby Moloney
Dr. Daniel Terry
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • burnout
  • thriving
  • nurses
  • workforce
  • organizational support
  • turnover

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Published Papers (4 papers)

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22 pages, 968 KB  
Article
Job Autonomy and Innovation in Healthcare and Human Services: Pathways Through Appraisal, Engagement, and Burnout
by Luke Pederson and Julie M. Slowiak
Healthcare 2026, 14(4), 437; https://doi.org/10.3390/healthcare14040437 - 9 Feb 2026
Cited by 2 | Viewed by 1120
Abstract
Background/Objectives: Healthcare and human service organizations face mounting pressures to adapt to social and public health challenges while maintaining quality care. Innovative work behavior among healthcare and human service professionals is critical to organizational resilience. Prior research suggests that job autonomy fosters [...] Read more.
Background/Objectives: Healthcare and human service organizations face mounting pressures to adapt to social and public health challenges while maintaining quality care. Innovative work behavior among healthcare and human service professionals is critical to organizational resilience. Prior research suggests that job autonomy fosters innovative work behavior, but the mechanisms underlying this relationship remain unclear. This study examined how cognitive appraisal, work engagement, and job burnout mediate the relationship between job autonomy and innovative work behavior. Methods: A non-experimental, cross-sectional online survey was conducted with 607 healthcare and human service professionals in the United States. Validated measures assessed job autonomy, cognitive appraisal, work engagement, job burnout, and innovative work behavior. Serial mediation analyses were performed using Hayes’ PROCESS macro (Model 6) with bootstrapping (n = 5000). Work innovation was included as a covariate to control for organizational climate effects. Results: Job autonomy was positively related to innovative work behavior, work engagement, and both challenge and hindrance appraisal. The direct relationship between job autonomy and job burnout was mixed, significant in the hindrance appraisal model but not in the challenge appraisal model. Mediation analyses revealed that challenge and hindrance appraisal significantly influenced the pathways from job autonomy to work engagement and job burnout, which in turn mediated the job autonomy—innovative work behavior relationship. Burnout had a significant negative effect on innovative work behavior, whereas engagement strengthened the positive relationship between job autonomy and innovative work behavior. The full model explained 65.12–67.73% of the variance in innovative work behavior. Conclusions: Job autonomy is a critical driver of innovative work behavior among healthcare and human service professionals, operating through appraisal, engagement, and burnout. Building on previous research, this study extends prior evidence by clarifying when autonomy enables professionals to thrive and innovate, and when it risks contributing to burnout. Findings underscore the importance of appraisal-based interventions and autonomy-supportive climates to sustain workforce well-being and organizational innovation. Full article
(This article belongs to the Special Issue Organizational Approaches That Support Nurses and Healthcare Workers to Thrive: Moving Beyond Burnout)
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19 pages, 579 KB  
Article
Comparing Thriving at Work Among Trans-Tasman Early-Career Nurses: A Multinational Cross-Sectional Study
by Willoughby Moloney, Daniel Terry, Stephen Cavanagh and Stephen Jacobs
Healthcare 2026, 14(3), 313; https://doi.org/10.3390/healthcare14030313 - 27 Jan 2026
Viewed by 994
Abstract
Background/Objectives: The Thriving at Work model proposes that organisations have a responsibility to provide supportive work environments that identify individual health outcomes, which organisations can use to determine where workforce support is needed. The aims of this study are to (1) identify [...] Read more.
Background/Objectives: The Thriving at Work model proposes that organisations have a responsibility to provide supportive work environments that identify individual health outcomes, which organisations can use to determine where workforce support is needed. The aims of this study are to (1) identify and compare the predictors of early-career nurses’ thriving at work in New Zealand and Australia and (2) provide innovative and theory-informed recommendations to improve organisational support of early-career nurses to increase retention in the profession. Design: A multinational cross-sectional study design was followed. Methods: The methods include a sub-study of an international action research programme to support the thriving of early-career nurses, which evaluates and compares results from surveys of nurses at approximately three months post-registration in 2024 and 2025. A theory-informed survey assesses predictors and outcomes of thriving at work. Results: Early-career nurses (N = 320) from New Zealand (n = 277) and Australia (n = 43) completed the survey. New Zealand early-career nurses experience greater quality of care and authenticity at work; however, they also report greater burnout. For Australian early-career nurses, authenticity at work is the greatest predictor of thriving. In New Zealand, thriving is linked to burnout and colleague support. Conclusions: New Zealand must focus on reducing burnout and fostering workplaces that value social connection if it wants to mitigate early-career nurse attrition to Australia for better working conditions. In Australia, the value of authenticity at work highlights the importance of organisational cultures that enable nurses to express their true selves and professional identity. The findings highlight the need for tailored approaches in each country to strengthen workforce sustainability and improve nurse wellbeing. Implications for the Profession: In New Zealand, additional funding to bolster the recruitment and retention of the nursing workforce is crucial to improve patient ratios and reduce workloads. The remuneration of nurses must also remain competitive with Australia. Additionally, workplaces should incorporate Māori values and practices into workplace policies to strengthen social connections. Australian organisations should include authentic management training, psychological safety initiatives, and policies that value diversity and encourage open communication. Full article
(This article belongs to the Special Issue Organizational Approaches That Support Nurses and Healthcare Workers to Thrive: Moving Beyond Burnout)
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13 pages, 269 KB  
Article
Organizational Climate, Ethical Work Environment, and Turnover Intentions Among Healthcare Workers in a Romanian Chronic Care Hospital: A Multidimensional Analysis
by Sorina Enășoni, Diana Szekely, Flavia Zara, Cristina Stefania Dumitru, Alexia Manole, Catalin Dumitru, Raul Patrascu and Alexandra Enache
Healthcare 2026, 14(2), 264; https://doi.org/10.3390/healthcare14020264 - 21 Jan 2026
Viewed by 827
Abstract
Background: Turnover intention among healthcare workers represents a growing challenge for chronic care institutions, particularly in resource-constrained healthcare systems. Organizational and ethical factors have been increasingly recognized as relevant correlates of workforce retention. Methods: This exploratory cross-sectional study was conducted in a Romanian [...] Read more.
Background: Turnover intention among healthcare workers represents a growing challenge for chronic care institutions, particularly in resource-constrained healthcare systems. Organizational and ethical factors have been increasingly recognized as relevant correlates of workforce retention. Methods: This exploratory cross-sectional study was conducted in a Romanian chronic care hospital between January 2023 and September 2024. A total of 62 healthcare workers were included using a census-based recruitment approach. Organizational climate, ethical work environment, job satisfaction, and turnover intention were assessed using adapted and composite self-report measures. Correlation, multivariate regression, and exploratory mediation analyses were performed. Results: Job satisfaction and ethical work environment were inversely associated with turnover intention in both correlation and multivariate analyses. Organizational climate did not retain an independent association with turnover intention after adjustment. Exploratory mediation analysis suggested that job satisfaction may partially account for the association between an ethical work environment and turnover intention. Higher turnover intention and less favorable organizational perceptions were observed among nursing and auxiliary healthcare staff compared to physicians. Conclusions: The findings suggest that organizational and ethical conditions, particularly those influencing job satisfaction, are relevant correlates of turnover intention in chronic care settings. Given the exploratory design and limited sample size, these results should be interpreted cautiously. Organizational strategies targeting ethical practices and everyday work satisfaction may represent feasible approaches to workforce retention in similar healthcare contexts. Full article
(This article belongs to the Special Issue Organizational Approaches That Support Nurses and Healthcare Workers to Thrive: Moving Beyond Burnout)

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17 pages, 754 KB  
Systematic Review
Mentoring in Hospital Settings: A Systematic Review of Guidance, Care, and Professional Development
by Giuliana Ventimiglia, Ilaria Setti and Marina Maffoni
Healthcare 2026, 14(4), 505; https://doi.org/10.3390/healthcare14040505 - 15 Feb 2026
Cited by 1 | Viewed by 2582
Abstract
Background/Objectives: Mentoring is defined as a supportive relationship between an experienced professional (mentor) and a less experienced individual (mentee), influencing skill development, professional confidence, and psychological well-being. This systematic review addresses the question: “Can support from a senior colleague positively impact junior healthcare [...] Read more.
Background/Objectives: Mentoring is defined as a supportive relationship between an experienced professional (mentor) and a less experienced individual (mentee), influencing skill development, professional confidence, and psychological well-being. This systematic review addresses the question: “Can support from a senior colleague positively impact junior healthcare workers?” Methods: Following PRISMA 2020 guidelines, a systematic literature search was performed (January 2004–December 2024) in Web of Science, PubMed, and Scopus databases, yielding 399 studies. Results: After rigorous screening and quality assessment using the QuADS checklist, 74 studies were included in the final analysis. The reviewed articles span various healthcare fields, including nursing, medicine, and midwifery, utilizing qualitative, quantitative, observational, and mixed-methods approaches. Key findings highlight the mentor’s role in academic and emotional support; fostering clinical and transversal skills such as communication, collaboration, and problem-solving; and enhancing self-efficacy, resilience, and autonomy, particularly during transitional or emotionally demanding periods. Challenges identified include the need for inclusive environments and standardized mentoring models. Conclusions: Overall, mentoring supports the professional and personal growth of junior healthcare professionals and contributes positively to training quality and clinical work. However, issues regarding equitable access, program standardization, and the need for further research to establish consolidated guidelines remain. Full article
(This article belongs to the Special Issue Organizational Approaches That Support Nurses and Healthcare Workers to Thrive: Moving Beyond Burnout)
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