# Workplace Challenges and Policy Responses in the Caribbean Nursing Workforce: Insights From Country Chief Nurses

## TL;DR

This study explores nursing workforce challenges in the Caribbean and identifies key concerns and policies proposed by chief nurses to improve working conditions.

## Contribution

The study provides the first description of Caribbean chief nurses' concerns and policy responses regarding nursing work environments.

## Key findings

- Five main concerns identified: physical environment, staffing/workload, safety/security, professional development, and nurses' well-being.
- Improvements and policies are inconsistent across Caribbean countries.
- Coordinated regional efforts are needed to address nursing work environment challenges.

## Abstract

The Caribbean faces significant nursing and midwifery workforce challenges. A 2023 PAHO policy advises Member States to develop and implement strategies to strengthen their health workforce, including “promoting decent work conditions.” Caribbean nurses' work conditions have not been described. The country's chief nurse has responsibility for policy development. The study purpose was to describe the Caribbean country chief nurses' concerns about nurses' work environments, strides made and polices implemented to support nurse work environments and quality care. Chief nurses of 20 Caribbean countries were surveyed. Inductive content analysis was done. Five concerns represented: (1) physical environment; (2) staffing and workload; (3) safety and security; (4) professional development; and (5) nurses' well‐being. Improvements and policies reflected similar themes. The predominant work environment concerns center on inadequate physical environment, nurse staffing and workloads, and inconsistent security. The sporadic improvements and few policies initiated in several countries may warrant coordinated regional effort to achieve broader improvement in working conditions. To optimize patient care and a healthy, safe nursing workforce, policymakers should consider the priorities of government chief nurses to improve working conditions.

This study employs a qualitative descriptive design to describe government chief nurses' concerns, strides, and policies related to improving nurses' work environments across 20 Caribbean countries in context of major health workforce challenges in the Caribbean region.Chief nurses identified five main areas of concern—physical environment, staffing and workload, safety and security, professional development, and nurses' well‐being—with improvements and policy actions largely reflecting these same themes but occurring inconsistently across the region.Our findings highlight the need for coordinated regional and international efforts to prioritize chief nurses' concerns and to strengthen nursing work environments.

This study employs a qualitative descriptive design to describe government chief nurses' concerns, strides, and policies related to improving nurses' work environments across 20 Caribbean countries in context of major health workforce challenges in the Caribbean region.

Chief nurses identified five main areas of concern—physical environment, staffing and workload, safety and security, professional development, and nurses' well‐being—with improvements and policy actions largely reflecting these same themes but occurring inconsistently across the region.

Our findings highlight the need for coordinated regional and international efforts to prioritize chief nurses' concerns and to strengthen nursing work environments.