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

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.