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[This is an excerpt.] Recruitment and retention in the nursing workforce have long been a concern (Buerhaus et al., 2017), particularly for minority nurses (Murray & Noone, 2022), but the severity and significance of nurse staffing shortages during the COVID-19 pandemic have brought these concerns to the forefront (Matthews et al., 2022). Understanding how to facilitate success for baccalaureate-prepared nurses is essential to building the nursing workforce. Nursing students' academic success and graduation are critical components of the nursing workforce. Although retention strategies have been developed to address barriers to graduation (Ackerman-Barger et al., 2020; Cameron et al., 2011; Etowa et al., 2005; Melillo et al., 2013; Murray et al., 2016), student retention remains a problem. Persistence has been identified as a key concept for understanding student retention in higher education (Nagaoka et al., 2013). The study of persistence in graduating Bachelor of Science in Nursing (BSN) students could provide insight into how these students navigate their educational program and why they choose to stay. This study examined factors that helped students to persist and succeed in a BSN program. [To read more, click View Resource.]

This paper examines the topic of physician burn-out from a philosophical lens. We explore the question of how the rise of physician burn-out may be related to an underlying erosion of meaning in medicine, characterised by the breakdown of the intersubjective relationship between doctors and patients. We argue that while commonly cited strategies for addressing burnout—including promoting work-life integration, cultivating workplace community, and fostering resilience—are critical for enhancing physician well-being, the common thread linking these approaches is that each identifies the physician as the primary locus of intervention. We propose that physician-centric approaches alone may be insufficient in addressing burnout, as the work might also involve shifting our attention to the intersubjective space that exists between the physician and the patient. To further elucidate the connection between intersubjectivity and the creation of meaning in medicine, we call on twentieth-century philosopher Emmanuel Levinas. Applying Levinas’s philosophy to the clinical context, we discuss the phenomenon of ‘depersonalisation’ and ask whether, rather than a mere consequence of burnout, depersonalisation might be a core cause of this condition. With these points we shed light on an idea that is relatively absent from the burn-out literature: that a person-oriented approach is vital not only for patient well-being but for physician wellness as well, as a process that ‘de-personalizes’ patients might result in a simultaneous dehumanisation of physicians themselves. Drawing inspiration from Levinas, we explore how a reorientation towards the intersubjective, dialogical dimension of the doctor-patient dyad could serve as one important ingredient in healing not only the patient, but the physician as well.

BACKGROUND: Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. RESEARCH AIM: To analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic. RESEARCH DESIGN: Qualitative analysis using a directed content methodology. PARTICIPANTS AND RESEARCH CONTEXT: The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. ETHICAL CONSIDERATIONS: Participant privacy and data confidentiality were addressed. FINDINGS: Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. DISCUSSION: This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. CONCLUSIONS: Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available.

OBJECTIVE: The aim of this study was to evaluate current levels of and factors contributing toward burnout and resiliency among new graduate nurses to identify effective mitigation strategies. BACKGROUND: New graduate nurses are at a high risk of increased turnover in the 1st year of employment. An evidence-based, graduate-nurse centered approach is essential to improving nurse retention among this cohort. METHODS: A cross-sectional study involving 43 new graduate nurses was completed in July 2021 (a subset of a larger sample of 390 staff nurses). Nurses were recruited to complete the Brief Resilience Scale, the Copenhagen Burnout Inventory, and a demographic survey. RESULTS: New graduate nurses scored within “normal resiliency.” This cohort reported moderate levels of burnout overall. Higher levels were reported within personal- and work-related subgroups. CONCLUSIONS: Strategies to reduce burnout and increase resiliency in new graduate nurses should be focused on improving personal and work-related burnout.

Our aim was to implement a well-studied coaching program for nurse practitioners working in long-term care facilities with the goal of reducing burnout and improving the well-being of these providers. Self-reported psychological metrics were used to assess the impact of the program.

BACKGROUND: In the early stages of the COVID-19 pandemic, strains on the healthcare system forced many U.S. states to revisit long-standing statutory limitations on the care coordinated by advanced practice registered nurses (APRNs). This was done by issuing waivers via executive, legislative, or board of nursing orders. PURPOSE: To identify the impact of temporary practice waivers on APRNs’ direct patient care during the COVID-19 pandemic. METHODS: This cross-sectional study utilized a two-phased approach. First, a confidential online survey was conducted of APRNs practicing across 27 U.S. states. Second, comprehensive APRN discipline data from 2019 to 2021 were retrieved from the National Council of State Boards of Nursing's Nursys database and reviewed. Univariable and multivariable binary logistic regression models were used to determine the significance of observed trends. RESULTS: A total of 16,699 APRNs responded to the survey for a response rate of 14.2%. APRNs practicing in private outpatient clinics, in rural areas, and in health provider shortage areas were more likely to report a positive effect of the practice waiver (all p < .05). Providers noted that the waivers allowed them more time with their current patients and expanded the geographic boundaries of their direct patient care to take on new patients. Furthermore, despite the changing profile of APRN care during the early stages of the pandemic, including a pronounced increase in telehealth usage, the current review found no evidence of an uptick in discipline cases brought against APRNs in 2021. CONCLUSION: Full practice authority for APRNs benefits patients by promoting expanded access to care and increasing the resiliency of our healthcare system without compromising patient safety. It is time for states and organizations that employ APRNs to recognize that permanently removing barriers to APRN practice is essential to the health of our nation.

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This resource is found in our Actionable Strategies for Government: Optimizing Workload & Workflows (Reduce Administrative Burden).

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BACKGROUND: Physician burnout is a multibillion-dollar issue in the United States. Despite its prevalence, burnout is difficult to accurately measure. Institutions generally rely on periodic surveys that are subject to recall bias. SMS text message–based surveys or assessments have been used in health care and have the advantage of easy accessibility and high response rates. OBJECTIVE: In this pilot project, we evaluated the utility of and participant engagement with a simple, longitudinal, and SMS text message–based mental health assessment system for physician-trainees at the study institution. The goal of the SMS text message–based assessment system was to track stress, burnout, empathy, engagement, and work satisfaction levels faced by users in their normal working conditions. METHODS: Three SMS text message-based questions per week for 5 weeks were sent to each participant. All data received were deidentified. Additionally, each participant had a deidentified personal web page to follow their scores as well as the aggregated scores of all participants over time. A 13-question optional survey was sent at the conclusion of the study to evaluate the usability of the platform. Descriptive statistics were performed. RESULTS: In all, 81 participants were recruited and answered at least six (mean 14; median 14; range 6-16) questions for a total of 1113 responses. Overall, 10 (17%) out of 59 participants responded “Yes” to having experienced a traumatic experience during the study period. Only 3 participants ever answered being “Not at all satisfied” with their job. The highest number of responses indicating that participants were stressed or burnt out came on day 25 in the 34-day study period. There were mixed levels of concern for the privacy of responses. No substantial correlations were noted between responses and having experienced a traumatic experience during the study period. Furthermore, 12 participants responded to the optional feedback survey, and all either agreed or strongly agreed that the SMS text message–based assessment system was easy to use and the number of texts received was reasonable. None of the 12 respondents indicated that using the SMS text message–based assessment system caused stress. CONCLUSIONS: Responses demonstrated that SMS text message–based mental health assessments are potentially useful for recording physician-trainee mental health levels in real time with minimal burden, but further study of SMS text message–based mental health assessments should address limitations such as improving response rates and clarifying participants’ sense of privacy when using the SMS text message–based assessment system. The findings of this pilot study can inform the development of institution-wide tools for assessing physician burnout and protecting physicians from occupational stress.

BACKGROUND: Physician burnout is a common problem, with onset frequently occurring during undergraduate education. Early intervention strategies that train medical students in psychological flexibility skills could support well-being and mitigate burnout risks associated with unmodifiable career stressors. There is a need for randomized controlled trials to assess effectiveness. As psychological flexibility varies contextually and among individuals, tailoring interventions may improve outcomes. Smartphone apps can facilitate individualization and accessibility, and the evaluation of this approach is an identified research priority. OBJECTIVE: This study aimed to evaluate the effectiveness of a stand-alone app-delivered Acceptance and Commitment Training intervention for improving medical students' self-reported burnout, well-being, psychological flexibility, and psychological distress outcomes. We aimed to explore whether an individualized app would demonstrate benefits over a nonindividualized version. METHODS: This parallel randomized controlled trial was conducted with a sample of medical students from 2 Australian universities (N=143). Participants were randomly allocated to 1 of 3 intervention arms (individualized, nonindividualized, and waitlist) using a 1:1:1 allocation ratio. Individualized and nonindividualized participants were blinded to group allocation. The 5-week intervention included an introductory module (stage 1) and on-demand access to short skill training activities (stage 2), which students accessed at their own pace. Stage 2 was either nonindividualized or individualized to meet students' identified psychological flexibility training needs. RESULTS: The mean differences in change from baseline between the intervention groups and the waitlist group were not statistically significant for burnout outcomes: exhaustion (primary; individualized: -0.52, 95% CI -3.70 to 2.65, P=.75; nonindividualized: 1.60, 95% CI -1.84 to 5.03, P=.37), cynicism (individualized: -1.26, 95% CI -4.46 to 1.94, P=.44; nonindividualized: 1.00, 95% CI -2.45 to 4.46, P=.57), and academic efficacy (individualized: 0.94, 95% CI -0.90 to 2.79, P=.32; nonindividualized: 2.02, 95% CI 0.02-4.03, P=.05). Following the intervention, the individualized group demonstrated improved psychological flexibility (0.50, 95% CI 0.12-0.89; P=.01), reduced inflexibility (0.48, 95% CI -0.92 to -0.04; P=.04), and reduced stress (-6.89, 95% CI -12.01 to 5.99; P=.01), and the nonindividualized group demonstrated improved well-being (6.46, 95% CI 0.49-12.42; P=.04) and stress (-6.36, 95% CI -11.90 to -0.83; P=.03) compared with waitlist participants. Between-group differences for the individualized and nonindividualized arms were not statistically significant. High attrition (75/143, 52.4%) was observed. CONCLUSIONS: This trial provides early support for the potential benefits of Acceptance and Commitment Training for medical student well-being and psychological outcomes and demonstrates that psychological flexibility and inflexibility can be trained using a smartphone app. Although postintervention burnout outcomes were not statistically significant, improvements in secondary outcomes could indicate early risk mitigation. Replication studies with larger samples and longer-term follow-up are required, and future research should focus on improving implementation frameworks to increase engagement and optimize individualization methods.

OBJECTIVE: This study aims to evaluate the impact of several organisational initiatives implemented as part of a physician engagement, wellness and excellence strategy at a large mental health hospital. Interventions that were examined include: communities of practice, peer support programme, mentorship programme and leadership and management programme for physicians. METHODS: A cross-sectional study, guided by the Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance evaluation framework, was conducted with physicians at a large academic mental health hospital in Toronto, Canada. Physicians were invited to complete an online survey in April 2021, which composed of questions on the awareness, use and perceived impact of the organisational wellness initiatives and the two-item Maslach Burnout Inventory tool. The survey was analysed using descriptive statistics and a thematic analysis. RESULTS: 103 survey responses (40.9% response rate) were gathered from physicians, with 39.8% of respondents reporting experiences of burn-out. Overall, there was variable reach and suboptimal use of the organisational interventions reported by physicians. Themes emerging from open-ended questions included the importance of addressing: workload and resource related factors; leadership and culture related factors; and factors related to the electronic medical record and virtual care. CONCLUSIONS: Organisational strategies to address physician burn-out and support physician wellness require repeated evaluation of the impact and relevance of initiatives with physicians, taking into account organisational culture, external variables, emerging barriers to access and participation, and physician needs and interest over time. These findings will be embedded as part of ongoing review of our organisational framework to guide changes to our physician engagement, wellness and excellence strategy.

Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included “moral injury” and “moral distress,” identifying 249 records. While individual risk factors predispose healthcare workers to MI, root causes stem from healthcare systems. Accumulation of moral stressors and potentially morally injurious events (PMIEs) (from administrative burden, institutional betrayal, lack of autonomy, corporatization of healthcare, and inadequate resources) result in MI. Individuals with MI develop moral resilience or residue, leading to burnout, job abandonment, and post-traumatic stress. Healthcare institutions should focus on administrative and climate interventions to prevent and address MI. Management should ensure autonomy, provide tangible support, reduce administrative burden, advocate for diversity of clinical healthcare roles in positions of interdisciplinary leadership, and communicate effectively. Strategies also exist for individuals to increase moral resilience, reducing the impact of moral stressors and PMIEs.

BACKGROUND: Given that emotional exhaustion and nurse engagement have significant implications for nurse well-being and organizational performance, determining how to increase nurse engagement while reducing nurse exhaustion is of value. PURPOSE: Resource loss and gain cycles, as theorized in conservation of resources theory, are examined using the experience of emotional exhaustion to evaluate loss cycles and work engagement to evaluate gain cycles. Furthermore, we integrate conservation of resources theory with regulatory focus theory to examine how the ways in which individuals approach work goals serves as a facilitator to the acceleration and deceleration of both of these cycles. METHODOLOGY/APPROACH: Using data from nurses working in a hospital in the Midwest United States at six time points spanning over 2 years, we demonstrate the accumulation effects of the cycles over time using latent change score modeling. RESULTS: We found that prevention focus was associated with the accelerated accumulation effects of emotional exhaustion and that promotion focus was associated with the accelerated accumulation effects of work engagement. Furthermore, prevention focus attenuated the acceleration of engagement, but promotion did not influence the acceleration of exhaustion. CONCLUSION: Our findings suggest that individual factors such as regulatory focus are key to helping nurses to better control their resource gain and loss cycles. PRACTICE IMPLICATIONS: We provide implications for nurse managers and health care administrators to help encourage promotion focus and suppress prevention focus in the workplace.

Undergraduate and graduate students are often enveloped in an array of stress and anxiety, and it is no surprise that undergraduate and graduate social work students are faced with high amounts of stress due to vicarious trauma as a result of exposure to via coursework and experiential learning. It also comes as no surprise that social work professionals are exposed to numerous stressors causing the burnout rate for social workers to be high. Mindfulness techniques are used in various cultures and religions around the world with the purpose of synching mind and body. Using mindfulness techniques, individuals can be fully aware and present, which allows for the identification of emotional and physical patterns and adjustment to provide the most benefits. Awareness and adaptation of one’s emotional and physical sensations, especially in a helping profession like social work, is crucial in combating stress and burnout. This thesis will examine various articles and peer-reviewed studies conducted on mindfulness techniques being implemented in undergraduate and graduate social work curricula. This thesis will hopefully link mindfulness training added to the pedagogy of undergraduate and graduate social work programs to a decrease in the stress and burnout rate for social work students.

Burnout is a phenomenon commonly found in the workplace. When burnout is job-related, it is considered job burnout. Historically, job burnout has been most common among those who work in human services fields and who deal with stressful situations on a regular basis. Job burnout consists of three components: emotional exhaustion, depersonalization, and feelings of work ineffectiveness. While job burnout may be common, not all workers in stressful fields experience it, which indicates that there must be organizational or individual factors that limit the likelihood of job burnout for some workers. This study examined the impact of four job-related factors (job stress, job involvement, job satisfaction, and organizational commitment) on the three components of job burnout for correctional workers in a large, maximum-security prison in the Southern United States. The findings indicated that the four job-related factors were related strongly and in the predicted direction to two or three of the measures of job burnout.

Achievement of the quadruple aim requires investment in the health and well-being of physicians. Its influence on essential elements of healthcare – access to care, patient satisfaction, quality of care and patient safety – cannot be ignored. The delivery of better health outcomes, lower healthcare costs and an improved patient experience rests on humanizing the clinician experience. The purpose of this study was to examine the impact of physician burnout on patient safety and outcomes and explore existing policies that may be amenable to policy intervention to address physician burnout. A literature review was used to identify factors contributing to physician burnout and the downstream effects on the quality of care delivered and patient outcomes. The search criteria were restricted to the years 2018 – 2023 and the following terms: “physician burnout,” “patient care” and “patient outcomes.” Among the eight articles used in the analysis, the following factors emerged as primary contributors to physician burnout: administrative burden/EHR, excessive workloads/long working hours, loss of autonomy and leadership culture/lack of alignment of professional values with those in leadership. The factors manifest at the bedside as a lack of empathy, poor decision-making skills and poor communication to patients and peers. On a larger scale, this translates to increased costs related to unnecessary tests, medical errors, malpractice claims/settlements and decreased access to care as physicians leave medicine. There are significant costs – both human and financial – associated with burnout. Developing a workplace environment optimal for delivery of care and aligning values of leadership/organization with the practices therein involves prioritizing these things, thus creating a culture of safety and demonstrating our commitment to it.

BACKGROUND: The COVID-19 pandemic has amplified long-standing issues of burnout and stress among the U.S. nursing workforce, renewing concerns of projected staffing shortages. Understanding how these issues affect nurses’ intent to leave the profession is critical to accurate workforce modeling. PURPOSE: To identify the personal and professional characteristics of nurses experiencing heightened workplace burnout and stress. METHODS: We used a subset of data from the 2022 National Nursing Workforce Survey for analysis. Binary logistic regression models and natural language processing were used to determine the significance of observed trends. RESULTS: Data from a total of 29,472 registered nurses (including advanced practice registered nurses) and 24,061 licensed practical nurses/licensed vocational nurses across 45 states were included in this analysis. More than half of the sample (62%) reported an increase in their workload during the COVID-19 pandemic. Similarly high proportions reported feeling emotionally drained (50.8%), used up (56.4%), fatigued (49.7%), burned out (45.1%), or at the end of their rope (29.4%) “a few times a week” or “every day.” These issues were most pronounced among nurses with 10 or fewer years of experience, driving an overall 3.3% decline in the U.S. nursing workforce during the past 2 years. CONCLUSION: High workloads and unprecedented levels of burnout during the COVID-19 pandemic have stressed the U.S. nursing workforce, particularly younger, less experienced RNs. These factors have already resulted in high levels of turnover with the potential for further declines. Coupled with disruptions to prelicensure nursing education and comparable declines among nursing support staff, this report calls for significant policy interventions to foster a more resilient and safe U.S. nursing workforce moving forward.

OBJECTIVE: There is emerging evidence that first responders, like military personnel, are at risk for exposure to potentially morally injurious events. However, studies examining expressions of moral injury in first responders are nascent, in large part due to the limited number of measures validated for use in this population. To address this gap, the present study sought to investigate the psychometric properties of the Expressions of Moral Injury Scale—Military Version (EMIS-M) in a sample of first responders. METHOD: The psychometric properties of the EMIS-M were investigated in a sample of 228 first responders to determine reliability, convergent validity, discriminative validity, and divergent validity. In addition, confirmatory factor analysis was conducted to test the bifactor model identified in a veteran sample (Currier et al., 2018). RESULTS: Results yielded an excellent fit for the bifactor model with correlated self-directed and other-directed subscales identified in the EMIS-M development study. In addition, the measure evidenced strong reliability, convergent validity, discriminative validity, and divergent validity. CONCLUSIONS: The findings of the present study suggest that the Expressions of Moral Injury Scale—First Responder Version is a psychometrically sound measure capable of assessing self- and other-directed expressions of moral injury in first responders. The significance of these findings to our understanding of moral injury in first responders and their implications for future research are discussed.

Burnout in family doctors (FDs) affects their well-being, patient care, and healthcare organizations, and is considered common worldwide. However, its measurement has been so inconsistent that whether the widely divergent prevalence figures can be meaningfully interpreted has been questioned. Our aim was to go further than previous systematic reviews to explore the meaning contribution and usefulness of FD-burnout prevalence estimates. Worldwide literature was systematically reviewed using Levac's scoping framework, with 249 papers undergoing full-text review. Of 176 studies measuring burnout, 78% used the Maslach Burnout Inventory (MBI), which measures burnout as now defined by the World Health Organization. We, therefore, concentrated on the MBI. Its burnout measurement was markedly inconsistent, with prevalence estimates ranging from 2.8% to 85.7%. Researchers made prevalence claims relating to burnout severity and implied diagnoses based on participants' MBI scores, even though the MBI has not been validated as a clinical or diagnostic tool. Except when comparisons were possible between certain studies, prevalence figures provided limited meaning and added little to the understanding of burnout in FDs. Our review revealed a lack of research-supported meaningful information about the prevalence of FD burnout and that care is required to avoid drawing unsubstantiated conclusions from prevalence results. This paper's overall purpose is to propose how obtaining meaningful prevalence estimates can begin, which are recognized as key to developing improved prevention policies and interventions. Researchers must adopt a consistent means to measure burnout, use the MBI as its authors intended, and explore making progress through quantitative and qualitative collaboration.

OBJECTIVE: The aims of this study were to explore the experiences of US clinical research nurses supporting the conduct of clinical trials before and during the COVID-19 pandemic and assess dimensions of burnout among these nurses using the Maslach Burnout Inventory-Human Services Survey. BACKGROUND: Clinical research nurses are a subspecialty of nursing that supports clinical trial conduct. Postpandemic clinical research nurse well-being, including indicators of burnout, has not been established. METHODS: A cross-sectional descriptive study via online survey was conducted. Results: A sample of US clinical research nurses scored overall high for the Maslach category of Emotional Exhaustion, moderate for Depersonalization, and moderate for Personal Achievement. Themes included together or apart, rewarding but challenging, and surviving or thriving. CONCLUSION: Supportive measures such as workplace appreciation and consistent change communication may benefit clinical research nurse well-being and reduce burnout during times of unpredicted crisis and beyond.

In 2019, the National Academy of Science identified clinician burnout as a growing public health concern. The COVID-19 pandemic has only compounded this crisis and transformed it into an escalating fracture within the US health care system. Concurrently evolving with this emergency is a rise in the number of nurses who intend to leave the profession. Frontline nurse leaders are the lynchpin in ensuring health care systems function. These leaders have accountability over patient care and clinician well-being. Focused efforts must address clinician burnout. However, without addressing the well-being of frontline nurse leaders, the fault line in our health care system becomes a vast chasm. Recently, published literature began to emerge describing and addressing frontline clinician burnout. Unfortunately, only a few, if any, address issues related to leaders. The aim of this qualitative case study research was to explore and discover general themes in system chief nurse executive leadership practices that support, mentor, develop, and retain nurse leaders as a basis for future research. Three major themes were identified for future study and exploration: enhancing leadership development programs; improving leader work environments; and focusing on leader well-being and support. Further research is needed to evaluate the effectiveness of these themes.

With the introduction of law enforcement-administered naloxone, officers are assuming the dual role of law enforcer and caregiver with opioid users. This study used cognitive role theory and Thorne’s interpretive approach to explore the dual roles experienced by officers. The purpose of this study was to understand (1) how officers who administer naloxone describe their experience of the dual role, and (2) how the officers describe the role expectations of law enforcer and caregiver. Seven officers completed semi-structured, one-on-one, telephone interviews. The eight themes that emerged were related to the officers’ views of (1) saving and changing opioid users’ lives; (2) humanizing the officers; (3) mental health, stress, and trauma of officers; (4) the cycle of opioid reuse and re-arrest of opioid users; (5) views of the opioid user; (6) views of their role; (7) flaws and recommended improvements to the system; and (8) views of the naloxone program. Findings showed the dual role has created role ambiguity and conflict and has created additional stress and trauma for the officers. Most officers in the study supported the use of naloxone and identified this new responsibility from the existing aspect of their role to save lives and improve the community. Recommendations included increased medical training to improve officers’ confidence in making medical decisions, policy improvements to reduce role ambiguity and conflict, department and community naloxone implementation campaigns to socialize the concept before implementation into a department, emotional and psychological monitoring and supports for officers administering naloxone, and more outreach for secondary support following naloxone administration leading to positive social change.