BACKGROUND

The COVID-19 pandemic disrupted education worldwide, prompting a rapid shift to emergency remote teaching that challenged students’ learning and mental health. Nursing students, in particular, faced heightened pressures due to the suspension or online adaptation of essential clinical experiences, alongside the need to master theoretical and practical competencies. Emerging evidence indicates that such stressors adversely affect students’ emotional and psychological well-being, potentially influencing academic outcomes. Understanding the relationship between mental health and academic performance among nursing students is crucial for developing targeted interventions that support their well-being and professional readiness.

OBJECTIVE

This study analyzed the mental health status and academic performance of graduating nursing students during the challenging period of remote learning amid the pandemic in a government school in Leyte.

METHODS

The study utilized a descriptive correlational design to explore the relationships between mental health status and academic performance among nursing students. A modified self-administered questionnaire was utilized to gather data. Ethical approval from Eastern Visayas Health Research and Development ConsortiumEthics Review with ERC number 2023-024 was secured, and data collection occurred through various methods. Data analysis used SPSS version 24, emphasizing the importance of understanding these relationships in educational settings.

RESULTS

The study assessed the demographic profile, online learning attributes, mental health status, and academic performance of 20 nursing students during the pandemic. All students passed their courses, despite reporting moderate emotional loneliness and irritability, but minimal fear of COVID-19. Significant correlations were found between demographic factors and mental health indicators. The null hypothesis, suggesting no relationship between demographic factors and mental health, is void, as significant associations were identified. Recommendations include enhancing mental health support in nursing education to address these challenges.

CONCLUSION

This study highlights the experiences of 20 nursing students from a government college in Leyte during the COVID-19 pandemic. Predominantly young women from rural, low-income backgrounds, these students faced challenges like poor internet access but successfully completed their academic requirements, showcasing resilience. While they reported low fear of COVID-19, moderate emotional loneliness and irritability indicated underlying mental health issues. The findings stress the need for educational institutions to provide mental health support and address the digital divide to enhance student well-being and success.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Statistics As Topic ; Psychological Well-being ; Indicators And Reagents ; Students, Nursing ; Suspensions ; Academic Performance ; Learning ; Pandemics ; Nursing ; Education, Nursing ; Covid-19 ; Mental Health

OBJECTIVES

This study explored the interplay of three Filipino cultural values—hiya (modesty/self-restraint), pakikisama (conflict-avoidance dimension of social harmony), and pakikipag-ugnayan (professional engagement, characterized by vigor, dedication, and absorption)—among Generation Z nurses in Quezon City. Specifically, it assessed their levels, examined interrelationships through correlation and path analysis, and developed a framework to illustrate their influence on nursing practice. In the Filipino context, hiya encompasses both positive dimensions, such as conscientiousness, moral accountability, and social responsibility, and constraining dimensions, including excessive self-restraint, fear of criticism, and inhibition. Pakikisama, while fostering harmony, may discourage assertiveness and limit open communication. Pakikipag-ugnayan, conceptualized here as engagement, reflects dedication, vigor, and absorption, which are vital for performance, patient safety, and workforce retention.

METHODS

A descriptive–correlational design was utilized to assess the relationships among hiya, pakikisama, and pakikipag-ugnayan. Data were gathered through a structured, self-administered questionnaire comprising validated scales for each construct, distributed in online formats to accommodate participants’ availability and work schedules. The purposive sample consisted of 115 Filipino Generation Z nurses engaged in direct patient care in various healthcare facilities in Quezon City. Data analysis involved descriptive statistics to summarize variable scores, Spearman’s rho to examine bivariate correlations, and path analysis to determine the direct and indirect effects among the variables. The results of the path analysis were used to develop a proposed framework illustrating the interplay of these cultural values in nursing practice.

RESULTS

Path analysis revealed distinct patterns in the interplay of hiya, pakikisama, and pakikipag-ugnayan among Generation Z nurses in Quezon City. Very high hiya scores (mean = 5.32) reflected both moral accountability and restraint-oriented tendencies. Despite these positive indicators, hiya showed a negative correlation with pakikipag-ugnayan, suggesting that its inhibiting side—marked by fear of criticism and avoidance of mistakes—may overshadow its constructive moral aspects. In contrast, the path analysis identified a moderate positive direct effect between hiya and pakikipag-ugnayan (β = 0.400, pCONCLUSION

Among Generation Z nurses, hiya demonstrates a dual role: while its ethical and conscientious aspects can strengthen pakikipag-ugnayan, its inhibiting side may suppress pakikipag-ugnayan. Pakikisama, operationalized as conflict avoidance and withholding dissent, emerged as a barrier to pakikipag-ugnayan by discouraging open communication. These findings informed the development of the Hiya–Pakikisama– Pakikipag-ugnayan Cultural Dynamics Framework, which illustrates how cultural values can simultaneously enable and constrain professional engagement. The framework has potential applications in nursing education and organizational practice, particularly in designing reflective learning, mentorship, and communication strategies that balance cultural sensitivity with assertiveness. Further validation across generations and healthcare settings is recommended to refine its applicability.

Human ; Weights And Measures ; Sensitivity And Specificity ; Retention (psychology) ; Education, Nursing ; Social Responsibility ; Appointments And Schedules ; Conflict (psychology)

Ethics ; Nursing

Nursing leadership and scholarship in the Philippines have evolved alongside the country's shifting socio-political and educational landscape. This feature article presents a first-person narrative of a nurse leader's journey from humble beginnings in Santiago, Isabela, to national and global leadership roles in education, regulation, and advocacy. This article aimed to illustrate how personal vocation, grounded in service and faith, can transform into professional leadership and scholarship that shape institutions, influence policy, and nurture future generations of Filipino nurses. Using autobiographical lens, I recounted formative experiences across clinical practice, education, administration, and regulation. These reflections are interwoven with leadership theories and scholarly evidence from global nursing literature that demonstrate how enduring principles such as servant leadership, integrity, resilience, compassion, and mentorship can guide professional practice. This narrative highlighted milestones such as pioneering collegiate nursing education at UERMMC, spearheading faculty and curricular reforms as Dean, championing ethical practice during the nursing licensure examination scandal, and advancing professional regulation through initiatives like the Career Progression and Specialization Program. It also underscored the role of resilience in overcoming personal affliction, the importance of mentorship in sustaining legacy, and the impact of integrity in safeguarding nursing's credibility. From the parable of the mustard seed to the reality of nation-building through nursing, this life story affirmed that leadership and scholarship are not individual achievements but collective legacies. By embracing lifelong learning, ethical practice and a commitment to national service, Filipino nurses can continue to grow as competent practitioners, compassionate caregivers, and visionary leaders who contribute to equitable and sustainable health systems. In telling this story, I also sought to situate my journey within the broader context of nursing leadership in the Philippines, where enduring challenges and emerging opportunities continue to call for vision, resilience, and integrity.

Human ; Scholarship ; Fellowships And Scholarships ; Resilience ; Resilience, Psychological ; Regulation ; Social Control, Formal ; Mentorships ; Mentors ; Education, Nursing ; Philippines

Public health nurses (PHNs) in the Philippines play a vital role in advancing Universal Health Care and Primary Health Care by serving as frontline leaders in community engagement, health promotion, and policy implementation. Despite their contributions, they face persistent challenges, including workforce shortages, wage disparities, hospital-centric education, and fragmented governance. Drawing from a reflexive narrative of community-based practice and organizational experience, this article situated the evolving role of PHNs within broader health systems transformation. The National Association of Public Health Nurses, Inc. (NAPHNI) established a unified platform for advocacy, leadership development, and recognition of advanced practice roles. Policy reforms such as a National Nursing Workforce Plan, passage of the Comprehensive Nursing Bill, and competitive compensation were imperative to empower PHNs. Strengthening public health nursing was discovered to be crucial in achieving health equity and a resilient healthcare system in the Philippines.

Human ; Public Health Nursing ; Universal Health Care ; Primary Health Care ; Health Equity

This integrative article explored how nurse-researchers craft and negotiate researcher identity through reflexivity. Drawing on three reflexive narratives situated across distinct practice and career contexts, including academe and military nursing, this article synthesized how personal histories, professional roles, and methodological training intersect in order to shape how one becomes a researcher. Guided by Benner's novice-to-expert lens and contemporary discussions on positionality and reflexive practice, this article's synthesis surfaced recurring themes: identity-in-motion rather than identity-as-status; persistence and vulnerability as engines of growth; insider–outsider movements and the ethical responsibilities being invited; and methodological pluralism as a value stance that links rigor with relevance and care. The narratives also illuminated how institutional cultures, resource constraints, and role expectations contour opportunities for inquiry, while reflexive writing functions as both method and pedagogy, supporting integrity, accountability, and epistemic fluency. It was argued in this article that cultivating researcher identity in nursing requires spaces that normalize doubt, foreground values, and make visible the relational, moral, and political textures of knowledge production. Implications included embedding explicit reflexivity and positionality work in curricula, mentoring, and research supervision; recognizing mixed-methods and qualitative approaches as complementary pathways to impact and to align institutional supports with nurses' dual commitments for both practice and scholarship. In this article, the process of becoming a nurse-researcher had been shown to be a continual practice of courage, reflexivity, and commitment that is by doing it, and learning it, until nurse-researchers make it.

Human ; Qualitative Research ; Military Nursing

Human ; Research ; Nursing

AIM

This study explored the developmental process of self-advocacy among nurses and proposed a conceptual framework, The Nurse Becoming Model of Self-Advocacy, to contribute to middle-range theory development.

METHODS

A constructivist grounded theory design guided this study. Data was gathered from 29 nurses through in-depth individual and group interviews across academe, hospitals, and professional organizations in Region I and the Cordillera Administrative Region. Theoretical and disconfirming sampling was used to refine categories. Data was analyzed using constant comparative methods.

FINDINGS

Self-advocacy emerged as a developmental trajectory comprising four interrelated stages: self-preservation, selfdevelopment, self-actualization, and self-transcendence. Novice nurses often relied on protective strategies such as silence and conformity, while experienced nurses engaged in assertiveness, credibility-building, leadership, and collective advocacy. Nurses emphasized that self-advocacy extended beyond the individual to encompass patients, the profession, and society, while highlighting its relational and collective nature.

CONCLUSION

Self-advocacy is a dynamic process and core dimension of professional identity. It evolves through stages of growth, integrating self-care, competence, engagement, and transcendence. Supporting self-advocacy through education, mentoring, reflective practice, and enabling organizational structures enhance nurses' well-being and strengthens their capacity to advocate for patients, advance the profession, and contribute to societal transformation. The Nurse Becoming Model of Self-Advocacy offers a transferable framework to guide nursing research, education, and policy toward empowerment and resilience.

Human ; Nursing ; Grounded Theory ; Empowerment ; Leadership ; Resilience ; Resilience, Psychological

BACKGROUND

Organizational commitment strengthens care delivery and system responsiveness, yet high turnover and workforce exhaustion threaten healthcare stability. Understanding factors that sustain commitment is especially critical during crises such as the COVID-19 pandemic.

AIM

This study examined how nurses' attitudes toward their practice environment predict organizational commitment at King Abdullah Medical City (KAMC), Makkah, Saudi Arabia.

DESIGN

Across-sectional predictive correlational design was used.

METHODS

Data was collected from 275 staff nurses between October and November 2020 using convenience sampling. Attitudes toward the practice environment were assessed with the Practice Environment Scale of the Nursing Work Index (PESNWI), while organizational commitment was measured using the Revised Three-Component Model Employee Commitment Survey. Descriptive statistics, Pearson's correlations, and multiple regression were conducted in SPSS version 21.

RESULTS

Nurses reported positive work attitudes, with the highest ratings for nursing care and interdisciplinary relationships, followed by management and leadership, and the lowest for adequate resources. Organizational commitment was moderate across affective, normative, and continuance domains. Regression analyses identified nursing care and interdisciplinary relationships as the most consistent predictor across all domains of commitment, including affective (p < .001), normative (p = .047), continuance (p = .004), and overall organizational commitment (p < .001). Adequate resources significantly predicted affective (p = .014) and overall commitment (p = .050), while management and leadership predicted normative commitment (p = .016).

CONCLUSION

Nurses' perceptions of their practice environment significantly shape organizational commitment during crisis conditions. Interdisciplinary collaboration consistently emerged as the strongest predictor, underscoring the value of teamwork and nurse–physician partnerships. Adequate staffing and resources also reinforced commitment, particularly in sustaining affective bonds. These findings underscored that supportive practice environments, through collaboration, adequate resources, and participatory leadership, enhance nurses' autonomy and sense of meaningful work, which in turn strengthen organizational commitment, retention, and resilience during crises.

Human ; Nurses ; Nursing ; Workforce ; Health Resources ; Covid-19 ; Work ; Leadership ; Environment ; Saudi Arabia

BACKGROUND

Outcomes-Based Education (OBE) in the Philippines has shifted perioperative training from numeric case quotas toward demonstrated competencies, with simulation increasingly used to address limited operating room (OR) exposure.

OBJECTIVE

This study determined the level of perioperative clinical performance among senior (4th year) nursing students and had also examined associations with four influencing domains: teaching–learning, interpersonal, student-related, and environmental.

METHODS

A descriptive–correlational study was conducted in AY 2023–2024 across higher education institutions in Eastern Visayas. A universal sample of 280 fourth-year BSN students who met minimum perioperative case requirements participated via online and paper surveys. Aresearcher-developed, expert-validated instrument that was anchored on CHED outcomes and PRC–BON guidelines was used to assess 11 competence domains in order to perceive influencing factors. Internal consistency was excellent (performance α = .987; factors α = .944). Descriptive statistics summarized competence; while Fisher’s Exact Test was used to assess associations (p < .05).

RESULTS

Competence was strongest in aseptic technique, patient safety, teamwork, documentation, and ethical–legal responsibilities. Lower ratings were noted for surgical skin preparation, anesthesia assistance, patient transport, medication safety, health education, and quality improvement. Among the four domains, only environmental factors (resources, workflow support, safety culture) were significantly associated with performance (Fisher’s Exact, p = .013).

CONCLUSION

Senior nursing students demonstrated strong technical and ethical perioperative competence but showed persistent gaps in less-frequent and higher-order competencies. Environmental supports in the OR decisively shaped performance. Programs should scale simulation for under-practiced tasks, strengthen mentorship, and explicitly integrate health education and quality improvement within perioperative training.

Human ; Learning ; Education ; Students, Nursing ; Mental Competency