1. Pickler, Rita H.

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Thank you to Drs. Draughon, Anderson, Burton, and Williams for contributing their perspective to the journal. I regret I was not clear about my intent in the "Back to Science" editorial. The point I hoped to make was the need for nurse scientists to focus their studies of nurse fatigue, burnout, or other measures of nurse well-being on the effect of these phenomena on outcomes of care. Whatever may affect health and care delivery seems to me the primary focus for nursing science. I am especially concerned that continued study of the effects on nurses of troubling workplace experiences has not resulted in organizational or health system improvements that diminish or remove the risk of these experiences. I daresay that until evidence clearly links nurse well-being to patient outcomes, few lasting changes to healthcare systems will occur. That is a shame, most particularly because until healthcare systems and institutions become healthier environments for their employees, the burden will remain on employees to engage in self-help and "resilience" building that cannot be sustained in unhealthy work settings that are underresourced or mismanaged. Systematic and systemic improvements to work environments are long overdue; one only has to look at how ill-prepared our healthcare systems were for the COVID-19 pandemic, lacking in supplies and staff in a long-standing and seemingly short-sighted concern for profit rather than workforce or patient well-being. I hope that nurse scientists and other healthcare researchers will redouble their efforts to develop system interventions, changing the healthcare system and eliminating the current deplorable work settings in which many nurses and other healthcare providers find themselves. I apologize that I did not make my intent clear in the editorial.