Cardiovascular diseases place significant burdens on patients, their families and support systems, and registered nurses directly involved in their care. Heart failure (HF), in particular, can place them under extreme stress. The American Heart Association (AHA) defines HF as a chronic condition one acquires through the duration of their lifetime where the heart does not pump efficiently enough to keep up with the body's demand for both blood and oxygen (AHA, 2023). The incidence of HF is rising in younger people and the prevalence continues to rise because of increased risk factors, a population that is aging, and improved effectiveness of therapies that have improved outcomes and survival (Khan et al., 2024).

More frequently, left ventricular assist devices (LVAD) are being utilized to support patients with end-stage HF as an advanced technology. An LVAD may be used as a means to improve patient quality of life and recovery of the ventricles within the heart in the interim between transitions to heart transplantation or simply for those who are not eligible to receive heart transplantation (Nicholson & Kaakeh, 2018). When LVAD implantation is used for non-transplant candidates, the device typically allows end-stage patients with HF to experience moderate improvement of quality of life while living with the disease (Latimer et al., 2021). More importantly, the statistical survival rate “at 5 years for patients with minimal or no risk factors was 77.4%, with preimplant risk factors only was 69.7%, with postimplant risk factors only was 52.1% and patients with coexisting pre- and postimplant risk factors was 43.5%” (Nayak et al., 2023, p. 776–777). With this invasive, yet lifesaving and life improving technology, LVADs give patients a chance to live their lives and experience more years surrounded by their friends and family while not experiencing the major burden of HF symptoms.

Even with the benefits of LVADs, patients who opt for this treatment plan may experience many life-altering changes, not only related to how to physically care for the device to prevent complications, but also psychological changes and challenges. Due to the device's appearance, invasiveness, and life altering implantation, patients often experience challenges in building self-esteem because of their impaired body image. With this surgery and the ongoing associated care, patients build strong relationships with their healthcare team members, especially their nurses.

End of life care for all patients can be a very challenging time for patients, families, friends, and health care staff. Knowing what decisions are best for the patient's well-being can be one of the most life altering phases for loved ones and patient support systems, especially those who have played such an integral role in the care of the LVAD patient during the majority of their implant life. Patients are evaluated by the palliative care team and in some cases will continue with palliative care once they have their implantation surgery due to the intense nature of the postoperative recovery period and life adjustments that must be made. Due to the intensity of established nurse-patient relationships, nurses experience distress related to the actions taken to care for and allow patients to have a natural and dignified death.

Nurses caring for patients with LVADs are at a higher risk of developing psychological distress because of the stressful nature and complex care they may experience. Nurses caring for patients with LVADs are often in stressful work environments and may be at higher risk of developing distress related to their care. High levels of stress causes nurses to experience distress. There is limited research and knowledge pertaining to how caring for these high acuity patients with LVADs truly impacts registered nurses' perceptions on their own mental health and what interventions are currently being used to support nurses as they are experiencing this distress.

Published literature exists nothing nurses' perceptions pertaining to stress when caring for patients with LVADs, however, there are gaps discussing the impact of care on the psychological well-being of nurses providing care to this population. This study aims to understand the impact of having cared for patients with LVADs on the mental health of nurses by aiming to answer the following question:1.

How does caring for patients with LVADs affect nurse's psychological health?

This study aimed to discover the impact of caring for patients with LVADs has on nurses' mental health. Additionally, it seeks to answer if nurses are utilizing appropriate coping mechanisms to manage their mental health. This study has the potential to act as a primary guide for organizations to reassess current resources that are available to nurses to ensure that their mental health concerns are being addressed when caring for complex patient populations with LVADs.