“We are exhausted, but we just love it”: A qualitative study exploring burnout and work engagement among advanced practice cancer nurses in Australia

Purpose: To explore advanced practice cancer nurses' experiences and perceptions of the factors that contribute to burnout and work engagement, and to understand how advanced practice cancer nurses cope with challenges and maintain their wellbeing in the working environment.Methods: A qualitative descriptive study was undertaken between April and May 2025.Oneon-one semi-structured interviews were conducted via Microsoft Teams with 23 advanced practice cancer nurses working in Australia.Data were analysed using NVivo 14 and Microsoft Excel, following the reflexive thematic analysis.Rigour was established through peer reviews, thick descriptions, and maintaining a comprehensive audit trail.Results: Four themes and ten sub-themes were generated: (1) Role demands and complexity (roles and responsibilities, workload and task management), (2) Organisational and professional support (teamwork and collaboration, organisational and system-level support),(3) Drivers of engagement (caring as core identity, professional fulfilment and growth, professional identity, recognition and voice), (4) Personal resources and strategies for wellbeing (self-care strategies, coping strategies, personal resources). Conclusion:The work environment of advanced practice cancer nurses largely contributes to their experiences of burnout and work engagement.Advanced practice cancer nurses are highly engaged with their work despite experiencing exhaustion.The experience of burnout and work engagement is a result of the dynamic interplay of multiple factors structured across individual, role-related, and organisational layers within a complex work environment.