INTRODUCTIONBurnout is characterized by loss of emotional strength, not valuing human beings living together with or offering service and decreased in job performance and success due to lack of interest related to occupational stressors.1Burnout was recognized as work related danger among human oriented professionals including health care professionals since they are required to work many hours to help humans and face a challenge of high demand and low resources.1 Burnout is due to prolonged work related stress that is not managed. In a work environment this leads to high worker turnover, absenteeism, compromise of interpersonal relationships, reduced productivity and low personal achievement. 2High level of burnout was identified among nurses working in ICU (Intensive Care Unit) and Emergency Department. A systematic review on burnout among ICU health professionals found the prevalence to range from 6% to 47%. 3 Moreover, this systematic review found the following risk factors: age, gender, work experience, ABSTRACT Background: Intensive Care Unit (ICU) and Emergency Department are more stressful areas therefore nurses in those areas are prone to high level of burnout than others. In Rwanda, studies on burnout among nurses are limited and there is no research targeting specifically nurses working in ICU and Emergency Department. Therefore, this study aimed to determine the level of burnout among nurses working in ICU and Emergency Department in a selected referral hospital of Kigali. Methods: A quantitative approach was adopted. The descriptive cross-sectional design was used. Sixty nurses were involved in the study and they were selected using a total population sampling strategy. A self-administered questionnaire and Maslach Burnout Inventory Human Service Survey were used to collect data. Data were analysed using SPSS version 21.0. Results: The study found high level of burnout among 61.7% of the participants under study. High workload and intention to leave were associated with burnout (P<0.05). Burnout was measured by high Emotional Exhaustion (EE) 29 (48.3%), high Depersonalization (DP) 15 (25%) and low Personal Accomplishment (PA) 30 (50%). Conclusions: The high level of burnout identified among ICU and emergency department nurses is mainly associated with high workload and intention to leave the work within the next 12 months.

At the heart of palliative care philosophy lies the requisite of expert collaboration across disciplines, specialties, and organizations to provide patient- and family-centered care. When working in a global health setting, myriad interpersonal and cross-cultural considerations must be acknowledged to promote effective communication and coordination between stakeholders. The purpose of this article is to share the experiences of those working to advance palliative care in Rwanda, East Africa, and examine their collective journeys in practice, education, and research. Through the exemplar of Rwanda's Human Resources for Health Program, this narrative provides contextual wisdom for nurses endeavoring to advance palliative care in resource-poor settings and offers lessons learned along the journey. When working internationally, understanding the identity of nursing against the backdrop of local-national-professional-political culture is crucial. Developing relationships with on-the-ground leaders to guide cultural adaptation is likely the most critical factor. This experience has sparked evolving palliative care research and the continued dissemination of palliative care knowledge. Mutually beneficial partnerships have been, and continue to be, the backbone of palliative care advancement in Rwanda. It is essential that nurses teaching palliative care continue to adapt education to support the ongoing development of culturally relevant palliative care literacy across nations.