BackgroundThis survey of rural nurses' experiences is part of a program evaluation of the Rural Surgical and Obstetrical Networks (RSON), a five-year initiative (2018-2023) to strengthen and stabilize rural hospitals in British Columbia (BC), Canada.PurposeOur aim was to measure changes in professional and work-related quality-of-life of rural surgical and obstetrical nurses in eight communities across BC and determine if the RSON initiative mitigated impacts of the COVID-19 pandemic on nurses' quality of life.MethodsThis longitudinal evaluation was administered via online surveys in 2021 and 2023. Work-related quality of life was measured with 23 items that assess job satisfaction, general wellbeing, work-life balance, stress level experienced at work, control, and working conditions. Professional quality of life was measured along three dimensions: compassion satisfaction (CS), burnout, and secondary traumatic stress (STS) (10 items each). Responses were linked by code and changes in quality of life were analyzed using paired Student's t-test.Results107 nurses participated at time 1 and 28 at time 2. Burnout and secondary traumatic stress scores at time 1 were lower among older nurses and those with children. Over the two-year period (2021 to 2023), significant increases were observed in burnout (