By Kathryn Chachula
May 2017
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What you need to know

The nature of nursing work in Manitoba predisposes nurses to the development of post-traumatic stress which is associated with an estimated 13% of newly-graduated Canadian nurses intending to leave the nursing profession. The ultimate goal of this research is to identify resiliency solutions and strategies that can be applied during nurses' undergraduate education to help ensure that the incoming generation of Manitoban nurses are well-prepared for the broadest range of workplace challenges and traumatic stress-inducing encounters within nursing practice.

Why this research is important

Despite efforts to address the Registered Nurse (RN) shortage in Canada, the Canadian Nurses Association predicts the Canadian nursing shortage will rise with an estimated shortage of 60,000 RNs by the year 2022. Approximately 43% of new nursing graduates report a high level of psychological distress, with as many as 88% of the nursing workforce being exposed to traumatic encounters involving verbal and physical threat. In light of these findings, there is a building sense of urgency to foster an environment within undergraduate nursing programs that acknowledges the presence of traumatic experiences within the nursing workforce. Given the stressful contexts nurses practice within, it is essential to identify how new nursing graduates can be better prepared to understand and draw on supportive institutional and behavioural mechanisms in order to mitigate traumatic stress upon their entry to the workforce.

How the research was done

Research pertaining to traumatic stress in undergraduate students builds upon a 2015 study which examined why newly-graduated nurses left the nursing profession within five years of graduation. Participants in the study were newly-graduated RNs from a Canadian university institution, having practiced in any of three western Canadian provinces which included British Columbia, Alberta, and Manitoba and were taking steps to leave the nursing profession within five years of entry-to-practice. Excluded were nurses who left the profession after more than five years of entry-to-practice, and those who left because of retirement or disciplinary action.

What the researcher found

The participants in the study left nursing to pursue careers that included law, education, midwifery, research, accounting, and global health. One of the key findings revealed that newly-graduated nurses require a variety of supports to establish a nursing identity and remain in the profession. These supports included reasonable patient-nurse ratios given the high-acuity of patients admitted to hospital settings; receiving a meaningful workplace orientation; respectful interprofessional teamwork; and employment under managers who were authentic and understanding in their interactions. New nurses furthermore required a sense of being welcomed, valued, respected and accepted into the workplace environment, as well as being provided with constructive feedback and emotional support in the face of traumatic experiences to face workplace challenges and bullying behaviours. As many as 75-85% of nurses experienced bullying, humiliation, blame, and criticism. Over time, newly-graduated nurses lost the joy of nursing practice which was compounded by the accumulation of negative effects without adequate supports. The process of exiting the nursing profession began during undergraduate nursing education and peaked within two-to-five years of professional practice resulting in permanently leaving the nursing profession.

How this research can be used

In nursing, professional satisfaction and perseverance depend on thoughtful and compassionate relationships, from nursing school onwards. A sustainable nursing workforce cannot exist without the bedrock of interpersonal support fostered through nursing education, health care policy, and workplace culture. Strategies to mitigate traumatic stress and promote healthy coping mechanisms within nursing students may interrupt or prevent an exodus of nurses from the Manitoba workforce if undergraduate nursing programs adopt and utilize strategies to mitigate compassion fatigue and traumatic stress leading to a vibrant and healthy nursing workforce.

About the Researcher

Kathryn Chachula, R.N., B.N., M.N.

chachulak@brandonu.ca

Kathryn Chachula is a Registered Nurse and Assistant Professor at Brandon University. Her research centres upon teaching and learning in nursing education, simulated learning environments, the transition experience of Licensed Practical Nurses into undergraduate nursing education, as well as the experience of newly-graduated Registered and Psychiatric Nurses entering the workforce. She currently sits on the Board of Directors at the College of Registered Nurses of Manitoba.

Keywords

• bullying
• exit from profession
• intention to leave
• newly-graduated nurses
• shiftwork
• student-teacher relationships
• traumatic stress
• workload

Publications Based on the Research

Chachula, K., Myrick, F., & Yonge, O. (2015). Letting go: How newly graduated registered nurses in Western Canada decide to exit the nursing profession. Nurse Education Today, 35, 912-918. doi: 10.1016/j.nedt.2015.02.024

Editor: Christiane Ramsey

Research at Brandon University follows comprehensive policies designed to safeguard ethics, to ensure academic integrity, to protect human and animal welfare and to prevent conflicts of interest.