Letting go: How newly graduated registered nurses in Western Canada decide to exit the nursing profession
Letting go: How newly graduated registered nurses in Western Canada decide to exit the nursing profession
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DOI：
10.1016/j.nedt.2015.02.024
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发表时间：
2015-07-01
影响因子：
3.9
通讯作者：
Yonge, Olive
中科院分区：
文献类型：
--
作者：
Chachula, Kathryn M.;Myrick, Florence.;Yonge, Olive
加拿大护士协会（CNA）估计，到2022年，加拿大的护士短缺将增加到6万名注册护士。进一步加剧这一危机的是，大约14-61%的新护理毕业生将改变护理角色或退出专业。目的：探讨加拿大西部新毕业的注册护士在五年内永久退出护理专业的决定所涉及的因素和基本的心理社会过程。设计：数据是通过非结构化和半结构化的访谈收集的，使用的是基格里亚扎根理论方法。参与者被发现是在一个过程中放手护理开始作为学生，并继续作为注册护士进入实践。确定了四个主要主题。1)导航的医疗保健系统和工作场所的限制：参与者遇到的困难，以适应轮班工作和工作量。2)协商社会关系，等级制度和麻烦的行为;特别是等级和横向暴力。3)面对恐惧，创伤和挑战。4)权衡竞争的奖励和紧张局势，导致离开护理专业。结论：学生和随后的新护理毕业生需要各种支持，以建立一个护理身份，并留在职业。这些支持包括可管理的工作量;有意义的方向;跨专业团队合作;以及参与转型和真实的领导结构。新护士需要一种被欢迎，重视，尊重和接受到工作环境中的感觉，以及建设性的反馈，情感支持和汇报，以面对工作场所的挑战。(C)2015爱思唯尔有限公司版权所有。
Background: The Canadian Nurses Association (CNA) estimates a nursing shortage in Canada will rise to 60,000 registered nurses by 2022. Further compounding this crisis is the approximate 14-61% of new nursing graduates who will change nursing roles or exit the profession.Aim: To explore the factors and basic psychosocial process involved in the decisions of newly graduated registered nurses in Western Canada who permanently exit the nursing profession within five years.Design: Data was collected through unstructured and semi-structured interviews using the Glaserian grounded theory method.Findings: Participants were found to be in a process of letting go of nursing that commenced as students and continued as they entered practice as registered nurses. Four major themes were identified. 1) Navigating constraints of the healthcare system and workplace: participants encountered difficulties adjusting to shiftwork and workload. 2) Negotiating social relationships, hierarchies, and troublesome behaviors; specifically hierarchal and horizontal violence. 3) Facing fears, traumas and challenges. 4) Weighing competing rewards and tensions which resulted in leaving the nursing profession.Conclusion: Students and subsequently new nursing graduates require a variety of supports to establish a nursing identity and remain in the profession. These supports include a manageable workload; meaningful orientation; interprofessional teamwork; and engagement within transformational and authentic leadership constructs. New nurses require a sense of being welcomed, valued, respected and accepted into the workplace environment, as well as constructive feedback, emotional support and debriefing to face workplace challenges. (C) 2015 Elsevier Ltd. All rights reserved.