Brenda Juby MN RN

Nurses regularly work in unpredictable environments in which they are exposed to potentially psychologically traumatic events which may include moral and ethical dilemmas. Exposure to traumatic events in the workplace can cause operational stress injuries (OSI) that can compromise a nurse's capacity to work which, in turn, has adverse effects on the healthcare system and the communities they serve. Returning to work after an OSI can be challenging, especially with repeated exposure to potentially traumatic situations and the physically and mentally demanding nature of a healthcare workplace. A workplace reintegration program (RP) originally developed for police officers may be of benefit for nurses who have been off work due to OSI. The purpose of this study was to explore the perceived need as well as potential adaptation, contextualization, and implementation of this RP for emergency room (ER) and intensive/critical care unit (ICU/CCU) nurses in two urban centers in Canada. This embedded mixed-methods study included questionnaires and focus groups with ER and ICU/CCU nurses (N=19) to investigate: (1) perceived strengths, facilitators, barriers, and challenges with the workplace reintegration of nurses after an OSI, and (2) the perceived need for an RP for nurses and ideas for adaption, contextualization, and implementation. In the quantitative results, it was observed that all study participants stated they had been exposed to psychologically traumatic events in the workplace. The vast majority of participants reported that their perceived traumatic event(s) caused or contributed to some psychological distress of which they sought mental healthcare. Almost half required time away from work after their traumatic event and only 11% were engaged in a return-to-work or workplace reintegration process to return to their previous work roles. Participants indicated that formalized processes were rarely used to support nurses returning to work after time off due to mental health challenges and agreed that the RP is needed in the nursing context. Themes that presented in the qualitative thematic analysis included: (1) The Perfect Storm: Current state of return-to-work, (2) Integral Needs and, (3) A Break in the Clouds: Hope for health. These themes highlighted the current realities of healthcare that may impede effective workplace reintegration after an OSI and emphasized the importance of education, buy-in, resources to support contextualization and implementation of the RP. The participants also recognized existing strengths, potentials, and possibilities the RP may bring to their profession and workplaces. Stemming from these results, exploration of innovative programs, such as the RP, may provide additional support to nurses affected by OSIs. Further research is needed regarding workplace reintegration for nurses as well as to further evaluate the RP for both public safety personnel and healthcare populations.