Workplace reintegration of nurses affected by operational stress injuries: A scoping literature review

Nurses regularly engage in unpredictable environments in which they are exposed to potentially psychologically traumatic events of which may include moral and ethical dilemmas. As a result of COVID-19, more nurses have been affected by traumatic and morally injurious events than ever before leading to increased rates of operational stress injury (OSI) which can result in staff taking leave from work, which then requires a successful return-to-work process. An unsuccessful workplace reintegration can be career ending for nurses and may affect the individual, their family, and wider community while contributing to the nursing shortages and an exodus of human capital within healthcare systems. Despite this, little attention has been provided to the return-to-work of nurses in the scientific literature. The sparse research regarding nurses with OSI have largely focused on clinical interventions and treatments, but neglect to address the important step after clinical interventions when workers are redeployed and expected to perform their occupational duties as before in an adverse environment. To address this, novel evidence-based approaches are needed; however, the lack of research specific to workplace reintegration poses a challenge to the development and implementation of such initiatives. The purpose of this scoping review is to explore the existing global literature regarding return to work and workplace reintegration initiatives for nurses after an operational stress injury. This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guidelines (PRISMAScR). Seven databases were searched with three concepts: (1) workplace reintegration, (2) nurses, and (3) operational stress injury. Eight studies were included in the final review. Included studies were both peer-reviewed and gray literature. Studies were largely from the privatized healthcare system in the United States or focused on American military nurses. The body of literature involving civilian nurses largely involved nurses experiencing substance abuse and had little mention of trauma or OSI. To develop and implement policies, procedures, and programs for return-to-work and workplace reintegration, it is imperative that OSI and exposure to traumatic experiences is recognized and acknowledged in nurses. Further research is needed regarding workplace reintegration for nurses and healthcare professionals.

Audience Take Away Notes:

• Identify that nurses experience trauma and OSIs which could lead to time off work or exiting the profession.
• Identify the existing literature on workplace reintegration for nurses with OSI.
• Explain the importance of evidence-based workplace reintegration practices for nurses with mental health challenges
• Outline recommendations for future research and practice needs or for nurses and other civilian populations returning to work after experiencing an OSI.
• Recognize the dire need for further research and attention to the workplace reintegration of nurses after experiencing OSI.

This presentation may assist those in the nursing profession by acknowledging the presence of OSI and bringing attention to the lack of knowledge, research, and attention to workplace reintegration for this population. Knowledge translation of issues surrounding OSI and workplace reintegration amongst the nursing profession may help academic and healthcare organizations by leading to increased research efforts, improved education for entry level nurses, and awareness of mental health and workplace reintegration challenges in healthcare settings. Attention to workplace reintegration as a component of workplace health and wellness strategies could assist organizations with retaining skilled staff. Additional research will provide a guide for policy, procedures and programs addressing workplace reintegration for nurses.