Factors Causing Nurses Leaving Clinical Practice In Acute Care

Factors Causing Nurses to Leave Clinical Practice and Participant Protection.
Americans strives to achieve success through long work hours and sacrifices that create lifestyles filled with strain to the person physical and psychological states. (Purdy, 2010). Nurses are leaving clinical practice due to fatigue, long understaffed work hours, unsupportive colleagues and work environments, and employers placing nurses and patients at risk (MacKusick, & Minick, 2010, Baker & Nussbaum, 2011). Decreases in motor and cognitive functions in a fatigued nurse could result in impaired judgement, impaired ability to recognize and respond to clinical changes, inadequate record keeping, poor communication, and medication administration errors which all
affect the patient’s safety (Baker & Nussbaum, 2011). One study of European nurses showed that nurses who work less than 12 hour shift report higher quality and safety for themselves and their patients because longer shift times may mitigate staffing shortages due to nurses leaving, thereby increasing quality risks (Griffiths, 2014). In order for the profession and others to understand what causes nurses to leave the profession, a thorough review is needed.
Purpose, Instrumentation, and Procedures
The aim of this research study is to learn more about the perceptions of registered nurses who have left clinical practice in the acute care setting.
A qualitative, phenomenological research design will be used in this study to investigate and to study individuals’ experiences with a particular phenomenon because it offers ways of understanding that are not offered by other research methodologies. This method permits the examination of conscious experience as experienced from the subjective point of view. The following guiding question will be investigated using a phenomenological method: What causes nurses to leave clinical practice in acute care settings? What is the experience of the nurses leaving clinical practice in acute care settings? To date there has been one qualitative study conducted in the United States on the reasons why nurses leave clinical practice in the acute care
settings.
The data for this research study will be gathered through a series of semi-structured interviews using open-ended questions to gather perceptions of registered nurses participants related to the purpose of the study. All interviews will be audiotaped with field notes being used to record observations and noted made during the interviews. Participants will be asked to take part in a series of at least two in-depth interviews, lasting approximately 1-2 hours each. The interviews will take place in a private room at the library. The interviews will contain broad, open-ended questions that will encourage the participants to express their perceptions and experiences as a student diagnosed with a mental illness returning to school. The first interview will cover topics about the registered nurse’s past and present work experiences, and their perceptions about why they left clinical practice in the acute care setting. The second interview will take place two to three weeks later. At this time the interviewer will complete a participant check, and review and clarify areas discussed in the first interview. This interview will give the participants the opportunity to rephrase, omit, expand upon, or add to topics that were discussed or not discussed in the initial interview.
The researcher will explain the purpose of the study, describe criteria for participation, and will identify confidentiality issues. Details as to the time, place, and purpose of a face to face meeting in the private room of the library will be given to each participant. Those participants that have signed the informed consent and agree to participate in the study will be scheduled for the initial interview to be held in a private room in the library. The researcher will use as many participants as needed to achieve saturation.
Risks and Benefits
Risks involved in this study include the possibility of psychological or emotional risks, such as embarrassment, uncomfortable, and anxiety that is associated with discussing the reasons why the participants left the acute care setting. Participants will be provided a sample question that will be similar to what they will be asked during the interview. This enables participants to determine if they are willing to participate in the study. Participants will be asked at regular intervals during the data acquisition if they are feeling uncomfortable and would like to stop.
There is a potential for revealing sensitive information about the participants personal experiences of the past. Participants will be informed of this risk during the initial meeting. Participants will be reminded at this time that they have the right to withhold information or refuse to answer any question that they do not feel comfortable answering. Another potential risk, is the amount of time required to participate in the study. Participants will be told that the researcher will be accommodating to their schedule when arranging interview times and changes. The researcher will come ready to interview at the scheduled times with all needed equipment. This includes, audio recorder, paper, material needed to conduct the interview, and pencils/pens.
Possible risk of identifying information leak and privacy could happen. The researcher will take any steps necessary to insure the confidentiality and privacy of the participants in the study. All interviews will be conducted in a private room with the door locked in the designated meeting area-library. Only the researcher and the participant will be present at and during the interview. No one will be allowed entry to the room during the interview. If an interruption occurs the audio recording will be stopped. The topics of the interview will not be discussed outside the room and interview sessions, except among the researcher and peer members. All data sources will be kept in a locked cabinet in the researcher’s office for five years. Only the researcher will have access to it. All participants’ identifying information such as signed consent forms will be kept in a separate locked cabinet from the interview data, in the researcher’s office which can only be accessed by the researcher. The names, address, and other identifying participant information on transcribe data will be omitted or changed. All audio interview tapes will be transcribed by the principal researcher and peer members. All data (transcriptions, consent forms, tapes, and field notes) sources will be shredded after the study has been completed for five years.
There will be no direct benefits of participants’ participation in the study.
However, health care workers may have a better understanding of why they chose to leave the acute care clinical setting. Although there is a chance of psychological or emotional risks occurring while answering the interview questions, the participants may enjoy discussing their experiences and find it therapeutic. Participants may, however, withdrawal from the study at any point in time they choose and for any reasons they see fit. The researcher may withdraw subjects if they consistently verbalize feeling uncomfortable, and if they show signs of anxiety, embarrassment, or illness.
Conclusion
The results of this research study may add to the current body of knowledge about the reasons why registered nurses are leaving clinical practice in the acute care setting. With this data education and workplace programs may provide improved resources and support to registered nurses in need. This study will gather information surrounding the reasons why registered nurses leave acute care
settings.