How Do We Keep our Heads above Water? An Embedded Mixed-Methods Study Exploring Implementation of a Workplace Reintegration Program for Nurses Affected by Operational Stress Injury

Abstract

Background: Nurses are exposed to potentially psychologically traumatic events which can lead to operational stress injuries (OSI). Workplace reintegration after an OSI can be challenging, especially with repeated exposure to potentially traumatic scenarios and workplace demands. A workplace reintegration program (RP) originally developed for police officers may be of benefit for nurses returning to work after an OSI. The purpose of this study is to investigate the perceived need for an RP for nurses, and its potential contextualization and implementation in the nursing context using an implementation science approach. Methods: This mixed-methods study collected data via questionnaires and focus groups from acute care nurses in Canada (N = 19). Data analysis was conducted using descriptive statistics, thematic analysis, and an organizational readiness assessment. Results: Study participants indicated that formalized processes were rarely used to support nurses returning to work after time off due to mental health challenges. Themes included (1) “The Perfect Storm”: the current state of return-to-work, (2) Integral Needs, and (3) A Break in the Clouds: hope for health. Conclusions: 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, and contextualization and evaluation of the RP.

“Collapsing into Darkness”: An Exploratory Qualitative Thematic Analysis of the Experience of Workplace Reintegration among Nurses with Operational Stress Injuries

“…Workplace reintegration and return-to-duty initiatives by PSP and military organizations may provide a template that could be contextualized and adapted to a healthcare environment [9]. Healthcare organizations would benefit from working collaboratively with external researchers to further inform approaches to workplace reintegration.…”

“…There is a paucity of research regarding essential post-clinical treatment when nurses are reintegrated into adverse environments and still expected to perform their occupational duties. The limited literature focusing on the return to work of nurses with mental health challenges has largely focused on military or civilian nurses experiencing substance use disorders in the United States [9][10][11]. Novel evidence-based approaches and programs can help facilitate the positive and effective reintegration of nurses into the workforce after experiencing an OSI.…”