Nurses returning to practice after an extended career break : a narrative study.

Statement of the Problem: The experience of nurses returning to practice after an extended career break has not been well researched and must be understood to facilitate a safe return. Literature Summary: The nursing shortage is predicted to worsen over the next several years and nurses not currently practicing are a potential pool of personnel with a lower cost associated with re-education (Stevens, 2014). There are few articles in the literature on returning to practice. The Texas board of nursing identified a high risk of errors if the nurse is out for greater than four years. Refresher courses and medical centers both have a stake and a responsibility in facilitating a safe return. Huggins (2005), examined efforts to develop a program in an organization that would allow nurses to be engaged academically and mentored back into practice. Yancy and Handley (2004) concluded that returning a nurse to practice was a complex process that goes beyond a mere refreshing of skills. Thesis Statement: Nurses returning to practice after a career break face challenges that must be understood for educators and employers to facilitate a safe and satisfying return to practice. Research Methodology: A qualitative narrative study was best suited for exploration of this poorly understood topic. A snowball method was used to find subjects who had returned to practice or were in the process of returning after a career break of at least five years. Recruitment was done through a professional nursing organization, social media, and referrals. Five nurses were identified, interviewed, and audio-recorded. The grand tour question was open-ended allowing the nurses to begin, progress, and end the story as they chose. Riessman (2010) discusses the natural impulse of people to narrate experiences of life, so subjects were simply asked to tell their story of returning to practice. Following the interviews, transcripts were generated and examined for commonalities, challenges, and learning needs. Summary of Findings: Nurses returning to practice face many challenges on the journey back. The unfamiliarity with technology, difficulty finding work, insecurity, and horizontal violence are some of the challenges. Nurses who return will often develop a heightened empathy towards others and a drive to become the expert in their practice area. Returners also report a sense of loyalty toward the employer that took a chance in hiring them which often results in longevity with the organization. Confirmation of Thesis: The return to practice nurses each have a story to tell that enlightens both educators and hospitals on how to facilitate a safe and satisfying return. Statement of the Significance of the Findings: Because the Bureau of Labor Statistics is anticipating a growing need for nurses, the returning nurse is a valuable resource to meet the predicted shortage. The critical and mortal nature of the profession makes assuring competency of the returning nurse a vital undertaking. Suggestions for Further Research: Returners come back to practice with a variety of work experiences and variation in length of time out of nursing. Creating a return to practice program that assures competency while providing for individualization for this diverse group is challenging and poorly researched. The fees associated with operating a return to practice program most often exceeds program charges and is pieced together from online sources. How adept individual instructors are at this process directly affects program quality. Economically standardizing curriculum and creating organizational cultures that can facilitate compassionate preceptorships and individualized extended residencies needs further research