title: Letting go: How newly graduated registered nurses in Western Canada decide to exit the nursing profession.
abstract: BACKGROUND
  The Canadian Nurses Association (CNA) estimates a nursing shortage in Canada will rise to 60,000 registered nurses by 2022. Further compounding this crisis is the approximate 14-61% of new nursing graduates who will change nursing roles or exit the profession.
  
  
  OBJECTIVE
  To explore the factors and basic psychosocial process involved in the decisions of newly graduated registered nurses in Western Canada who permanently exit the nursing profession within five years.
  
  
  METHODS
  Data was collected through unstructured and semi-structured interviews using the Glaserian grounded theory method.
  
  
  RESULTS
  Participants were found to be in a process of letting go of nursing that commenced as students and continued as they entered practice as registered nurses. Four major themes were identified. 1) Navigating constraints of the healthcare system and workplace: participants encountered difficulties adjusting to shiftwork and workload. 2) Negotiating social relationships, hierarchies, and troublesome behaviors; specifically hierarchal and horizontal violence. 3) Facing fears, traumas and challenges. 4) Weighing competing rewards and tensions which resulted in leaving the nursing profession.
  
  
  CONCLUSIONS
  Students and subsequently new nursing graduates require a variety of supports to establish a nursing identity and remain in the profession. These supports include a manageable workload; meaningful orientation; interprofessional teamwork; and engagement within transformational and authentic leadership constructs. New nurses require a sense of being welcomed, valued, respected and accepted into the workplace environment, as well as constructive feedback, emotional support and debriefing to face workplace challenges.
authors: Faculty of Health Studies, Brandon University, 270-18th Street, Brandon, Manitoba R7A 6A9, Canada. Electronic address: chachulak@brandonu.ca.
authors: Kathryn M
authors: KM
authors: Chachula
authors: Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Electronic address: flo.myrick@ualberta.ca.
authors: Florence
authors: F
authors: Myrick
authors: Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Electronic address: olive.yonge@ualberta.ca.
authors: Olive
authors: O
authors: Yonge
mesh_terms: D000328:Adult; D058445:Bullying; D002170:Canada; D002321:Career Choice; D004508:Education, Nursing, Baccalaureate; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D009726:Nurses; D010563:Personnel Turnover; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology*
keywords: Bullying; Exit from profession; Grounded theory; Intention to leave; Newly graduated nurses; Shiftwork; Student–teacher relationships; Workload