Provincial Survey of New Nursing Graduates

Report Prepared by the Manitoba Centre for Nursing and Health Research Faculty of Nursing of Manitoba

May, 2013

Diana Clarke, RN, PhD Associate Dean, Research Faculty of Nursing, Director—Manitoba Centre for Nursing and Health Research (MCNHR)

James Plohman, MSc Research Technician, MCNHR

Diane Cepanec, MA Associate Director, MCNHR

© 2013

1 Table of Contents

Executive Summary…………...….……..…………………………………………………Page 1.

Introduction………………...………………………………………………………………Page 2.

Purpose…….………...……...………………………………………………………………Page 2.

Study Procedure…………....………………………………………………………………Page 2.

Data Collection…...………...………………………………………………………………Page 3.

Characteristics of New Nursing Graduates…...…………….……………………………Page 4.

Employed New Nursing Graduates Current Employment Characteristics……………...………………...…………Page 7.. Initial Employment Search……….………………...…………………………..Page 9. The 6 Months Since Graduation…....………..…………………………………Page 11 Employment Satisfaction…….………………………………………………...Page 13 Employed Outside of Manitoba…..…………………....………………………Page 15

Unemployed New Nursing Graduates ..…………..…..…………………………………Page 16

New Nursing Graduates Seeking Employment Outside Manitoba..….…..…………...Page 19

Acknowledgements

This project was funded by the Nurses Retention and Recruitment Fund of Manitoba. Assistance in gathering con- tact information for the graduates was provided by Suzanne Wowchuk and staff from the College of Registered Nurses of Manitoba, Susan Barbeau (University College of the North), Tracey Collyer (), Dan- iel Gagné (Université de Saint-Boniface) and Linda Katz (). Student Research Assistants em- ployed by the Manitoba Centre for Nursing and Health Research conducted telephone survey interviews (Angela Miller, Leia Kehler, Rachel Usick).

2 Executive Summary

Most of the 256 nurses surveyed were employed (n=237; 93%) with only eight of these employed outside of Manitoba in other Canadian provinces.

All 8 new nursing graduates employed outside of Manitoba were working in other Canadian provinces with personal reasons related to family/friends (n=6) being the most commonly selected factor influencing their decision to leave Manitoba.

Of the 237 employed nurses, 41% (n=116) were in full-time positions and half (n=107; 50%) were in part- time positions with the remainder holding multiple (n=8; 3%) or casual (n=11; 5%) positions.

Collectively, almost half of the employed graduates were employed in Surgery (n=54; 23%) or Medicine (n=52; 22%).

The most commonly cited factors that lead to nurses accepting their first nursing position were that the po- sition was in the practice area in which they wanted to work (n=160) and that they had their senior clinical practicum in the same facility (n=142).

Almost two-thirds of the working graduates (n=153; 65%) have held only one nursing position since grad- uating, one-quarter have held two positions (n=64; 27%) and 8% (n=18) have held 3 or more positions.

Most (n=212; 91%) of the new nursing graduates were satisfied with their employment status. Ninety (91%) of the full time nurses were satisfied with their employment, 104 (90%) of the part-time graduates were satisfied with their employment. All of the nurses with multiple positions (n=8) and most of the nurs- es with casual employment (10 of 11) were satisfied with their employment type.

Eleven employed graduates and 3 unemployed graduates reported that they are currently seeking employ- ment outside of Manitoba (n=14).

Family/personal reasons (n=9), travel and weather (n=8) and professional opportunities (n=8) were the most commonly selected opportunities attracting new nurses to work outside of Manitoba.

3 1 Introduction New graduates are the future of the nursing work force in Manitoba. Unless health care institutions find ways to recruit and retain more nurses, nursing shortages will seriously affect the delivery of health ser- vices to patients in Manitoba. In order to develop good recruitment and retention strategies, it is important to know where new nurses are finding employment and what is attracting them to work in a chosen loca- tion and practice area.

Purpose The purpose of the survey was to gather information about new nursing graduate’s employment status, employment intentions and employment preferences. In addition, feedback on the education they received as well as their plans for further education were also collected.

Study Procedure With funding from the Nurses Recruitment and Retention Fund, and project assistance from each of the participating nursing schools and the College of Registered Nurses of Manitoba, the Manitoba Centre for Nursing and Health Research (MCNHR) conducted a survey of graduates from RN accredited nursing programs in Manitoba (Brandon University, University of Manitoba, University College of the North, Université de Saint-Boniface and Red River College) approximately 6 months after they graduated.

The MCNHR coordinated provincial data collection, analysis and reporting. A site coordinator at each participating RN program was responsible for distributing and collecting a contact information form from all potential graduates of their program prior to graduation. On the graduate contact information form, the graduates were asked to provide the MCNHR with a permanent postal address, email address and phone number at which they could be reach 6 months post-graduation. They were also asked for their consent to authorize the College of Registered Nurses of Manitoba (CRNM) to provide the MCNHR with the email address, phone number and mailing address associated with their CRNM membership 6 months af- ter graduation. The contact information obtain from the CRNM was used to ensure up-to-date contact in- formation was available for contacting the graduates.

The site coordinators were responsible for providing the MCNHR with all of the signed contact infor- mation forms in July, November 2011 and February, 2012. The MCNHR then provided the CRNM with all the names of graduates who had given their consent for the MCNHR to collect their postal address, email address, and/or phone number. Applicable copies of the signed contact information forms were provided to the CRNM as proof that the members had given their consent for the CRNM to release their contact information to the MCNHR. The CRNM conducted a search of their membership records to ex- tract the applicable contact information of all consenting graduates. This information was then forwarded on to the MCNHR coordinator for use in conducting the survey in April, August and November, 2013. Contact information was obtained for a total of 340 (82%) of the 414 nurses that graduated during the sur- vey time period.

4 2 Data Collection In April, August and November 2012, attempts were made to contact a total of 340 nurses who had graduated in September/October, 2011, February and May/June 2012 respectively. The Red River College diploma program graduates complete their programs at various time points throughout the year but only officially graduate in May. Therefore, these graduates were interviewed with the graduate group that immediately fol- lowed the date at which they completed their program. The nurses were contacted through online, telephone and postal mail delivery methods. In total, 256 of 340 (75%) of the nurses who were contacted, completed the survey. This was 62% (256 of 414) of the nurses that graduated during the survey time period. In total, there were 205 graduates from the University of Manitoba, 46 from Brandon University, 59 from the Red River College diploma program, 46 from the Red River College/University of Manitoba Joint Baccalaureate of Nursing Program, 29 from the Université de St. Boniface and 29 from the University College of the North.

The survey was administered through the use of a secure online survey provider called Fluidsurveys.com. A survey invitation email containing a web-link to the online survey was sent to all available graduate’s email addresses. Graduates who did not respond to the initial email request were sent two reminder emails. All three emails sent to potential participants contained a web-link they could follow to opt-out of participating in the survey. No one chose to use this opt-out link. Graduates who did not respond to the email survey request were contacted by telephone to conduct the survey over the phone and let them know that they could com- plete the survey online if they preferred. They were called at varying times of the day and evening to attempt to ask them to complete the survey. After at least 6 attempts were made to contact the graduates by tele- phone, the remaining non-responders were sent a hardcopy to their postal addresses along with a postage paid envelope to use in returning the completed survey. A total of 176 (69%) survey participants completed the survey online, 75 (29%) completed it over the telephone and 5 (3%) completed the hardcopy and returned it by postal mail. Almost a third (n=51; 29%) of the survey participants that completed the survey online did not do so until they received at least one telephone call requesting their participation in the survey. All data collected from the survey was collected into a Provincial Nursing Graduate Database in the form of an SPSS data file housed in the MCNHR. The employment data of those surveyed are presented in this report.

5 3 Characteristics of New Nursing Graduates Figure 1. Age of new nursing graduates (n=256) Figure 1 shows the age distribution 140 of the new nursing graduates (n=256). 45% 120 100 Almost three-quarters (n=188; 73%) % 80 28% were less than 30 years old. 60 88% (n=224) were female and 12% 40 10% 10% (n=31) were male. One didn’t answer. 4% 4% 20 0 About a quarter of the nurses were <= 24 25-29 30-34 35-39 40-44 >= 45 born outside of (n=36; 28%). Age Group (Years)

Figure 2. Marital status of new nursing graduates (n=256)

Figure 2 shows the marital status of the <1% new nursing graduates (n=256). 4%

Single/Never Married More than half (n=149; 58%) reported be- (n=149; 58%) ing single/never married, a little over a 38% Married/Common- third (n=96; 38%) were living married/ Law (n=96; 38%) common-law and the rest were either sepa- rated/divorced or didn’t respond to this Separated/Divorced (n=10; 4%) question. 58% No Response (n=1; < 1%)

Figure 3. Educational institutions from which the surveyed new nursing graduates graduated (n=256)

6% 13% Figure 3 shows the number of surveyed Brandon University (n=34; 13) 15% new nursing graduates that graduated from each of the participating institu- University of Manitoba (n=126; 49%) tions.

Université St. Boniface (n=22; 9%)

8% A total of 256 nurses participated in the Red River College/University of Manitoba Joint Baccalaureate of Nursing survey out of a total of 472 that graduat- (n=21; 8%) ed during this period. Red River College (diploma program) 9% (n=38; 15%)

49% University College of the North (n=15; 6%)

6 4 Characteristics of New Nursing Graduates (continued) Figure 4. Current health regions of residents of the new nursing graduates (n=256)

4% 1% Figure 4 shows the health region of residence 4% of the new nursing graduates.

10%

Winnipeg (n=165; 64%) Almost two-thirds (64%; n=165) reported Interlake Eastman (n=12; 5%) living in . Prairie Mountain (n=30; 12%) 12% Southern (n=27; 11%) Northern (n=10; 4%) Only 4% (n=10) reported that they are cur- Outside Manitoba in Canada (n=10; 4%) No Response (n=2; 1%) rently living outside of Manitoba in another 5% 64% province.

Table 1. Facilities at which new nursing graduates Table 1 summarizes the health care institu- had their senior practicums (n=256) tions in which the new nursing graduates had Number Percentage their senior clinical practicums. Winnipeg Facilities (n=179) Hospitals (n=169) The Health Sciences Centre (n=72; 28%) and Health Sciences Centre 75 29% St. Boniface General Hospital (n=52; 20%) in St. Boniface Hospital 52 20% Winnipeg collectively hosted almost half of Seven Oaks General Hospital 8 3% the new nursing graduates (n=124; 48%)

Victoria General Hospital 13 5% About three quarters of the employed nurses Concordia General Hospital 12 5% (n=172; 73%) indicated that their clinical Grace General Hospital 7 3% practicums assisted them in finding their first Other Winnipeg Hospital 2 1% nursing positions. Long Term Care or Community Health (n=10) 10 4% 70% (n=163) of the employed nurses are cur- Rural Manitoba Facilities (n=72) rently working in the same facility as where Hospitals 40 16% they had their senior clinical practicum. Long Term Care or Community Health 9 4% Rural Mixed Service Facilities 9 4% About 59% (n=140) of the employed nurses Rural Regional Health Authorities 10 4% indicated their first nursing position was in the same unit in which they had their senior Other 4 2% clinical practicum. Outside Manitoba Facilities (n=3) 3 1% No Response (n=2) 2 2% Total New Nursing Graduates Surveyed 256 100%

7 5 Characteristics of New Nursing Graduates (continued)

Table 2. Areas of practice in which new nursing graduates had their senior practicums

Area of Specialty Number Percentage Medicine 61 24% Surgery 53 21% Several (Multiple) Clinical Areas 29 11% Maternal/Newborn 28 11% Emergency Care 19 7% Pediatrics/Child 14 5% Geriatrics/Long Term Care 5 2% Cardiology or Oncology 6 2% Community Health or Home Care 10 4% Critical Care (ICU, CCU) 4 2% Rehabilitation 7 3% Operating/Recovery Room 6 2% Palliative Care 6 2% Psychiatric/Mental Health 6 2% No Response 2 1% Total 256 100%

Table 2 summarizes the areas of practice in which the new nursing graduates had their senior clinical practicums.

Medicine (n=61; 24%) and surgery (n=53; 21%) were the two areas in which almost half of the new nursing graduates had their senior clinical practicums (n=114; 45%)

8 6 Employed New Nursing Graduates - Current Employment Characteristics Figure 5. Employment Rate of New Nursing Graduates (n=256)

7% < 1% Figure 5 depicts the percentage of self-reported employed nurse graduates (n=256) Employed in Nursing (n=237; 93%) Most (n=237; 93%) of the nurse graduates re- No Employed in Nursing but seeking employment ported being employed at the time of the survey. (n=18; 7%) Not Employed and not seeking nursing employment (n=1; < 1%)

93%

Figure 6. Type of employment held by employed new 93% (n=237) of the new nursing graduates nursing graduates reported they were employed in a nursing po- sition (Figure 6). 5% 1% Full Time Permanent 4% (n=77; 32%) Of the 237 employed nurses, 41% (n=116) 32% Full Time Term (n=22; were in full-time positions and half (50%; 13% 9%) n=107) were in part-time positions. Part Time Permanent (n=85; 36%) Only 3% (n=8) reported holding multiple posi- Part Time Term (n=31; tions and 5% (n= 11) had casual positions. 13%)

Multiple Positions (n=9; 4%) When asked if they are currently working as many hours as they would like to work, most Casual (n=11; 5%) 36% 9% (n=204; 80%) said they were, only 21 (8%) said they would like more hours and 10 (4%) No Response (n=2; 1%) said they would like fewer hours.

Figure 7 shows the employment status of only the Figure 7. Type of employment held by Université de St. Boniface educated new nursing graduates Université de St. Boniface graduates (n=22).

Université de St. Boniface offers a 3 year diploma program that allows their graduates to seek their

14% Registered Nurse designation upon graduation. However, their students may enroll in an additional 1 year of study in a partnership with the University 41% 18% of Ottawa to obtain their Baccalaureate of Nursing Part Time Permanent (n=9; 41%) Part Time Term (n=4; 18%) degree. Multiple Positions (n=2; 9%) Casual (n=4; 18%) Unemployed (n=3; 14%) Some of the graduates from Université de St. Boni- face may have elected to enroll in this 4th year of study, and as such may not be available to work full 9% -time.

18% More than half reported being employed in part- time positions (n=13; 59%). 9 7 Employed New Nursing Graduates - Current Employment Characteristics (continued) Table 3 lists the current employers of the graduates with the Health Sciences Centre (n=59; 25%) and St. Boniface General Hospital (n=56; 24%) together employing almost half the employed nurses surveyed (n=115; 49%)

Table 4 lists the areas of practice of the employed nurses in descending order of frequency. Almost half of the nurses were employed in either surgery (n=54; 23%) or medicine (n=52; 22%)

Table 5 lists the mean EFTs of full-time and part-time employed new nursing graduates who are em- ployed outside (Rural Manitoba) and inside of Winnipeg. Those working in multiple and casual posi- tions were excluded from this table. All 5 nurses included in the table who were working outside of Manitoba were employed in full-time positions (n=5). Three additional nurses working outside the prov- ince had casual or multiple positions.

Table 3. New nursing graduates current places of Table 4. Areas of practice of employed new employment (n=237) nursing graduates (n=237) Employer Types Number Percentage Area of Practice Number Percentage Winnipeg Facilities (n=160) Surgery 54 23% Hospitals (n=149) Medicine 52 22% Health Sciences Centre 59 25% Multiple Clinical Areas 23 10% St. Boniface Hospital 56 24% Other (Various Specialties) 25 11% Seven Oaks General Hospital 9 4% Maternal/Newborn 22 9% Victoria General Hospital 9 4% Emergency Care 20 8% Concordia General Hospital 8 3% Pediatrics/Children 10 4% Grace General Hospital 8 3% Geriatrics/Long Term Care 9 4% Long Term Care or Community Health Operating/Recovery Room 7 3% (n=11) 11 5% Rehabilitation 6 3% Rural Manitoba Facilities (n=60) Palliative Care 5 2% Hospitals 53 22% No Response 4 2% Long Term Care 5 21% Total 237 100% Other 2 1% Facilities Outside Manitoba (n=7) 7 3% Employed in Multiple Facilities (n=8) 8 3% No Response (n=2) 2 1% Total Employed Graduates 237 100%

Table 5. Full-time and part-time employed new nursing graduate’s EFTs (n=214). *Those that reported having multiple or casual employment positions are not included. Place of Employment Number Mean EFT Std. Deviation Minimum Maximum Winnipeg 153 0.79 0.22 0.40 1.00 Rural Manitoba 56 0.83 0.19 0.50 1.00 Other Provinces 5 1 0.00 1.00 1.00 Total 214 0.8 0.21 0.40 1.00 10 8 Employed New Nursing Graduates - Initial Employment Search

Graduates were asked to choose from a Table 6. Deciding factors in new nursing graduates list of deciding factors that were im- accepting their first nursing position* portant to them in accepting their first Factor Number nursing positions. Practice area I wanted to work in 160 Had senior clinical practicum there 142 Table 6 summarizes the factors chosen. Position is close to home 126 Many graduates provided more than one First place to offer employment 123 deciding factor. Positive reputation of the facility/organization 99 Had student clinical placement there 53 The two most commonly selected factors Work on another unit within the same facility/ in deciding what employment to accept organization 41 were that the position was in the practice Recruitment strategies of facility/organization (ie. em- area in which they wanted to work ployment type, signing bonus) 31 (n=160) and that the position was in the Worked on the unit in another role 23 same place where they had their senior Various other factors 16 clinical practicum (n=142). Supportive staff and work environment 13 * Note—Total number of responses is not equal to n=237 (100%) as new nursing graduates could identify multiple deciding factors.

Most graduates found employment as soon as they wanted (n=214; 90%)

Twenty of the 237 (8%) employed graduates reported they could not find employment as soon as they wanted after graduation. Three did not answer this question.

Figure 8 summarizes the reasons that Figure 8. Reasons employed new nursing graduates did not were provided by employed new nurs- finding employment as soon as they wanted. (n=20) ing graduates for not finding nursing em- ployment as soon as they wanted.

5% Of the 20 who were not able to find work as soon as they wanted 6 reported having

20% 30% difficulty finding job opportunities and Difficult finding job opportunities and getting hired (n=6; 30%) getting hired. Could only find casual positions (n=2; 10%) No job in my specialty area (n=5; 25%) 14 reported not finding employment as

No full time jobs available (n=2; 10%) soon as they wanted as they were partic- ular about the employment they were Administrative delays (n=4; 20%) 10% willing to accept (only found casual, no No Response (n=1; 5%) full time positions or jobs in a specific 10% specialty area.

25% Four experienced administrative matters which delayed the start of their employ- ment. 11 9 Employed New Nursing Graduates - Initial Employment Search (cont’d)

Figure 9. Manitoba Regions in which employed new nursing graduates searched for employment (n=237) 43 of the 237 employed graduates searched for employment in more than Northern n=11 one Manitoba RHA.

Winnipeg/Churchill n=176 Figure 9 shows the number of graduates that reported searching for employment

Southern n=33 in each RHA.

Health Regions

Interlake Eastern n=15

Prairie Mountain n=41

0 20 40 60 80 100 120 140 160 180 200 Number of Graduates * Note- Multiple locations were selected by 43 nurses Figure 10. Locations outside of Manitoba where employed new nursing graduates have searched for employment Figure 10 shows the number of em- (n=30) ployed new nursing graduates that sought employment outside of Manito- ba.

Other Countries n=6 30 graduates sought employment in the United States, other countries and/or other provinces.

Other Provinces n=22 Location 3 graduates sought out employment in more than one category.

United States n=7

0 5 10 15 20 25 Number of Graduates

* Note- Multiple locations were selected by 3 nurses Employed new nursing graduates that Figure 11. Reasons employed new nursing graduates sought employment outside of Manitoba (n=32) had sought employment outside of Man- itoba were asked why they had sought out employment outside of Manitoba Other n=3 (n=35)

Seeking Particular Employment n=3 Two employed new nursing graduates provided two reasons for having sought Higher Wages n=5 employment outside of Manitoba.

Family/Personal n=11 Outside Manitoba As shown in Figure 11, family/personal Adventure n=10 reasons and adventure were the most Reasons Reasons for Seeking Employment frequently cited reason for seeking em- 0 2 4 6 8 10 12 ployment outside of Manitoba. Frequency of Responses 12 10 Employed New Nursing Graduates - The 6 Months Since Graduation Figure 12. Number of employment positions held by new nursing graduates since graduation

180 As shown in Figure 12, about a third (35%; 160 153 n=82) of the 237 employed nurses reported 140 having been employed in more than one po- 120 sition since graduation. 100 80

64 Number of Nurses 60 40 18 20 2 0 1 2 3+ No Response Number of Positions Held Since Graduation

Table 7. Reasons employed new nursing graduates have The 82 employed nurses who have held had more than one nursing position since graduation* more than one position since graduating Reasons Number provided a number of reasons (Table 7) Had term positions 31 with some providing more than one reason. Switched to permanent position 26 The most common reasons given for having Switched out of float/relief pool or casual position 22 more than one position since graduation Switched to greater EFT position 13 were employment in term positions that had Changed area of practice 12 finished (n=31), switching into permanent Have multiple concurrent positions 7 positions (n=26) and switching out of float/ Other Reasons 5 relief pool or casual positions (n=22). Started out in term mentorship position 4 Changed location of employment 3 Switched to lower EFT position 2 * Note- Multiple reasons were selected by some new nurses Table 8. Desired primary area of practice that nurses Most (n=197; 83%) of the 237 employed were seeking upon graduation but didn’t find. graduates found employment in their area of practice of choice. Area of Practice Number Percentage Public Health 8 21% The 38 nurses that did not find employment Surgery 8 21% in their practice area of choice were asked Medicine 4 11% to identify their desired area of practice. As Changed mind from initial plan 2 5% shown in Table 8, Public Health and Sur- ER 2 5% gery were the two most commonly cited Labour and Delivery 2 5% areas of practice in which nurses wanted Maternal/Child 2 5% employment but could not find it.

No Preference 2 5% Pediatrics 2 5% Antepartum/Gynecology 1 3% ICU 1 3% Oncology 1 3% Other 1 3% Palliative Care 1 3% Postpartum 1 3% Total 38 100% 13 11 Employed New Nursing Graduates - The 6 Months Since Graduation (continued) Figure 13. Reasons why employed new nursing graduates did not find the employment status they were seeking upon graduation New nursing graduates that did not obtain the employment status of choice were asked why they thought they didn’t find their em- I don't know 1 ployment of choice. 45 provided one rea-

Did not have seniority in the facility 4 son and 10 provided more than one re- sponse.

Other 5 The reasons provided are summarized in Figure 13. Did not have qualifications required 11 The most reported reason for not finding their employment of choice was that it was Did not have experience required 18 not available (n=37). Lack of experience and lack of qualifica- Employment of choice not available 37 tions were the second and third most com-

0 5 10 15 20 25 30 35 40 mon reasons provided. Frequency of Responses Employed new nursing graduates were Table 9. Employment intentions of employed new asked about their employment intentions nursing graduates within the next year. within the next year which are summarized in Table 9. Employment Intentions Number Remain in my current position 148 Most employed new nursing graduates indi- Look for another position with current employer 76 cated they intend to remain in their current Look for another nursing position in Manitoba 52 position (n=148) or look for another position Look for a nursing position in another province 19 within their current place of employment Look for another position in another country 11 (n=76). Look for another position in the U.S. 8 Other 5 Some selected more than one category.

0 Return from a different country or province for a

Figure 14. Reasons employed new nursing graduates provided for having an intention to seek employment in Of the 17 graduates who indicated an inten- another country in the next year. tion to seek employment in another country in the future, 15 provided a reason for hav- ing this desire (Figure 14).

Most (n=11) of the 15 were looking for ad- 4 venture and travel experiences and the re- Adventure/Travel maining 4 intend to go to another country for family/personal reasons. Family/Personal Reasons 11

14 12 Employed New Nursing Graduates - Employment Satisfaction

About three-quarters (n=185; 79%) of the employed new nursing graduates reported that they found em- ployment in the employment area that they were seeking at graduation. Four employed new nursing graduates did not answer this question.

The 48 employed graduates that did not find the employment type they were looking for all indicated they were hoping to find permanent positions with almost two-thirds looking for part-time positions (n=31; 65%) and another one-third looking for full-time positions (n=14; 29%) (Figure 15).

Almost all of the 31 employed nurses who had searched for part-time employment, wanted positions with an EFT of 0.7 or greater (n=28) and the remaining three wanted an EFT of 0.5

Figure 15. Employment type sought at graduation by currently employed nurses who did not find their desired employment type (n=48)

1, 2% 2, 4%

14, 29% Full Time Permanent Part Time Permanent Multiple Positions Other 31, 65%

15 13 Employed New Nursing Graduates - Employment Satisfaction (continued) Despite the fact that only 79% of the employed graduates found the employment type they were seeking, a greater percentage, 91% (n=212), reported being satisfied with their current employment position.

As shown in Table 10, all the nurses who held multiple positions were satisfied with the employment type they held. The part time permanent (92% satisfied), full time term (91%) and casually employed (91%) nurses were as satisfied or more satisfied than the mean. Three didn't answer this question.

Table 10. Employment satisfaction of nurses by employment type (n=234)

Employment Satisfaction Position Held Satisfied (n) Unsatisfied(n) Total Full Time Permanent 70 (91%) 7 (9%) 77 (100%) Full Time Term 20 (91%) 2 (9%) 22 100%) Part Time Perma- 78 (92%) 7 (8%) 85 (100%) nent Part Time Term 26 (84%) 5 (16%) 31 (100%) Multiple Positions 8 (100%) 0 (0%) 8 (100%) Casual 10 (91%) 1 (9%) 11 (100%)

Even though most of the employed nurses were satisfied with their current employment type, 40% (n=95) reported that they are looking for another position.

The 95 employed nurses that were seeking other employment were asked what kind of employment they were looking for. Many wanted to change several characteristics of their employment. Their responses are summarized in Figure 16.

The most commonly cited things that these nurses were wanting to change about their employment was their area of practice (n=30) and not surprisingly to obtain a permanent position (n=24).

Figure 16. Employed new nursing graduates that indicated they are looking for another position provided the changes they would like to make to their employment (n=95).

Get out of Float or Casual Position 4 Other 6 Move into a Casual Position 6 Increased EFT 7 Full Time 10 Decreased EFT 12 Change Facility of Employment 15 Obtain a Permanent Position 24 Change Area of Practice 30 0 5 10 15 20 25 30 35 Frequency 16 14 Employed New Nursing Graduates - Employed Outside Manitoba (n=8)

Eight of the 237 employed graduates are working outside of Manitoba in other Canadian provinces.

Five of the 8 worked as a nurse in Manitoba before leaving Manitoba

All 5 that worked in Manitoba before leaving secured an employment position in another province before leaving Manitoba.

There were 2 additional graduates that received offers of employment from employers in another province and 2 that received offers from employers in the U.S.

Graduates were working outside of Manitoba were asked to select from a list of factors that influ- enced their decision to leave the Manitoba. Many graduates selected multiple influences. Tables 11 summarizes these results.

The most commonly cited influence for leaving the province was personal reasons (n=8)

These personal reasons included following an employed spouse out of the province and moving to be closer to family and friends.

Graduates that were working outside of Manitoba were asked to select from a list of factors that would motivate them to return to work as an RN in Manitoba. Many graduates selected multiple influ- ences. Tables 12 summarizes these results.

Again family considerations was the most commonly cited factor (n=4). Availability of full time work, better wages and benefits and education and training opportunities were each selected as moti- vations by 3 graduates.

Table 11. Factors that influenced new nurses Table 12. Factors that would motivate nurses to decision to leave Manitoba. return to Manitoba.

Opportunities Number Motivations Number Personal Reasons (Family/Friends) 6 Family Considerations 4 Better Pay and Benefits 2 Availability of Full Time Work 3 Career Opportunities 1 Better Wages & Benefits 3 Cost of Living 1 Education / Training 3 Lack of Permanent Positions 1 Availability of Employment in Specific Areas 2 Other (Where I want to live) 1 Job Security 2 Signing bonus / relocation Assistance 1 Other (plan on returning in 5-10 years) 1 Work load/ work conditions 1 Workload / Work Conditions 1 Hours of Work 0 Availability of Part Time Work 0 Lack of Employment in Specific Areas 0 Different Scheduling Practices 0 Lack of Full Time Positions 0 Relocation Expenses 0

17 15 Unemployed New Nursing Graduates (n=18) Figure 17. Length of time spent searching for nursing employment by unemployed new nursing graduates (n=18)

12 10 10 Only 7% (n=18) of the graduates reported 8 being currently unemployed in nursing but 6 were seeking employment in nursing. 4 4 Frequency 2 Figure 17 illustrates the length of time these 2 1 1 unemployed graduates have been searching 0 Less than 1 1-2 3-6 More than No for nursing employment. month months months 6 months Response Length of Time Searching for Employment

Figure 18. Type of employment sought by unemployed new nursing graduates

6% As shown in Figure 18, eleven of the 18 un- employed graduates were seeking part-time positions. 33% Full Time Permanent (n=6; 33%) Full Time Term (n=1; Most (16 of 18) unemployed graduates were 6%) looking for permanent positions. Part Time Permanent (n=10; 56%) Part Time Term (n=1; 56% 6%) 5%

Figure 19. Desired shift sought by unemployed new nursing graduates (n=18)

22% 8 hour day / evening (n=10; 56%) 8 hour day / night (n=4; 22%) 12 hour day / night (n=4; 22% 56% 22%)

Figure 19 depicts the desired shift of the unemployed graduates. A little more than half (n=10) of the un- employed graduates wanted an 8 hour day / evening shift (10 of 18).

18 16 Unemployed New Nursing Graduates (n=18; continued)

Figure 20. Types of employers with which unemployed new nursing graduates are seeking employment (n=38)

Other 1

F Community Health 4 a c T Private nursing agency 3 i y l p Long term care 6 i e t Personal care home 7 y

Hospital 17

0 5 10 15 20 Frequency

*Respondents could select multiple employer types

Figure 20 summarizes the employer types with which unemployed new nursing graduates are seeking em- ployment. Some chose more than one employer type. Most were seeking employment with more than one type of employer.

Employment in hospitals was sought after by all but one of the 17 unemployed graduates.

19 17 Unemployed New Nursing Graduates (n=18; continued) Many of the 18 unemployed nurses reported seeking employment in more than one area of practice. They reported looking for employment in a wide variety of areas but Geriatrics/long term care (n=7), maternal/newborn (n=6) and medicine (n=6) were the most highly sought after areas of employment by this group as shown in Table 13.

Table 13. Primary areas of practice in which unemployed graduates are seeking employment

Area Number Percentage Geriatrics/Long term care 7 12% Maternal/Newborn 6 10% Medicine 6 10% Palliative Care 5 9% Surgery 5 9% Community Health 4 7% Pediatrics/Children 4 7% Rehabilitation 4 7% Home Care 3 5% Psychiatric/Mental Health 3 5% Emergency Care 2 3% Operating/Recovery Room 2 3% Ambulatory Care 1 2% Critical Care (ICU/CCU) 1 2% Oncology 1 2% Relief Pool 1 2% Acute Care 1 2% Gynecology 1 2% No Response 1 2% * Respondents could select multiple areas of practice.

Figure 21 shows the health regions where unemployed nurses are seeking employment.

Five of the unemployed nurses are searching for employment in more than one RHA.

Figure 21. Health Regions where unemployed nurses are seeking employment. (n=24)

M Not in Manitoba 2 a Northern 3 n Southern 3 R i Prairie Mountain 3 t H A Interlake Eastern 3 o Winnipeg/Churchill 10 b a 0 2 4 6 8 10 12 Frequency

* Note– Five graduates were seeking employment in more than one RHA. 20 18 New Nursing Graduates Seeking Employment Outside Manitoba (n=14) Eleven employed graduates and 3 unemployed graduates reported that they are currently seeking employ- ment outside of Manitoba (n=14).

Figure 22 lists the locations that these graduates are seeking employment.

Ten of the 14 were seeking employment in other provinces.

Figure 22. Locations outside of Manitoba where new nursing graduates are seeking employment. (n=16)

12 10 10 8 6 4 3 3 Frequency 2 0 United Other Other States Provinces Countries Location

* Note– One graduate was seeking employment in all three categories

21 19 New Nursing Graduates Seeking Employment Outside Manitoba (n=14; continued)

Table 14 summarizes the opportunities that are at- Table 14. Opportunities that are attracting new nursing graduates to seek employment outside of tracting these nurses to seek employment outside of Manitoba. Manitoba. They were asked to select from a list of possible opportunities. Many graduates chose more Opportunities Number than one opportunity. Family/Personal 9 Travel & Weather 8 The most commonly cited opportunities are family/ Professional Opportunities 8 personal reasons (n=9), travel and weather (n=8) and Workload/Work Conditions 3 professional opportunities (n=8). Pay & Benefits 3 Recruitment Strategies 2 Cost of Living 1 Other 1

* Note– Graduates each selected multiple oppor- tunities from the list.

Table 15 summarizes the challenges that are encour- Table 15. Challenges encouraging nurses to seek aging these graduates to seek employment outside of employment outside of Manitoba Manitoba. They were asked to select from a list of Challenges Number possible challenges. Family or Personal Issues 5 Again challenges related to family/personal and Weather 3 weather were encouraging graduates to seek employ- No Challenge, just want adventure 3 ment outside of Manitoba. Lack of Employment in Certain Specialty Areas 2 Lack of Employment in Certain Locations 2 Three cited they were just looking for adventure and Cost of Living 2 not experiencing challenges encouraging them to None of the Above 2 leave Manitoba Lack of Full Time Employment 1 Only 3 of the 14 graduates seeking employment out- Lack of Permanent Employment 1 side of Manitoba would stay in Manitoba if offered Not Feeling Valued 1 Lack of Educational Opportunities 1 the employment type they are seeking. Lack of Career Opportunities 1 Other 1 Work or Workload Conditions 0 * Note– Graduates each selected multiple challenges from the list.

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