Provincial Survey of New Manitoba Nursing Graduates

Provincial Survey of New Manitoba Nursing Graduates Report Prepared by the Manitoba Centre for Nursing and Health Research Faculty of Nursing University of Manitoba May, 2013 Diana Clarke, RN, PhD Associate Dean, Research Faculty of Nursing, University of Manitoba 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 contact 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 (Brandon University), Daniel Gagné (Université de Saint-Boniface) and Linda Katz (Red River College). Student Research Assistants employed 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 parttime 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 position 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 graduating, 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 nurses 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 employment 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. 1 3

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 services 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 location 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 after graduation. The contact information obtain from the CRNM was used to ensure up-to-date contact information was available for contacting the graduates. The site coordinators were responsible for providing the MCNHR with all of the signed contact information 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 extract 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 survey time period. 2 4

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 followed 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 complete 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 telephone, 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. 3 5

Characteristics of New Nursing Graduates Figure 1. Age of new nursing graduates (n=256) 140 120 45% 100 % 80 28% 60 40 10% 10% 20 4% 4% 0 <= 24 25-29 30-34 35-39 40-44 >= 45 Age Group (Years) Figure 1 shows the age distribution of the new nursing graduates (n=256). Almost three-quarters (n=188; 73%) were less than 30 years old. 88% (n=224) were female and 12% (n=31) were male. One didn t answer. About a quarter of the nurses were born outside of Canada (n=36; 28%). Figure 2. Marital status of new nursing graduates (n=256) Figure 2 shows the marital status of the new nursing graduates (n=256). 4% <1% More than half (n=149; 58%) reported being single/never married, a little over a third (n=96; 38%) were living married/ common-law and the rest were either separated/divorced or didn t respond to this question. 38% 58% Single/Never Married (n=149; 58%) Married/Common- Law (n=96; 38%) Separated/Divorced (n=10; 4%) No Response (n=1; < 1%) Figure 3. Educational institutions from which the surveyed new nursing graduates graduated (n=256) 15% 6% 13% Brandon University (n=34; 13) University of Manitoba (n=126; 49%) Figure 3 shows the number of surveyed new nursing graduates that graduated from each of the participating institutions. 8% 9% Université St. Boniface (n=22; 9%) Red River College/University of Manitoba Joint Baccalaureate of Nursing (n=21; 8%) Red River College (diploma program) (n=38; 15%) A total of 256 nurses participated in the survey out of a total of 472 that graduated during this period. 49% University College of the North (n=15; 6%) 4 6

Characteristics of New Nursing Graduates (continued) Figure 4. Current health regions of residents of the new nursing graduates (n=256) 4% 4% 1% Figure 4 shows the health region of residence of the new nursing graduates. 10% Winnipeg (n=165; 64%) Interlake Eastman (n=12; 5%) Prairie Mountain (n=30; 12%) Almost two-thirds (64%; n=165) reported living in Winnipeg. 12% 5% 64% Southern (n=27; 11%) Northern (n=10; 4%) Outside Manitoba in Canada (n=10; 4%) No Response (n=2; 1%) Only 4% (n=10) reported that they are currently living outside of Manitoba in another province. Table 1. Facilities at which new nursing graduates had their senior practicums (n=256) Number Percentage Winnipeg Facilities (n=179) Hospitals (n=169) Health Sciences Centre 75 29% St. Boniface Hospital 52 20% Seven Oaks General Hospital 8 3% Victoria General Hospital 13 5% Concordia General Hospital 12 5% Grace General Hospital 7 3% Other Winnipeg Hospital 2 1% Long Term Care or Community Health (n=10) 10 4% Rural Manitoba Facilities (n=72) Hospitals 40 16% Long Term Care or Community Health 9 4% Rural Mixed Service Facilities 9 4% Rural Regional Health Authorities 10 4% Other 4 2% Outside Manitoba Facilities (n=3) 3 1% No Response (n=2) 2 2% Total New Nursing Graduates Surveyed 256 100% Table 1 summarizes the health care institutions in which the new nursing graduates had their senior clinical practicums. The Health Sciences Centre (n=72; 28%) and St. Boniface General Hospital (n=52; 20%) in Winnipeg collectively hosted almost half of the new nursing graduates (n=124; 48%) About three quarters of the employed nurses (n=172; 73%) indicated that their clinical practicums assisted them in finding their first nursing positions. 70% (n=163) of the employed nurses are currently working in the same facility as where they had their senior clinical practicum. About 59% (n=140) of the employed nurses indicated their first nursing position was in the same unit in which they had their senior clinical practicum. 5 7

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%) 6 8

Employed New Nursing Graduates - Current Employment Characteristics Figure 5. Employment Rate of New Nursing Graduates (n=256) 7% < 1% Employed in Nursing (n=237; 93%) No Employed in Nursing but seeking employment (n=18; 7%) Not Employed and not seeking nursing employment (n=1; < 1%) Figure 5 depicts the percentage of self-reported employed nurse graduates (n=256) Most (n=237; 93%) of the nurse graduates reported being employed at the time of the survey. 93% Figure 6. Type of employment held by employed new nursing graduates 13% 36% 4% 5% 1% Full Time Permanent (n=77; 32%) 32% Figure 7. Type of employment held by Université de St. Boniface educated new nursing graduates 9% Full Time Term (n=22; 9%) Part Time Permanent (n=85; 36%) Part Time Term (n=31; 13%) Multiple Positions (n=9; 4%) Casual (n=11; 5%) No Response (n=2; 1%) 93% (n=237) of the new nursing graduates reported they were employed in a nursing position (Figure 6). Of the 237 employed nurses, 41% (n=116) were in full-time positions and half (50%; n=107) were in part-time positions. Only 3% (n=8) reported holding multiple positions and 5% (n= 11) had casual positions. When asked if they are currently working as many hours as they would like to work, most (n=204; 80%) said they were, only 21 (8%) said they would like more hours and 10 (4%) said they would like fewer hours. Figure 7 shows the employment status of only the Université de St. Boniface graduates (n=22). 18% 14% 41% Part Time Permanent (n=9; 41%) Part Time Term (n=4; 18%) Université de St. Boniface offers a 3 year diploma program that allows their graduates to seek their Registered Nurse designation upon graduation. However, their students may enroll in an additional 1 year of study in a partnership with the University of Ottawa to obtain their Baccalaureate of Nursing degree. Multiple Positions (n=2; 9%) 9% Casual (n=4; 18%) Unemployed (n=3; 14%) Some of the graduates from Université de St. Boniface may have elected to enroll in this 4th year of study, and as such may not be available to work full -time. 18% More than half reported being employed in parttime 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 employed outside (Rural Manitoba) and inside of Winnipeg. Those working in multiple and casual positions 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 province had casual or multiple positions. Table 3. New nursing graduates current places of employment (n=237) Employer Types Number Percentage Winnipeg Facilities (n=160) Hospitals (n=149) Health Sciences Centre 59 25% St. Boniface Hospital 56 24% Seven Oaks General Hospital 9 4% Victoria General Hospital 9 4% Concordia General Hospital 8 3% Grace General Hospital 8 3% Long Term Care or Community Health (n=11) 11 5% Rural Manitoba Facilities (n=60) Hospitals 53 22% Long Term Care 5 21% 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 4. Areas of practice of employed new nursing graduates (n=237) Area of Practice Number Percentage Surgery 54 23% Medicine 52 22% Multiple Clinical Areas 23 10% Other (Various Specialties) 25 11% Maternal/Newborn 22 9% Emergency Care 20 8% Pediatrics/Children 10 4% Geriatrics/Long Term Care 9 4% Operating/Recovery Room 7 3% Rehabilitation 6 3% Palliative Care 5 2% No Response 4 2% Total 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 8 10

Employed New Nursing Graduates - Initial Employment Search Graduates were asked to choose from a list of deciding factors that were important to them in accepting their first nursing positions. Table 6 summarizes the factors chosen. Many graduates provided more than one deciding factor. The two most commonly selected factors in deciding what employment to accept were that the position was in the practice area in which they wanted to work (n=160) and that the position was in the same place where they had their senior clinical practicum (n=142). Table 6. Deciding factors in new nursing graduates accepting their first nursing position* Factor Number Practice area I wanted to work in 160 Had senior clinical practicum there 142 Position is close to home 126 First place to offer employment 123 Positive reputation of the facility/organization 99 Had student clinical placement there 53 Work on another unit within the same facility/ organization 41 Recruitment strategies of facility/organization (ie. employment type, signing bonus) 31 Worked on the unit in another role 23 Various other factors 16 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. Reasons employed new nursing graduates did not finding employment as soon as they wanted. (n=20) Figure 8 summarizes the reasons that were provided by employed new nursing graduates for not finding nursing employment as soon as they wanted. 20% 5% 30% Difficult finding job opportunities and getting hired (n=6; 30%) Of the 20 who were not able to find work as soon as they wanted 6 reported having difficulty finding job opportunities and getting hired. 10% 10% Could only find casual positions (n=2; 10%) No job in my specialty area (n=5; 25%) No full time jobs available (n=2; 10%) Administrative delays (n=4; 20%) No Response (n=1; 5%) 14 reported not finding employment as soon as they wanted as they were particular about the employment they were willing to accept (only found casual, no full time positions or jobs in a specific specialty area. 25% Four experienced administrative matters which delayed the start of their employment. 11 9

Reasons for Seeking Employment Outside Manitoba Location Health Regions Employed New Nursing Graduates - Initial Employment Search (cont d) Figure 9. Manitoba Regions in which employed new nursing graduates searched for employment (n=237) Northern n=11 43 of the 237 employed graduates searched for employment in more than one Manitoba RHA. Winnipeg/Churchill Southern n=33 n=176 Figure 9 shows the number of graduates that reported searching for employment in each RHA. 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 (n=30) Figure 10 shows the number of employed new nursing graduates that sought employment outside of Manitoba. Other Countries n=6 30 graduates sought employment in the United States, other countries and/or other provinces. Other Provinces n=22 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 Figure 11. Reasons employed new nursing graduates sought employment outside of Manitoba (n=32) Other n=3 Employed new nursing graduates that had sought employment outside of Manitoba were asked why they had sought out employment outside of Manitoba (n=35) Seeking Particular Employment Higher Wages n=3 n=5 Two employed new nursing graduates provided two reasons for having sought employment outside of Manitoba. Family/Personal Adventure n=11 n=10 0 2 4 6 8 10 12 Frequency of Responses 10 As shown in Figure 11, family/personal reasons and adventure were the most frequently cited reason for seeking employment outside of Manitoba. 12

Number of Nurses Employed New Nursing Graduates - The 6 Months Since Graduation Figure 12. Number of employment positions held by new nursing graduates since graduation 180 160 140 120 100 153 As shown in Figure 12, about a third (35%; n=82) of the 237 employed nurses reported having been employed in more than one position since graduation. 80 60 64 40 20 0 18 2 1 2 3+ No Response Number of Positions Held Since Graduation Table 7. Reasons employed new nursing graduates have had more than one nursing position since graduation* Reasons Number Had term positions 31 Switched to permanent position 26 Switched out of float/relief pool or casual position 22 Switched to greater EFT position 13 Changed area of practice 12 Have multiple concurrent positions 7 Other Reasons 5 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 were seeking upon graduation but didn t find. Area of Practice Number Percentage Public Health 8 21% Surgery 8 21% Medicine 4 11% Changed mind from initial plan 2 5% ER 2 5% Labour and Delivery 2 5% Maternal/Child 2 5% 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% 11 The 82 employed nurses who have held more than one position since graduating provided a number of reasons (Table 7) with some providing more than one reason. The most common reasons given for having more than one position since graduation were employment in term positions that had finished (n=31), switching into permanent positions (n=26) and switching out of float/ relief pool or casual positions (n=22). Most (n=197; 83%) of the 237 employed graduates found employment in their area of practice of choice. The 38 nurses that did not find employment in their practice area of choice were asked to identify their desired area of practice. As shown in Table 8, Public Health and Surgery were the two most commonly cited areas of practice in which nurses wanted employment but could not find it. 13

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 I don't know Did not have seniority in the facility Other Did not have qualifications required Did not have experience required Employment of choice not available 1 4 5 11 18 0 5 10 15 20 25 30 35 40 Frequency of Responses 37 New nursing graduates that did not obtain the employment status of choice were asked why they thought they didn t find their employment of choice. 45 provided one reason and 10 provided more than one response. The reasons provided are summarized in Figure 13. The most reported reason for not finding their employment of choice was that it was not available (n=37). Lack of experience and lack of qualifications were the second and third most common reasons provided. Table 9. Employment intentions of employed new nursing graduates within the next year. Employment Intentions Number Remain in my current position 148 Look for another position with current employer 76 Look for another nursing position in Manitoba 52 Look for a nursing position in another province 19 Look for another position in another country 11 Look for another position in the U.S. 8 Other 5 Return from a different country or province for a 0 Employed new nursing graduates were asked about their employment intentions within the next year which are summarized in Table 9. Most employed new nursing graduates indicated they intend to remain in their current position (n=148) or look for another position within their current place of employment (n=76). Some selected more than one category. Figure 14. Reasons employed new nursing graduates provided for having an intention to seek employment in another country in the next year. Of the 17 graduates who indicated an intention to seek employment in another country in the future, 15 provided a reason for having this desire (Figure 14). 4 11 Adventure/Travel Family/Personal Reasons Most (n=11) of the 15 were looking for adventure and travel experiences and the remaining 4 intend to go to another country for family/personal reasons. 12 14

Employed New Nursing Graduates - Employment Satisfaction About three-quarters (n=185; 79%) of the employed new nursing graduates reported that they found employment 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% 31, 65% 14, 29% Full Time Permanent Part Time Permanent Multiple Positions Other 13 15

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 Permanent 78 (92%) 7 (8%) 85 (100%) 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 Other Move into a Casual Position Increased EFT Full Time Decreased EFT Change Facility of Employment Obtain a Permanent Position Change Area of Practice 4 6 6 7 10 12 15 24 30 0 5 10 15 20 25 30 35 14 Frequency 16

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 influenced 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 influences. 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 motivations by 3 graduates. Table 11. Factors that influenced new nurses decision to leave Manitoba. Opportunities Number Personal Reasons (Family/Friends) 6 Better Pay and Benefits 2 Career Opportunities 1 Cost of Living 1 Lack of Permanent Positions 1 Other (Where I want to live) 1 Signing bonus / relocation Assistance 1 Work load/ work conditions 1 Hours of Work 0 Lack of Employment in Specific Areas 0 Lack of Full Time Positions 0 Table 12. Factors that would motivate nurses to return to Manitoba. Motivations Number Family Considerations 4 Availability of Full Time Work 3 Better Wages & Benefits 3 Education / Training 3 Availability of Employment in Specific Areas 2 Job Security 2 Other (plan on returning in 5-10 years) 1 Workload / Work Conditions 1 Availability of Part Time Work 0 Different Scheduling Practices 0 Relocation Expenses 0 15 17

Frequency 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 8 6 4 2 0 10 Less than 1 month 2 1-2 months 4 3-6 months 1 1 More than 6 months Length of Time Searching for Employment No Response Only 7% (n=18) of the graduates reported being currently unemployed in nursing but were seeking employment in nursing. Figure 17 illustrates the length of time these unemployed graduates have been searching for nursing employment. Figure 18. Type of employment sought by unemployed new nursing graduates 6% 33% Full Time Permanent (n=6; 33%) Full Time Term (n=1; 6%) Part Time Permanent (n=10; 56%) As shown in Figure 18, eleven of the 18 unemployed graduates were seeking part-time positions. Most (16 of 18) unemployed graduates were looking for permanent positions. 56% 5% Part Time Term (n=1; 6%) Figure 19. Desired shift sought by unemployed new nursing graduates (n=18) 22% 22% 56% 8 hour day / evening (n=10; 56%) 8 hour day / night (n=4; 22%) 12 hour day / night (n=4; 22%) Figure 19 depicts the desired shift of the unemployed graduates. A little more than half (n=10) of the unemployed graduates wanted an 8 hour day / evening shift (10 of 18). 16 18

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 a c i l i T y p e Community Health Private nursing agency Long term care 3 4 6 t y Personal care home 7 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 employment. 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. 17 19

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 a n i t o b a R H A Not in Manitoba Northern Southern Prairie Mountain Interlake Eastern Winnipeg/Churchill 2 3 3 3 3 10 0 2 4 6 8 10 12 Frequency * Note Five graduates were seeking employment in more than one RHA. 18 20

Frequency New Nursing Graduates Seeking Employment Outside Manitoba (n=14) Eleven employed graduates and 3 unemployed graduates reported that they are currently seeking employment 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 8 6 4 2 0 3 United States 10 Other Provinces Location 3 Other Countries * Note One graduate was seeking employment in all three categories 19 21

New Nursing Graduates Seeking Employment Outside Manitoba (n=14; continued) Table 14 summarizes the opportunities that are attracting these nurses to seek employment outside of Manitoba. They were asked to select from a list of possible opportunities. Many graduates chose more than one opportunity. The most commonly cited opportunities are family/ personal reasons (n=9), travel and weather (n=8) and professional opportunities (n=8). Table 14. Opportunities that are attracting new nursing graduates to seek employment outside of Manitoba. Opportunities Number Family/Personal 9 Travel & Weather 8 Professional Opportunities 8 Workload/Work Conditions 3 Pay & Benefits 3 Recruitment Strategies 2 Cost of Living 1 Other 1 * Note Graduates each selected multiple opportunities from the list. Table 15 summarizes the challenges that are encouraging these graduates to seek employment outside of Manitoba. They were asked to select from a list of possible challenges. Again challenges related to family/personal and weather were encouraging graduates to seek employment outside of Manitoba. Three cited they were just looking for adventure and not experiencing challenges encouraging them to leave Manitoba Only 3 of the 14 graduates seeking employment outside of Manitoba would stay in Manitoba if offered the employment type they are seeking. Table 15. Challenges encouraging nurses to seek employment outside of Manitoba Challenges Number Family or Personal Issues 5 Weather 3 No Challenge, just want adventure 3 Lack of Employment in Certain Specialty Areas 2 Lack of Employment in Certain Locations 2 Cost of Living 2 None of the Above 2 Lack of Full Time Employment 1 Lack of Permanent Employment 1 Not Feeling Valued 1 Lack of Educational Opportunities 1 Lack of Career Opportunities 1 Other 1 Work or Workload Conditions 0 * Note Graduates each selected multiple challenges from the list. 20 22