Examination of Nurse Work Life: A Survey of Licensed Practical Nurses in Alberta, Canada

Introduction: Nurses face many physical and emotional challenges in their work which can lead to burnout, anxiety, turnover, and increased intent to leave nursing practice (Rushton, Batcheller, Schroeder, & Donohue, 2015; Shields & Wilkins, 2006). To support a strong, resilient nursing workforce into the future, it is important to understand the work life of nurses and focus on strengthening healthy work environments. In the literature, there has been considerable interest in the work life of nurses. Much attention has been paid to the interrelated areas of nurse burnout and resilience (Guo et al., 2017; Jackson, Vandall-Walker, Vanderspank-Wright, Wishart, & Moore, 2018). Attention has also been directed at nurse health-related quality of life, particularly its association with workforce retention and intention to leave the profession (Perry et al., 2017). Increased understanding in these areas has valuable implications for creating healthy, supportive work environments. There is limited literature in these areas, however, specific to practical nurses.

Background: Licensed practical nurses (LPNs) are one of the three regulated nursing professions in Alberta, Canada. Currently, there are close to 16,000 LPNs registered in Alberta, accounting for approximately 26% of the total provincial professional nursing family (CIHI, 2016). This nursing group is expected to continue to grow with consistently high to full capacity enrollment in practical nurse programs across the province.

LPNs are accountable for their individual practice and are involved in the assessment, nursing diagnosis, planning, implementation, and evaluation of nursing care across the care continuum, working in collaboration with clients, families, and other health service providers. LPNs predominantly provide direct client care in hospitals, community health, and nursing homes/long-term care. As important members of healthcare teams, LPNs continue to assume expanded roles across various practice settings.

With Alberta’s aging population, the overall demand for nurses to provide continuing care to seniors is projected to steadily increase over the next 20 years. Demands on the nursing workforce will also intensify as care needs around complex, chronic diseases continue to grow. In addition to these shifts in our health system, there is a considerable portion of the nursing workforce heading towards retirement. To meet the demands of ongoing shifts in our health system, it is critical to support a resilient and stable workforce. Healthy work environments can play a key role given the links shown in previous studies to nurse retention (Aiken, Sloane, Bruyneel, Van den Heede, & Sermeus, 2013; Heinen et al., 2013) and reduced nurse turnover rates (O’Brien-Pallas, Murphy, Shamian, Li, & Hayes, 2010).

CLPNA Member Survey: The College of Licensed Practical Nurses of Alberta (CLPNA) is the regulatory body of LPNs in the province. As the regulator of the profession, the CLPNA is mandated to serve and protect the public. During August 2018, the CLPNA will survey its entire membership of close to 16,000 LPNs. The CLPNA Member Survey is designed to provide a well-rounded understanding of the work life of Alberta’s LPNs. Informed by the literature, the survey includes questions on work environment, burnout, resilience, intention to stay, health status, and quality of life.

Widely used standardized measures, with strong psychometric properties, are used in the survey. These measures include the Practice Environment Scale of the Nursing Work Index (PES-NWI, Lake, 2002), the Maslach Burnout Inventory-Human Services Survey (MBI-HSS, Maslach & Jackson, 1981), the Intent to Stay Measure (Kim, Price, Mueller & Watson, 1996), the Connor-Davidson Resilience Scale 10 (CD-RISC 10, Connor & Davidson, 2003), and the Medical Outcomes Study 36-item Short Form Health Survey (SF-36, Hays, 1994).

Results: Results from the survey are anticipated to be available by early 2019.

Implications: The CLPNA Member Survey will offer a rich dataset unlike any previously collected in the province on this provider group. The information is highly relevant to the current Canadian healthcare context and can inform activities (e.g. professional development) that enhance the professional well-being of LPN practitioners. Understanding the context in which LPNs work is an essential step in creating better work practices and environments, benefiting both the profession and ultimately the quality of care for patients.