Research| Volume 49, ISSUE 2, P210-221, March 2023

Download started.


Uncovering the Experience: Return to Work of Nurses After Parental Leave

Published:November 18, 2022DOI:



      To understand the experiences of emergency nurses who have returned to work after parental leave, specifically relating to the return to work transition, work-life balance, work engagement, and opportunities to continue human milk expression.


      Nurses (N = 19) were recruited from 5 emergency departments within 1 hospital system in the United States Midwest. Nurses (n = 11) were eligible to participate in a one-on-one interview if they had returned from parental leave within 6 months of the interview date. Nurses (n = 8) were eligible to participate in a focus group if they had returned from parental leave within 2 years of the interview date. Interviews were structured and data collection concluded when researchers believed data saturation was reached. Interviews were audio recorded and transcribed verbatim. Data were analyzed using Braun and Clarke’s qualitative thematic analysis 6-phase framework.


      Three major themes from the data were identified: (1) work engagement, (2) lactation, and (3) childcare. Work engagement was broken down into the subthemes: lack of communication, perceived engagement expectations, and actual engagement. Lactation was broken down into the subthemes: the act of pumping, lactation breaks, and lactation rooms. The coronavirus disease 2019 pandemic impact on return-to-work is described under each major theme.


      Our findings provide insight into the unique challenges and experiences of nurses navigating parental leave and return-to-work in the emergency department. Strategies such as provision of managerial check-ins, return to work reorientation, lactation break coverage, enhanced supplementary lactation support, and leadership-provided accommodation may lighten the burden of these challenges and improve the returning nurse’s job satisfaction.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Smiley R.A.
        • Ruttinger C.
        • Oliveira C.M.
        • et al.
        The 2020 national nursing workforce survey.
        J Nurs Regul. 2021; 12: S1-S96
      1. Women in the labor force: a databook. U.S. Bureau of Labor Statistics. Published April 2021.
        • Wambach K.
        • Britt E.
        Breastfeeding support experiences of registered nurses in a large children’s hospital system.
        J Obstet Gynecol Neonatal Nurs. 2018; 47: 632-640
        • Gorman V.L.
        Future emergency nursing workforce: what the evidence is telling us.
        J Emerg Nurs. 2019; 45: 132-136
      2. EI maternity and parental benefits, what these benefits offer. Government of Canada.
        • Lucia-Casademunt A.M.
        • Garcia-Cabrera A.M.
        • Padilla-Angulo L.
        • Cuellar-Molina D.
        Returning to work after childbirth in Europe: well-being, work-life balance, and the interplay of supervisor support.
        Front Psychol. 2018; 9: 68
        • Falletta L.
        • Abbruzzese S.
        • Fischbein R.
        • Shura R.
        • Eng A.
        • Alemagno S.
        Work reentry after childbirth: predictors of self-rated health in month one among a sample of university faculty and staff.
        Saf Health Work. 2020; 11: 19-25
        • Hsu H.C.
        • Wickrama K.A.S.
        Maternal life stress and health during the first 3 years postpartum.
        Women Health. 2018; 58: 565-582
        • Schwab-Reese L.M.
        • Ramirez M.
        • Ashida S.
        • Peek-Asa C.
        Psychosocial employment characteristics and postpartum maternal mental health symptoms.
        Am J Ind Med. 2017; 60: 109-120
        • Wickramasinghe N.D.
        • Horton J.
        • Darshika I.
        • et al.
        Productivity cost due to postpartum ill health: a cross-sectional study in Sri Lanka.
        PLoS One. 2017; 12e0185883
        • Gomez-Salgado J.
        • Dominguez-Salas S.
        • Romero-Martin M.
        • Romero A.
        • Coronado-Vazquez V.
        • Ruiz-Frutos C.
        Work engagement and psychological distress of health professionals during the COVID-19 pandemic.
        J Nurs Manag. 2021; 29: 1016-1025
        • Lavoie-Tremblay M.
        • Gélinas C.
        • Aubé T.
        • et al.
        Influence of caring for COVID-19 patients on nurse’s turnover, work satisfaction and quality of care.
        J Nurs Manag. 2022; 30: 33-43
        • Kurtessis J.N.
        • Eisenberger R.
        • Ford M.T.
        • Buffardi L.C.
        • Stewart K.A.
        • Adis C.S.
        Perceived organizational support: a meta-analytic evaluation of organizational support theory.
        J Manag. 2017; 43: 1854-1884
        • Parcsi L.
        • Curtin M.
        Experiences of occupational therapists returning to work after maternity leave.
        Aust Occup Ther J. 2013; 60: 252-259
        • Hampshire N.
        • Califano G.
        • Spinks D.
        Focus groups.
        in: Hampshire N. Califano G. Spinks D. Mastering Collaboration in a Product Team: 70 Techniques to Help Teams Build Better Products. Springer, 2022: 26-27
        • Tracy S.J.
        Qualitative Research Methods: Collecting Evidence, Crafting Analysis, Communicating Impact.
        John Wiley and Sons, 2019
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Macbeth D.
        On “reflexivity” in qualitative research: two readings, and a third.
        Qual Inq. 2001; 7: 35-68
        • Morse J.M.
        Critical analysis of strategies for determining rigor in qualitative inquiry.
        Qual Health Res. 2015; 25: 1212-1222
        • Lincoln Y.S.
        • Guba E.G.
        Naturalistic Inquiry.
        SAGE Publications, 1985
        • Zahn C.M.
        • ACOG statement on COVID-19 and pregnancy
        The American College of Obstetricians and Gynecologists.
        (Published June 24, 2020)
        • Edemba P.W.
        • Irimu G.
        • Musoke R.
        Knowledge attitudes and practice of breastmilk expression and storage among working mothers with infants under six months of age in Kenya.
        Int Breastfeed J. 2022; 17: 33
        • Vilar-Compte M.
        • Hernandez-Cordero S.
        • Ancira-Moreno M.
        • et al.
        Breastfeeding at the workplace: a systematic review of interventions to improve workplace environments to facilitate breastfeeding among working women.
        Int J Equity Health. 2021; 20: 110
        • Eglash A.
        • Malloy M.L.
        Breastmilk expression and breast pump technology.
        Clin Obstet Gynaecol. 2015; 58: 855-867
        • Gomez L.
        • Verd S.
        • de-la-Banda G.
        • et al.
        Perinatal psychological interventions to promote breastfeeding: a narrative review.
        Int Breastfeed J. 2021; 16: 8
        • Freeman G.
        • Bharwani A.
        • Brown A.
        • Ruzycki S.M.
        Challenges to navigating pregnancy and parenthood for physician parents: a framework analysis of qualitative data.
        J Gen Intern Med. 2021; 36: 3697-3703
        • MacVane C.Z.
        • Fix M.L.
        • Strout T.D.
        • Zimmerman K.D.
        • Bloch R.B.
        • Hein C.L.
        Congratulations, you’re pregnant! Now about your shifts….: the state of maternity leave attitudes and culture in EM.
        West J Emerg Med. 2017; 18: 800-810
        • Juengst S.B.
        • Royston A.
        • Huang I.
        • Wright B.
        Family leave and return-to-work experiences of physician mothers.
        JAMA Netw Open. 2019; 2e1913054
        • Duru D.C.
        • Hammoud M.S.
        Identifying effective retention strategies for front-line nurses.
        Nurs Manag (Harrow). 2022; 29: 17-24
        • Landon E.
        • Selk A.
        Understanding the experiences of obstetrics and gynaecology residents who take parental leave during training in Canada: a needs assessment.
        J Obstet Gynaecol Can. 2018; 40: 1453-1458
      3. Corvin J, Nabours B, Bularca S, Haile A. Approaching a new normal: lessons learned transitioning family education programming to a virtual environment. Health Promot Pract. Published online September 18, 2021.

        • Jantzer A.M.
        • Anderson J.
        • Kuehl R.A.
        Breastfeeding support in the workplace: the relationships among breastfeeding support, work-life balance, and job satisfaction.
        J Hum Lact. 2018; 34: 379-385
      4. Pumping milk. La Leche League International.
        • van Dellen S.A.
        • Wisse B.
        • Mobach M.P.
        • Albers C.J.
        • Dijkstra A.
        A cross-sectional study of lactation room quality and Dutch working mothers’ satisfaction, perceived ease of, and perceived support for breast milk expression at work.
        Int Breastfeed J. 2021; 16: 67
        • van Dellen S.A.
        • Wisse B.
        • Mobach M.P.
        Effects of lactation room quality on working mothers’ feelings and thoughts related to breastfeeding and work: a randomized controlled trial and a field experiment.
        Int Breastfeed J. 2022; 17: 57
        • Shanafelt T.
        • Ripp J.
        • Trockel M.
        Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic.
        JAMA. 2020; 323: 2133-2134
        • Ruppanner L.
        • Moller S.
        • Sayer L.
        Expensive childcare and short school days = lower maternal employment and more time in childcare? Evidence from the American time use survey.
        Socius. 2019; 5: 1-14


      Emily K. Hill is Lead Clinical Research Nurse Coordinator, Clinical Research Unit, Northwestern Medicine, Chicago, IL. ORCID identifier:


      Olivia M. Bimbi is a Clinical Nurse, Emergency Department, Northwestern Medicine; and a PhD student, University of Illinois Chicago, Chicago, IL. ORCID identifier:


      Natasha Crooks is an Assistant Professor, Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL. ORCID identifier:


      Ryan Brown is a Clinical Nurse, Emergency Department, Northwestern Medicine, Chicago, IL; and Member, Illinois ENA.


      Angela B. Maeder is an Assistant Clinical Professor, Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL; and a Clinical Nurse, Labor and Delivery, Northwestern Medicine, Chicago, IL. ORCID identifier: