dissertationThis study was designed in two sequential phases; 1) to describe the career paths of experienced nurses related to the intention to leave direct patient care and decisions associated with changing or advancing their education, and 2) to explore how pregnancy, childbirth, and mothering young children impact the lives of nurses working in direct patient care. A multimethod qualitative design with two qualitative components, QUAL1 → QUAL2, was utilized. Study participants were female nurses educated in the United States and licensed in Utah from 6 to 12 years. The QUAL1 core component consisted of unstructured interviews (n = 39), the results of which were used to form the QUAL2 sequential component of semistructured interviews (n = 45). Findings from QUAL1 revealed that mothering responsibilities and family obligations strongly influenced nurses with regard to career decisions and educational advancement. Organizational impacts such as lack of employer appreciation and inflexible scheduling/lack of control over the schedule by the nurse led to a "tipping point" for nurses, and to thoughts of intention to leave and ultimately resignation from their position. The second phase of the study focused on the nurse when pregnant and working in direct patient care and/or while having young children at home. Results revealed that there are distinct physical and emotional challenges and hardships experienced by female nurses. There were few accommodations in workload for pregnancy, and few supports, and major challenges regarding breastfeeding. Financial necessity, and the satisfaction derived from working in patient care, kept nurses working at the bedside
