Buying Time: Maternity Leave Policies and Critical Care Nurses’ Return to Work

Background The nursing profession faces critical workforce shortages, intensified by high attrition linked to burnout and inadequate family supports. In the United States, maternity leave remains short and often unpaid, forcing premature returns to work that undermine health, family bonding, and career longevity. Although previous studies have quantified these outcomes, few have captured the moral distress and role strain experienced by nurse-mothers. Objective To explore the lived experiences of nurse-mothers navigating maternity leave transitions within critical care settings. Methods This study was guided by interpretive phenomenology. Purposive sampling was used to enroll 54 US critical care nurses in the study. Semistructured audiovisual interviews conducted between April and August 2024 were transcribed and analyzed using the hermeneutic circle. Results The analysis yielded 4 themes: (1) paid time off supplementation for maternity leave; (2) national responsibility in addressing unpaid, underpaid, and brief leave; (3) critical care nurses’ need for more time; and (4) the need for additional support and adaptive policies. Conclusions For critical care nurses, maternity leave often becomes a moral and existential dilemma shaped by time scarcity and financial strain, contributing to burnout and attrition. Evidence-based strategies to address the problem include front-loading paid leave, phased return-to-work options, and guaranteed lactation coverage. Aligning US policy with international standards regarding extended paid leave could promote retention, enhance staffing flexibility, and protect the quality of patient care.