Abstract

To investigate transition in newly qualified nurses through an exploration of their stressors and stress experiences during their first 12months postqualifying. Globally, thousands of new nurses qualify annually. They are crucial for the profession and healthcare service delivery. Work-related stress has multiple serious consequences, yet there is a lack of robust, empirical evidence that directly analyses newly qualified nurses and the stress they feel and experience in the workplace. Understanding what causes newly qualified nurses' stress is vital to retaining and nurturing this vital component of the workforce. Longitudinal, explanatory sequential mixed methods, cohort study. At the point of qualification (n=288), 6months postqualifying (n=107) and 12months postqualifying (n=86), newly qualified nurses completed the Nursing Stress Scale, with 14 completing a one-to-one interview at 12months postqualifying. Data were collected from 2010 - 2012. Inferential statistics, "thematic analysis" and "side-by-side comparisons in a discussion" were used for analysis. Workload was consistently the highest reported stressor with inadequate staffing and managing multiple role demands given as explanations. Incivility within the workplace was a noted stressor. Conversely, being part of "a good team" provided a civil, supportive, facilitative work environment. Entering nurse education with previous healthcare experience had a mediating effect on the reported frequency of stressors. Newly qualified nurses encounter multiple work-related stressors over their first 12months postqualifying, which are intrinsically entwined with their transition. Employing organizations need to be more proactive in managing their workload and addressing workplace incivility.

Highlights

  • Stress amongst the nursing workforce is an international cause for concern with its known professional, organisational and personal consequences (O’Henley et al 1997, McVicar 2003, Lim et al 2010)

  • Newly qualified nurses encounter multiple work-related stressors over their first 12 months post-qualifying, which are intrinsically entwined with their transition

  • Employing organisations need to be more proactive in managing their workload and addressing workplace incivility

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Summary

Background

Nursing students in the UK and internationally undergo several years of theoretical and practical education in order to qualify as a nurse. Qualified nurse stressors (quantitative) Table 2 shows the mean total and subscale stress results per phase. ‘Workload’ was the most frequently reported stressor at each time point over the first 12 months post-qualifying This result complimented the qualitative theme ‘managing the work/workload’, which provides the reasons why participants reported workload as such a significant source of stress. There was no significant difference for this stressor from Phase 1 to Phase 3 This is a divergent result from the outcomes of the qualitative analysis where no Phase 4 participant mentioned ‘death and dying’ as a source of stress. Stressors and stress experiences (qualitative) From the Phase 4 qualitative data analysis, 3 themes were identified: ‘feeling responsible and terrified’, ‘it’s not the job, it’s the people you work with’ and ‘managing the work/workload’ The latter theme was complimentary to the quantitative results.

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