New Graduate Registered Nurses Experiences in the Acute Care Setting

Abstract

Focused question: Does enrollment in a new nursing graduate transition program with an assigned preceptor improve new nursing graduate transition experiences in the acute care settings and assist the new nursing graduate with handling negative environments? Purpose Fink, Krugman, Casey and Goode (2008) stated that the transition of graduate nurses from an educational program into the professional practice setting has been a long-standing issue and is widely recognized as a period of high stress, role adjustment and reality shock. Many hospitals are choosing to cut or highly consolidate any type of new graduate transition program due to budget cuts and the current state of healthcare finances. Delaney (2003) defined the term transition to practice as the period of time when a new graduate nurse undergoes a process of learning and adjustment in order to acquire the skills, knowledge, and values required to become a functioning member of the healthcare team. Further investigation and research related to new graduate transition to practice is imperative to the healthcare profession. It is of importance to determine the impact of new graduate transition programs on enhancing new graduate nurse’s experiences so that educational institutions can assist in further educating nursing students on what to expect upon entering the acute care setting. The healthcare facilities can further benefit in having a better understanding of what tools are needed to assist new graduates with their transition to practice; whether that be access to preceptors, mentors and/or lateral staff in addition to tools to deal with the current healthcare environment. Casey, Fink, Krugman, Propst (2004) stated that graduate nurses have become a significant part of hospital recruitment as staffing issues become greater related to the nursing shortage. Casey, et al (2004) stated that new graduate nurse turnover in the United States ranges from 55-61% within the first two years of employment. This turnover is of great expense to healthcare organizations when it is estimated to cost over 33,000 dollars to orient a new nurse, not including the amount of money it will cost to find a replacement for the lost new graduates and then their orientation to the facility and assigned work area. The researcher plans to evaluate new nursing graduates who are or have been enrolled in a new nursing graduate transition program as well as evaluate new nursing graduates who did not have a transition program to assist them with their transition to practice. The purpose of the survey is to evaluate the new nursing graduate’s experiences transitioning from academia to real-world nursing in an acute care facility. Methodology The study will be a quantitative non-experimental comparative study to determine the impact of a new graduate transition program on enhancing new nursing graduates’ experiences in acute care settings. The population will be new graduate nurses less than two years of employment. The study will contrast the two groups of new graduates related to their exposure or lack of exposure to a new graduate transition program and how their new graduate experiences are potentially affected. The sample size will be limited to the new nursing graduates (ADN, BSN, ABSN) with less than two years of employment at acute care facilities in North Carolina. The researcher will be administering the Casey Fink New Nursing Graduate Survey Tool in paper and pencil format to new nursing graduates from ADN, BSN and Accelerated BSN programs with 24 months or less work experience as an RN. Objectives The Case Fink New Nursing Graduate Survey Tool will allow the researcher to evaluate enrollment in a New Nursing Graduate Program, length of program/orientation to a new role, assignment of a preceptor, number of preceptors, and availability of preceptor. New nursing graduate retention, employment satisfaction, perceived anxiety and stress, identification of key areas of stress, clinical skill performance, performance of RN role and responsibilities, perceived exposure to negative environments, perceived satisfaction and dissatisfaction with current RN employment, level of support, previous healthcare experience, and current work pattern will also be explored.