Transitioning to practice in long-term care: New graduate nurses' experience of an accelerated transition to nurse leader.

Abstract

To describe the transition to practice experience of new graduate nurses in long-term care. Nursing is facing increasing pressures related to outpaced demands and a greater acuity of patients accessing services. Hiring new graduate nurses into long-term care (LTC) is a strategy to counteract these pressures, however, little is known about the transition experience of new graduate Registered and Licensed Practical Nurses in this setting. A qualitative, explanatory case-study design explored the transition to practice experience of seven new graduate nurses and the observations of two LTC directors from two homes. The study focused on the self-described transition to practice experience and those contextual factors present in LTC that influenced this experience. Thematic analysis of semi-structured interview transcripts and key document review were completed in 2017. Results of this study introduced contextual factors that must be considered in LTC as each influences the transition to practice experienced by new graduate nurses. These factors included five processes that resulted in an accelerated transition to practice experience: (a) struggling to meet expectations; (b) practicing in isolation; (c) relying on others; (d) developing skill and confidence despite challenges; and (e) recognizing complexity and value in LTC practice. The findings from this study refute universally applied transition to practice theory and contribute new understanding of the experience of the new graduate nurses in LTC settings. This study reinforces the need for greater support for nursing graduates in LTC settings.