Graduate Nurse Experience Research Articles

Identification of statewide core competencies for new graduate nurses at the beginning of practice and after a 12-month nurse residency program

AimTo inform the development of statewide core competencies for new graduate nurses at the beginning of their professional career and after completing a 12-month nurse residency program. BackgroundAlthough studies have attempted to clarify the expected core competencies of new graduate nurses at the beginning of their professional career, results are mixed. Additionally, nurse residency program competency expectations vary. DesignA retrospective cross-sectional study using a purposive sample of a national nurse residency program database. MethodsWilcoxon Signed Rank tests compared retrospective self-report data between January 1st 2017 and December 31st 2019, from 2916 acute care hospital new graduate nurses working in the state of Maryland, USA, to examine their perceptions of competency at hire and after completing a nationally standardized 12-month nurse residency program. The study used six domains from the Casey Fink Graduate Nurse Experience Survey© 2006 and the Vizient/AACN Nurse Residency Program™ Progression survey. ResultsNew graduate nurses' self-report of competency increased from a mean score of 4.81 at the beginning of a nurse residency program to 6.67 after completion of 12-month nurse residency program (scale of 0–10). At the beginning of a nurse residendy program, new graduate nursesreported a low level of comfort in three of the six survey domains: communication and leadership, high-intensity skills and patient safety. At 12 months, new graduate nurses reported higher levels of comfort in all six survey domains, with statistically significant increases (Wilcoxon Signed Rank test, α =0.05). ConclusionsFour domains for ongoing competency development were identified for the nurse residency program curriculum—communication and leadership, patient safety, complex patient assignments and end-of-life care—with the expectation that new graduate nurses achieve competency at program completion. New graduate nurses’ perceptions corroborated findings from a statewide study of academicians and practice leaders, thus helping to develop realistic core competencies for new graduate nurses entering the workforce and after completing a 12-month nurse residency program.

Consumers’ Experiences of Comprehensive-Prepared Graduate Nurses and Their Nursing Care in Acute Mental Health Settings

Pre-registration nursing education has long moved away from preparing nurses with mental health specialisation to nurses with comprehensive knowledge and skills. However, the consumers’ experiences of comprehensive-prepared nurses and their nursing care has not been widely explored. This paper reports on a study with consumers to explore their experiences with comprehensive-prepared graduate nurses and the nursing care that they provide in acute mental health settings. An exploratory qualitative study using semi-structured interviews was chosen as the research method. Purposeful sampling recruited 12 consumers and data saturation was achieved. Braun and Clarke’s method of thematic analysis was used to analyse the collected data and three themes emerged. The themes are: (i) You got what it takes to be a mental health nurse, (ii) Slow down and spend quality time with us, and (iii) Read in between the lines when we share our negative lived experiences. The findings are useful for identifying strategies to develop evidence-based nursing education for comprehensive-prepared graduate nurses to improve the consumers’ experiences of their nursing care.

Impact of the Pandemic on Newly Licensed Nurses' Role Transition Experiences.

This study examined differences in newly licensed nurses' role transition experiences while enrolled in a nurse residency program before and during the pandemic. The Casey-Fink Graduate Nurse Experience Survey measured baseline, 6-month, and 12-month program outcomes. The prepandemic cohort had higher subscale scores at baseline. Both cohort groups showed significant increases in role confidence, patient safety, communication/leadership, and job satisfaction. Despite the pandemic, nurse residency program completion rates remained stable. Implications for nursing professional development practitioners are presented.

“Discovering shine through feedback seeking”---feedback seeking among new graduate nurses: a qualitative study

BackgroundFeedback is critical to improving practitioners’ clinical practice and professional growth. Although they are still considered junior practitioners, their feedback-seeking experiences have yet to be investigated. This study aimed to understand the fundamental thoughts and experiences of new graduate nurses regarding feedback-seeking and to identify the main factors that influence their feedback-seeking behaviors.MethodsConducting a descriptive phenomenological study, semi-structured in-depth interviews with newly graduated nurses from four hospitals in Zhejiang Province, China, face-to-face or via video call in the hospital conference room through purposive and snowball sampling. Interview data were evaluated using Colaizzi’s 7-step phenomenological data analysis. The COREQ checklist was followed.ResultsA total of 15 new graduate nurses were interviewed as a sample, and 13 categories emerged from our data. They were categorized into four central elements: (1) perceptions and attitudes, (2) drivers, (3) dilemmas and needs, and (4) transformation and growth.ConclusionsThis study found that new graduate nurses have various needs but face dilemmas in the feedback-seeking process. Nursing managers should be proficient at providing positive leadership, collaborating with clinical mentors to foster an atmosphere where new graduate nurses may obtain honest, transparent, and fair feedback, and exercising caution when providing negative feedback.

Experience of New Graduate Nurses in Nurse Residency Programs During the COVID-19 World Pandemic.

Individuals who entered any nursing program during the coronavirus disease 2019 (COVID-19) world pandemic were exposed to a different and chaotic learning environment. The goal of this study was to describe the experience of 452 new graduate nurses (NGNs) who entered the profession between 2020 and 2022. This study was a qualitative thematic analysis of an open-ended survey from the American Nurses Credentialing Center Practice Transition Accreditation Program® (PTAP®). The thematic analysis resulted in five themes: the pandemic was a significant disruptor, the program was a generally negative experience, the quality of the preceptors and mentors made a difference, the content of the program made an impact, and the residency program prepared NGNs for the RN role by building confidence and promoting relationship building and a sense of community. The 2020-2022 world pandemic created a challenging environment for NGNs to enter nursing and had implications for practice. [J Contin Educ Nurs. 2024;55(2):87-93.].

Qualitative perspectives of new graduate nurses to educational preparation for patient care

Background: A phenomenological qualitative study were conducted and investigated the perceptions of new Nursing graduates in relation to their educational preparation in caring for patients. Practice readiness and preparedness of new nurses continue to be a challenge in 21st century healthcare delivery system. To adapt to the rapidly varying and advancing healthcare settings; nurse educators must regularly assess and review education curricula, teaching-learning strategies and programs adopted to prepare new professional nurses. In Malaysia, Nursing Education Task Force was formed– Ministry of Higher Education (MOHE), 2010. ‘Development of Nursing Education in Malaysia towards the year 2020’. The aim of this task force is to improve and transform Nursing Education in Malaysia from Diploma to degree programmes by the year 2020, to prepare New Nurses to practice in all priority areas of nursing care.Purpose: To explore and describe the experiences of new graduate nurses working in hospitals and their perceptions in relation to educational preparation for patient care.Method: Using a Phenomenological Qualitative study, This Study focused on the lived and expressed experiences of the participants. It involved the description and interpretation of human experiences so that the experience could be better understood.Results: Seven Themes were extracted from the significant statements and formulated meanings of the ten respondents who voluntarily participated in this study. Orientation process, Value of preceptor, Solidifying concepts, Knowledge, Role transition, Doctors’ behaviour towards new staff and Staff shortage were among the needs of the new graduate Nurses that needs to be addressed.Conclusion: This study was able to provide insights into the lived experiences of ten new nurses and their perceptions in relation to educational preparations for patient care. Recommendations were also made to meet and support the new nurses’ needs. These findings, which may have important implications for nursing practice, management, education and to nursing profession as a whole, need further study in a larger scale to explore more on the lived and expressed experiences of the new nurses and to strongly support this research study.

Newly licensed nurses’ transition during the pandemic after participating in nurse apprentice program

BackgroundNurse apprentice/externship programs, some including students obtaining an apprentice license before graduation, prepare students to transition to practice. Some United States regions authorised new apprentice programs during the coronavirus disease 2019 pandemic. AimWe aimed to compare how newly licensed registered nurses (RNs) who participated or did not participate in an apprentice program during the pandemic perceived the transition to practice. MethodsWe compared participants with (n = 14) and without (n = 18) apprentice training by administering surveys at 2, 6, and 12 months post RN employment. Participants completed the Casey-Fink Graduate Nurse Experience Survey (CFGNES) and Oldenburg Burnout Inventory (OLBI). We used Cronbach’s alpha to assess survey domain internal consistency and compared CFGNES scores between cohorts using a linear regression model. FindingsThe nurse apprentice and standard training cohorts had mean composite CFGNES scores of 76.8 (SD = 7.52) vs. 71.9 (SD = 6.68), p < 0.01; higher scores suggested positive values for workplace support, stress, communication/leadership, and professional satisfaction. Participant OLBI scores indicated burnout among both cohorts. DiscussionThe recipients of the nurse apprentice program perceived transitioning into RN roles more favourably than those without this experience, implying newly licensed RNs benefit from nurse apprentice experiences. Job/professional satisfaction and workplace integration may play a role in promoting the transition to practice. ConclusionNurse apprentice programs may promote satisfaction and acclimatisation among newly licensed RNs, even during pandemic work conditions. Healthcare leaders are encouraged to advocate for nurse apprentice programs, including pathways for apprentice licensure and program implementation.

The graduate nurse experience: A New Zealand perspective

Introduction: The move from senior student to novice/advanced beginner registered nurse has been noted to be a stressful period. This longitudinal study follows the experiences of five cohorts of graduate New Zealand registered nurses throughout their first year of practice (n = 530). Methods: Data were collected via self-report survey using the Casey-Fink Graduate Nurse Experience Survey© at three points throughout the first year of practice. Results: Exploratory factor analysis (EFA) resulted in a 5-factor solution for 24 items from section two of the survey: professional support, professional role, professional concerns, professional communication and personal stress. Most respondents (93%) were female, New Zealand Europeans (80%) working in either surgical or medical clinical areas. Professional support from preceptors and exposure to positive role models contributed to a sense of being supported for 81% of the respondents. Satisfaction with choosing the professional role of nursing remained constant with over 90% agreeing or strongly agreeing they had made the right career choice. Across time, respondents reported few professional concerns and few concerns about professional communication. Concerns about personal stress were consistent, with 50% reporting stress related to issues such as finances, childcare and job performance. Conclusion: Contrary to other research, a honeymoon period was not evident (other than the initial high satisfaction with salary), rather the nurses’ satisfaction with nursing remained high throughout the year.

Transition Into Practice: Beyond Hospital Walls.

Historically, evidence has shown the importance of nurse residency programs, yet few organizations have implemented them outside of hospital settings. This article shares nurses' experiences and outcomes in an out-of-hospital nurse residency program that transitioned bachelor of science in nursing graduates through an academic-practice partnership. A mixed methods design was used that consisted of qualitative interviews (pre- and postresidency) and quantitative surveys (Casey-Fink Graduate Nurse Experience Survey, a job satisfaction survey, and a preceptee evaluation survey). Forty-four nurses participated. Qualitative findings were supported by the quantitative data. Results showed that confidence, competence, job satisfaction, and retention improved with an out-of-hospital residency program. Ensuring that every new graduate is afforded a nurse residency should be the goal, regardless of setting, to reduce turnover, ensure workforce stability, and ultimately improve patient outcomes. Academic-practice partnerships can help build resource capacity, especially in these settings, to achieve this goal. [J Contin Educ Nurs. 2023;54(7):327-336.].

New nurses’ transition to practice experience after completion of the enhancement training program in the Sultanate of Oman

In 2021, the Directorate General of Nursing Affairs (DGNA) at the Ministry of Health (MOH) in the Sultanate of Oman has established a 12-month training program for new nursing graduates known as the Enhancement Training Program (ETP). The program aims to intensively train novice nurses in seven critical specialties and equip them with the specialty knowledge, skills, and professional competence required to deliver safe and specialized care to critically ill patients. This study aims to determine the levels of confidence, comfort, satisfaction, stress, and experiences of transition-to-practice among nurses who completed the program successfully, and to assess the differences in the levels of confidence, comfort, satisfaction, stress, and experiences of transition-to-practice among the nurses participated in different specialties. The study sample target the first cohort of nurses who participated in the ETP from June 2021 to June 2022 and passed the program successfully (n = 313). Casey-Fink Graduate Nurse Experience Survey was utilized to evaluate the experiences of the participating nurses. Statistical Package for the Social Sciences (SPSS) version 29 software used to analyze the collected data by performing descriptive analysis using means and standard deviations. Inferential analysis (analysis of variance [ANOVA]) was conducted to assess the variance between the groups so as to identify any statistical differences among the means of all the specialty groups. The findings of this study provide evidence supporting the effectiveness of the ETP in boosting the confidence, comfort, and satisfaction of novice nurses.

Experiences of New Graduate Nurses' Transition to Practice During the Covid-19 Pandemic

Amaç: Dünyayı etkileyen bir pandemi döneminde meslek yaşamına adım atmak, hemşireler için birçok farklı deneyimi beraberinde getirmektedir. Araştırmada Covid-19 pandemi sürecinde mesleğe yeni başlayan hemşirelerin deneyimlerinin belirlenmesi amaçlanmıştır. Yöntem: Tanımlayıcı ve niteliksel tipte olan araştırma, 21 hemşire ile yürütülmüştür. Veriler “Tanıtıcı Form” ve “Yarı Yapılandırılmış Soru Formu” kullanılarak toplanmıştır. Bulgular: Hemşirelerin ifadeleri doğrultusunda üç ana (olumlu, olumsuz, belirsizlik), 10 alt tema (olumlu etkiler: özgüveni arttırması, mesleğe hızlı uyumu sağlaması ve baş etmeyi kolaylaştırması, olumsuz etkiler: korku/tedirginlik, endişe, stres ve yorgunluk/tükenmişlik, belirsizlik: heyecan, merak ve şaşkınlık) belirlenmiştir. Sonuç: Pandemi döneminde mesleğe başlayan hemşirelerin bu süreçte olumsuz, olumlu ve belirsiz duygu ya da deneyimler yaşadıkları sonucuna varılmıştır.

Associations Between the COVID-19 Pandemic and New Nurses’ Transition to Practice Outcomes: A Multi-site, Longitudinal Study

The transition between nursing school and nursing practice has been well studied and recognized as a turbulent time for new nurses. Existing literature suggests that transition to practice (TTP) programs can successfully support new nurses through this challenging period. However, TTP program outcomes have not been studied related to the COVID-19 pandemic, which altered TTP experiences for many new nurses by limiting their access to clinical sites for hands-on patient care experience and shifting delivery of nursing education and TTP programs from in-person to virtual environments. The purpose of this study was to analyze the associations between TTP outcomes and the COVID-19 pandemic. This was a retrospective correlational, longitudinal study using secondary analysis of Vizient /AACN Nurse Residency Program survey data from the Casey-Fink Graduate Nurse Experience Survey and the Nurse Resident Progression Survey. Self-reported data from new nurses in Southeast Texas who participated in a standardized TTP program before the COVID-19 pandemic (2017-2019) were compared with self-reported data from nurses who participated in the TTP program during the pandemic (2020 and 2021). A total of 2,673 nurses participated in this study. When adjusting for demographic composition of the cohorts, statistically significant differences (p < .05) were identified in the advocacy, patient safety, and commitment outcomes with a decline in change scores from baseline to 12 months in the COVID-19 pandemic cohort compared to the pre-COVID-19 pandemic cohort. Our findings provide new information on the impact of the COVID-19 pandemic on new nurses' participating in a standardized TTP program. The results indicate that patient safety and commitment to staying employed in the organization and the nursing profession should be priority improvement areas for employers and TTP program staff as they work to support new nurses' TTP in a pandemic.

Role transition from education to practice and its impact on the career futures of Omani nurses

The aim of this study was to examine new Omani graduate nurses' role transition from education to practice. We also sought to describe factors that may affect the effective transition of new Omani graduates to their professional nurse role. There is a substantial literature on the process of transition from graduation to being a professional nurse in countries across the globe; however, little is known about new Omani graduate nurses' role transition from education to practice. This study had a descriptive cross-sectional design. Data were collected from nurses who at the time of the study had been working for at least 3 months but not longer than 2 years. Role transition was assessed with the Comfort and Confidence subscale of the Casey-Fink Graduate Nurse Experience Survey (Casey et al., 2004). The survey consists of a 24-items that are rated on a 4-point Likert scale. We conducted a multivariate regression analysis to assess the factors that influence nurses' role transition. These factors included participants' demographic information, employment orientation durations, preceptorship duration and length of time before employment. The total sample consisted of 405 nurses working in 13 hospitals in Oman. Most (68.89%) had worked as a nurse for less than 6 months. The average internship and orientation durations were approximately 6 months (SD = 1.58) and 2 weeks (SD = 1.79), respectively. The number of preceptors assigned to new graduate nurses ranged from none to four. The average score on the Comfort and Confidence subscale was 2.96 (SD = 0.38). Results from the regression analysis demonstrated that age (β=0.029, SE = 0.012, p=.021), waiting time before employment (β=-0.035, SE = 0.013, p=.007) and employment orientation duration (β=-0.007, SE = 0.003, p=.018) were statistically significant factors influencing role transition experience among newly joined nurses. The results suggest that appropriate intervention strategies at the national level are needed to enhance the transition of nursing school graduates to their professional role. Strategies directed toward shortening the waiting time before employment and improving the internship experience are examples of priority-level tactics that can enhance Omani nursing graduates' transition to their professional role.

New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic

The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as they transition into their registered nurse roles. However, this subset of nurses has yet to be explored in the context of the Covid-19 pandemic. To explore the experiences of new graduate nurses entering the profession in Ontario, Canada, during the Covid-19 pandemic approximately one year after entering the profession. Thorne's interpretive description method was utilized. All participants identified as completing second entry nursing programs, offering a unique perspective on new graduate nurse transition. Four themes emerged in the data: 'Virtual Didn't Cut It,' 'Go Where You Know,' 'Picking Up the Pieces,' and 'Learning When to Say No and Let Go.' Participants felt ill prepared to enter the profession and were cognizant of the various challenges facing the nursing profession, and how these pre-existing challenges were exacerbated by the pandemic. They acknowledged the need to protect themselves against burnout and poor mental health, and as such, made calculated early career decisions - demonstrating strong socio-political knowing. Half of the participants had already left their first nursing job; citing unmet orientation, mental health, and wellbeing needs. However, all participants were steadfast in remaining in the nursing profession. Second entry new graduate nurses remain a unique subset of nurses that require more scholarly attention as their transition experiences may differ from the traditional trajectory of new graduate nurses.

‘Happy, excited, terrified’ feelings from the floor: a phenomenological inquiry into the lived experiences of nurses who transition from student to registered nurse

Background: There has been a recent focus in the literature on newly graduated nurses and the reasons why many are leaving the profession in the first year of practice. Some have reported physical, emotional and social upheaval, with a number deciding not to continue. Aim: This research aims to explore the lived experiences of graduate nurses during the first six months of their new role within a person-centred graduate programme, and to enable graduate nurses to explore and learn from those experiences by participating as co-researchers in the programme. Methods: This study is underpinned by person-centred and participative research methods. Graduate nurses became co-researchers and participated in the collection and analysis of data relating to their own and their colleagues’ experiences, using a hermeneutic phenomenological approach. Results: Healthful and empowering relationships in the workplace provided a psychologically safe space for graduate nurses to grow into their role Providing paid protected time supported the transition from novice to confident staff nurse Being co-researchers provided the graduate nurses with awareness of the need to evaluate their practice and to use evidence to inform practice Conclusion: This study suggests newly qualified nurses need more than skills training to progress in their new registered nurse role. Protected time, empathetic colleagues and a person-centred culture enabled the nurses to socialise into their new roles. Nurturing graduate nurses, providing time and a psychologically safe space, has the potential to benefit the individual and also the organisation in attracting and retaining staff. Implications for practice: Nurturing graduate nurses can play an important role in supporting the sustainability of the nursing workforce and enhancing person-centred care Structured facilitative and person-centred graduate programmes that integrate theory, clinical skills and psychological awareness are important in enabling graduate nurses to gain confidence personally and professionally Further research and creative and participative programmes are needed to support graduate nurses to remain in the profession

A Descriptive Phenomenological Study on Professional Role Transition of New Graduate Nurses in Selected Hospital, Bangalore

Background: Nursing is the largest, the most diverse, and one of the most respected among the health care professions. Nurses play an integral role in the healthcare system and they have been correctly referred to as the heart of healthcare. The climate and culture have perhaps the largest impact on a new graduate nurse’s transition into the workforce. New graduates often have a difficult time distinguishing between prioritizing patients and prioritizing care. Objective: The objective of this research was to describe the experiences of new graduate nurses during their professional role transition in their first twelve to eighteen months of experience in critical care areas. Methods: A Descriptive phenomenological approach was selected for the study. Based on the Descriptive phenomenological approach four step was used: bracketing, intuiting, analysis and describing. The investigators identified and clarified their interest in the study and maintained initial reflective note and memoing. Results: The initial stage, (1-3 months) of professional roles transition of new graduate nurses was marked by a high level of stress, fear and disappointment with the disparity between what is anticipated and what is expected from them. Through their professional journey during next 4-5 months, they found themselves moderately stressful, confident and being trusted by their seniors. By the end of 12 months all the graduates have gained confidence and higher level of decision-making abilities and wanted to empower themselves through higher education. Interpretation and Conclusion: The findings of the study shown that life experiences of newly graduate nurses gradually change as they transit from novice to skilled nurse. Keywords: Transition, Professional role transition, and new graduate nurse.

Transition to Practice: The Use of Virtual Clinical Replacement During the COVID-19 Pandemic and Its Impact on New Graduate Nurse Readiness

This study investigated graduate nurse readiness for practice after receiving virtual clinical replacement experiences during the COVID-19 pandemic. The pandemic led to the closure of clinical sites for many undergraduate nursing students. Nurse educators replaced the hospital setting with virtual clinical replacement experiences, potentially affecting readiness for practice in graduate nurses. The Casey-Fink Graduate Nurse Experience Survey was used to collect data in the areas of demographics, comfort level with skills, work environment stress, job satisfaction, role transition, and the impact of the virtual clinical experience on transition to practice. Descriptive statistics and independent t-tests were used for analysis. The virtual clinical replacement experience was statistically significant with greater confidence in providing for patient safety, stronger professional communication/leadership skills, and recognized support in the workplace. The use of virtual clinical replacement experiences had a positive impact on new graduate nurses' transition to practice.

Exploration of the graduate nursing program in a forensic mental health setting: A qualitative enquiry

BackgroundForensic mental health nursing is a specialised practice area. Graduate programs are essential for recruitment and retention. There have, however, been very few studies exploring forensic mental health graduate programs. AimThe aim of this study was to explore the experience of graduate nurses who completed a 2-year graduate program in a forensic mental health service in the state of Victoria Australia, and the nurses who support the graduates in the program. MethodsAn exploratory study was conducted gathering data via one-to-one interviews, with purposive sample of 20 forensic mental health nurses. FindingsAnalysis resulted in the interpretation of two themes; essential ingredients and ‘hitting hurdles’. DiscussionGraduate nurses commence with limited knowledge, experience challenges, and organisational pressures. ConclusionTransition to practice was enhanced with consistent support, university education, and program structure.

A case study of new nurses’ transition from university to work

AimTo explore the experiences of new graduate nurses enrolled in a hospital-based transition to practice program, to gain insight into what new graduate nurses thought about their university training and preparedness for practice. BackgroundNursing transition programs are challenging but are fundamentally about ensuring new graduate nurses are provided the necessary opportunities to allow them to successfully transition into autonomous practice. Understanding the ‘lived’ experiences of new graduate nurses may improve transition programs by considering the difficulties new graduate nurses experience around the rigors and reality of practice. MethodThe researchers used a self-developed Graduate Nurse Workplace Preparation Survey to explore the perceptions of new graduate nurses undertaking a Transition to Professional Practice Program in an Australian metropolitan hospital to investigate the experiences of transition readiness in relation to new graduate nurses’ satisfaction with their undergraduate degree preparation. ResultsA total of 69 new graduate nurses were enrolled in the Transition to Practice Program and 23% (n = 16) completed the New Graduate Nurse Workplace Preparation Survey. Survey responses were analyzed using descriptive statistics and Leximancer was used for thematic analysis of participant comments. The study found that a successful transition from undergraduate nurse to new graduate nurse can be made if undergraduate nurses experience variation during their university clinical placements in terms of patient acuity, complexity, workload, and clinical setting. Successful transition from undergraduate nurse to new graduate nurse is enhanced by Transition to Practice Programs building upon the new graduate nurses’ previous undergraduate nursing clinical experiences. ConclusionTransition to practice and readiness for the role of newly Registered Nurse (new graduate nurse) is an important stage in the professional development of a Registered Nurse and the transition issues related to university preparation made by new graduate nurses in this study corresponded with issues raised in similar preparation and transition literature suggesting that continued work in undergraduate training and clinical placement is required. However, by understanding new graduate nurses’ university preparation satisfaction levels and issues faced during the transition to practice period both universities and clinical placement staff can work together to improve new graduate nurses’ success in Transition to Professional Practice Programs.

A review: Developing an ecological model approach to co-worker incivility experiences of new graduate nurses.

To explore how an ecological approach be used to explore relationships among workplace empowerment, authentic leadership, trust in management, areas of work life and co-worker incivility experiences of new graduate nurses. Key concepts related to new graduate nurses' incivility experience informed the research question building on the findings of our first author's integrative review. Second, relevant theories and concepts were identified by conducting a literature review. Third, the themes build on prior theories and factors to propose a hypothetical model. (2016-2019) CINAHL, OVID, PSYCINFO, PUBMED, EBSCO, ERIC, SCOPUS, Cochrane Library; PROQUEST and Google Scholar. (a) Constructs identified in an IR (Blackstock et al., 2018) guided a literature review on predictive variables linked to new graduate nurse's co-worker incivility experiences; (b) an ecological approach was explored; and (c) we demonstrate how multidimensional organizational factors related to incivility experiences of new graduate nurses can be situated in an ecological model. Structural and organizational factors, and nurse leaders influencing new graduate nurses' experiences are situated in an ecological model. Placing new graduate nurses' co-worker incivility experiences in the microsystem and close to the mesosystem (nurse supervisor) and exosystem (workplace empowerment) of our ecological model provides new insights into their incivility experiences and informs future research. The ecological approach and operational definition of incivility help to clarify incivility behaviours as not merely individual behaviours observed by others needing corrective cognitive behaviours, nor support in a graduate transition program, but rather a symptom of work environment factors contributing to multidimensional work environments of new graduate nurses' and influence incivility behaviours. New graduate nurse co-worker incivility research could measure change across time and across system domains informed by this ecological approach and can shape new ways of thinking about how to prevent and mitigate incivility.